Why does my recurring itchy back rash not heal?

Question

Hello doctor,

I have been dealing with a rash on and off for months, mainly along the midline of my lower back. Occasionally, I also notice smaller patches on other parts of my torso, including under my right nipple and sometimes on the sides or front. The rash does not appear on my face, neck, or extremities.

The rash is mostly itchy, but at times, I feel a brief, sharp, episodic pain in the area. There are no pustules, crusting, fever, fatigue, or other symptoms. Otherwise, I feel healthy.

I have tried several treatments, including a Medrol Dose Pack, Claritin, Benadryl (oral and topical), Hydrocortisone 1 % cream, Calamine lotion, and Triamcinolone acetonide. The oral steroids helped temporarily, but the rash returned. An urgent care clinician suspected contact dermatitis, though he was not certain, and prescribed a two-week Prednisone taper starting at 30 mg.

I have switched to fragrance-free laundry detergent and rinse my clothes twice, but the rash still recurs. I am not aware of any allergies and have not changed my routine. I have been under significant work and family stress, which seems to make the situation more frustrating.

I take Norvasc 10 mg for hypertension and occasional Ambien for sleep. My comprehensive blood tests in August, including CBC, metabolic panel, liver function, thyroid tests, ESR, CRP, and cholesterol, were all normal. I have never experienced this type of rash before.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I went through your query and understood your concern.

It seems like you are suffering from eczema (a skin condition where your skin becomes extra sensitive and easily irritated). I understand how frustrating and stressful these recurring rashes must feel, especially when they improve for a while and then return. Based on your symptoms, I would suggest a few gentle but consistent skin care measures.

First, please keep your skin very well moisturized. Apply a good, fragrance-free moisturizer several times a day, especially over the affected areas on your back and trunk. Keeping the skin barrier strong can significantly reduce flare-ups.

While bathing, use a very mild, soap-free or gentle cleanser. Avoid using a loofah or body scrub, as friction can irritate the skin further. Also, make sure to use lukewarm water instead of hot water, since hot showers can dry out and inflame the skin.

For the active rash, a slightly stronger topical steroid applied twice daily for a short, supervised duration may help settle the inflammation more effectively.

You may also consider taking Levocetirizine 5 mg once daily at night to help control itching and reduce the allergic component. Kindly consult a specialist, talk with them, and take the medications with their consent.

I hope this has helped you.

Thanks and regards.

Answer 2

Hello,

Welcome back to icliniq.com.

Eczema can occur at any age. Eczema becomes more prominent in winter with increasing age and skin dryness. The tablet Prednisone (corticosteroid) will definitely help in treating eczema or irritant contact dermatitis.

Usually, the treatment is the same for eczema and contact dermatitis. However, I suggest moisturizing your body well with a good moisturizer.

I hope this has helped you.

Kindly revert so I can assist you further.

Thank you.