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Fri, Jul 25, 2014

Dr. Kestner: This lady had a itchy problem

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Some time ago a patient (I’ll call her Susan) came to see me with an unusual problem.

Most patients are referred to me because of chronic pain, spine or joint problems. Some are referred for problems that are not responding well to conventional treatment such as irritable bowel syndrome, fibromyalgia, chronic sinusitis or other problems.

Susan had an itchy problem. She frequently had tiny red bumps appear in large areas of her body that drove her crazy with itching. She had learned not to scratch because this would break the inflamed skin.

Susan had tried over-the-counter and prescription medications, lotions and creams. She had tried various remedies recommended by friends.

Although Susan found temporary relief from some of the proposed solutions, nothing had brought lasting relief. Now she was ready to try acupuncture.

Susan told me she was reluctant to try acupuncture because she was afraid of needles. I assured her that she would be comfortable and showed her how tiny the needles are but she remained unconvinced. She just knew she was desperate and was willing to try anything.

Itching can be caused by an extraordinarily wide range of underlying conditions.

In some cases, an allergic reaction to a drug, food, environmental chemical or other agent is the trigger.

Changes in the body’s nervous system can cause people to develop sensitivities to almost anything. Perfumes, cleaning supplies, even chemicals used in household goods manufacturing and house paint have been know to cause allergic itching.

Reactions to various drugs are often responsible.

I always ask patients if they have changed medications. Even if they haven’t had a new prescription, the manufacturer of the drugs may have altered the chemical makeup of the compound that resulted in a reaction. Even something as simple as a change in the coloring agent, the filler or binder can cause problems for susceptible individuals. Another common concern is the unpredictable interactions between drugs once in the human body.

In many cases urticaria (hives) will appear and disappear within hours. In most cases they will disappear in a day or two. In some very frustrating situations the condition can be extremely persistent and may recur over years.

Itching can be a sign of possibly serious medical conditions so a medical diagnosis of persistent itching is essential prior to beginning any treatment.

Various medications have been tried. Since the inflammatory process that causes itching usually involves the release of histamine, allergy medications called anti-histamines are often used.

Other medications are selected because they inhibit certain immune responses. For example, oral steroids and steroid creams such as hydrocortisone inhibit the immune response. This can result in a reduced inflammation response that leads to itching.

As anyone that has ever had an itch knows, scratching can be a quick way to bring relief in many cases. However, due to the damaging effects of scratching on the inflamed skin, patients are often advised not to scratch persistent itching conditions.

Scratching stimulates nerve endings in the body that transmit pain impulses, as well as touch and pressure. Exactly how that relieves itching is not completely clear, but it is theorized that the aggressive stimulation of these sensory nerves actually blocks the itch sensation in the brain.

So, how does acupuncture work to help itchy conditions?

In a way, it works sort of like scratching. Acupuncture stimulates several different types of nerve fibers in the peripheral nervous system. This in turn transmits signals to the central nervous system that actually have been shown to activate various parts of the brain in ways to relieve symptoms such as pain and itching. Interestingly, the benefits can be long lasting or possibly permanent.

So, how did Susan respond to acupuncture?

In spite of her reservations, she discovered that the treatments are quite comfortable and the needles are so fine that there is virtually no pain.

Initially, her symptoms showed only slight improvement. Within a few weeks, however, she was seeing very good results. Her progress continued until her skin had returned to its normal healthy condition and she was itch-free.

Next week a story about a nearby facility that combines high-quality care with old-fashioned caring.

Dr. Mark Kestner
www.DrKestner.com
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