A neuropathic itch is an itch that results from nervous system damage rather than issues with the skin.

Itching is a normal sensation to experience from time to time. However, when an itch results from nervous system damage, doctors call it a neuropathic itch.

A neuropathic itch can feel different than a normal itching sensation. It can occur for various reasons, including stroke. Scratching may not provide relief from this type of itch.

Below, we look at the symptoms, causes, and treatment of neuropathic itch. We also discuss the outlook for people with this condition.

A doctor and patient look at a chart together hile attempting to diagnose neuropathic itchShare on Pinterest
zoranm/Getty Images

A neuropathic itch happens when there is damage to the nervous system.

Damage to either the central or peripheral nervous system can cause a neuropathic itch, according to an older article from 2010.

While a regular itch results from some kind of issue with the skin, a neuropathic itch has a different, deeper origin.

A neuropathic itch may produce an itching sensation or a feeling of pins and needles. The itching may be very severe.

Neuropathic itch may also produce the following sensations:

  • burning
  • wetness
  • electric shocks
  • pain
  • numbness
  • crawling
  • severe cold

Some people with neuropathic itch may also experience other symptoms such as:

  • prickling and chilling of the skin
  • increase in skin sensitivity
  • decrease in skin sensitivity

In people with neuropathic itch, scratching can also make the itch worse.

There is very little understanding of the bodily mechanisms that create itching sensations.

Research suggests that lesions in the nervous system that damage itch-related neurons may cause neuropathic itch. Conditions and diseases that may cause neuropathic itch include:

Doctors may have difficulty diagnosing neuropathic itch, as they may initially assume that the problem is skin-related.

However, a dermatologist can rule out any dermatological causes of itching.

Doctors usually prescribe topical treatments to people who present with itching. They may suspect neuropathic itch when these treatments do not work.

However, it can be tough to find the exact cause. If traditional anti-itch therapies do not work, people should consult a neurologist.

Doctors may perform a skin biopsy to check for neuropathic itch.

Treating neuropathic itch is difficult because most anti-itch medications do not provide relief.

Treatments typically involve local anesthetics or physical barriers to prevent scratching, as scratching too much or too hard can cause painful lesions or other unintentional self-injury.

Other treatments and therapies may include:

Other behavioral interventions may include:

  • cutting the fingernails
  • wearing protective garments
  • applying moisturizer regularly
  • avoiding warm or hot temperatures
  • wearing loose clothing

There is no research on the associated risk factors for neuropathic itch. It is possible for two people to have the same health condition and only one of them experience neuropathic itch as a symptom.

In some people, the nervous system injury also causes loss of sensation, leading to constant scratching and eventual self-injury.

In one case, a woman who had neuropathic itch after contracting shingles scratched her head so vigorously that she scratched through her skin and skull right to her brain without experiencing pain. As a result, she had to wear a locked helmet when sleeping.

Skin changes due to constant itching can also occur. If people scratch so much that they break the skin, this can also lead to an infection.

It can be challenging for people to cope with neuropathic itch.

Although an itch may seem innocuous to many people, being unable to find relief from chronic, severe itching can significantly affect a person’s quality of life.

For instance, it can impair their ability to sleep and perform regular activities.

According to an older 2011 study, living with neuropathic itch is similar to living with any other condition that causes chronic pain.

People with this type of chronic pain may benefit from joining a support group or going to therapy sessions.

As neuropathic itch is difficult to treat, management of the condition often involves taking measures to prevent scratching.

People who end up scratching vigorously in their sleep, for example, may need to protect the skin by covering it with a helmet or bandages.

A person with an itch that feels impossible to relieve may be experiencing neuropathic itch.

They should first see a dermatologist to rule out any skin-related conditions, such as eczema or rash.

If topical anti-itch treatments do not work, a consultation with a neurologist may be necessary.

Getting help is essential to prevent complications, which commonly involve skin infection or damage.

People with neuropathic itch may find it helpful to join a support group or get therapy to cope with this form of chronic pain.