I have itching on my upper back. Is it due to dry skin?

Question

Hello doctor,

I have upper back itching, and I have consulted many doctors, and they told me that it is dry skin and advised a moisturizing cream, Lozivate MF, and tablet Moyzee.

Please help me.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Thank you for your detailed history and blood report. Your serum IgE (immunoglobulin E) levels are normal, meaning it is not because of atopic dermatitis. I will guide you through the most likely causes and the correct treatment steps.

Since your itching is long-term, mainly on the upper back, and has not improved with moisturizers or steroid creams, there are two common possibilities:

Notalgia paresthetica, a very common nerve-related condition caused by irritation of the sensory nerves of the upper back. Its typical features are a localised itching between the shoulder blades, no visible rash, or only mild discoloration.

It does not show much improvement with moisturizers or steroids. Often associated with neck muscle strain or posture issues.

Chronic xerotic or eczematous dermatitis is caused by dry skin, but usually improves with consistent moisturization, which, in your case, did not help fully, making this less likely.

Continue moisturizing, but add a nerve-based treatment. Since nerve-related itching is likely:

Capsaicin 0.025 % cream, applied twice daily for two to four weeks (burning sensation in the first few days is normal) or Gabapentin 100 mg at night (if itching is severe; only under doctor supervision).
Improve your back muscle and nerve health by shoulder blade stretching, posture correction, and applying a warm compress on the upper back for 10 minutes.

Gentle massage of paraspinal muscles (you can find a video on the internet). These help relieve pressure on the spinal nerves. If dry skin is contributing, use:

Moyzee twice daily.
Avoid hot showers.
Use gentle soaps.

Avoid using Lozivate cream for too long, as it may cause thinning of the skin. If possible, please send me a picture of your back so that I can see if there is scaling, any visible signs of dermatitis, and can prescribe you any additional medicine if possible.

I hope this helps.

Thank you.