Brief Answer:
Some more information needed, some advices given

Detailed Answer:
Hi,

Thank you for asking at "Ask a Doctor" service.

Itchiness can be caused from several conditions from allergic reactions, eczema, dry skin or infections and rarely from liver conditions. Having some more information will help us better assist you. Kindly asked to let me know of the following:
- do you have any rash or any peeling of the skin ?
- do you have any yellowing of the eyes or skin or dark color of urine?
- do you have fever?
- is the itchiness symmetrical or more to one side?
- any one else you are in contact with has skin rash or itchiness?
- do you have any problems with your liver or hepatitis?

The information above will help in better understanding the cause of your itchiness but meanwhile there are a few things you can do to help with it:
- take loratadine 10 mg at night (if you do not need to drive you can have one now and one at night)
- use some simple moisturising cream with perolium 2 times a day on the area to keep the skin hydrated
- avoid chemicals locally or other cream as sometimes local reaction might make itchiness worse
- meanwhile watch if certain food or situations make you worse


Please let me know of the above information. Waiting to hear from you soon.

Kind regards,

Dr. Antoneta Zotaj, General & Family Physician

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Brief Answer:
Some more information needed, some advices given

Detailed Answer:
Hi,

Thank you for asking at "Ask a Doctor" service.

Itchiness can be caused from several conditions from allergic reactions, eczema, dry skin or infections and rarely from liver conditions. Having some more information will help us better assist you. Kindly asked to let me know of the following:
- do you have any rash or any peeling of the skin ?
- do you have any yellowing of the eyes or skin or dark color of urine?
- do you have fever?
- is the itchiness symmetrical or more to one side?
- any one else you are in contact with has skin rash or itchiness?
- do you have any problems with your liver or hepatitis?

The information above will help in better understanding the cause of your itchiness but meanwhile there are a few things you can do to help with it:
- take loratadine 10 mg at night (if you do not need to drive you can have one now and one at night)
- use some simple moisturising cream with perolium 2 times a day on the area to keep the skin hydrated
- avoid chemicals locally or other cream as sometimes local reaction might make itchiness worse
- meanwhile watch if certain food or situations make you worse


Please let me know of the above information. Waiting to hear from you soon.

Kind regards,

Dr. Antoneta Zotaj, General & Family Physician

---

Brief Answer:
Possible causes explained and some advises given

Detailed Answer:
Hello,

Thank you for the information provided.

I am not worried about liver problems at the moment, generally liver problems cause itchiness without a skin rash and the urine is dark but the skin is yellow and the eyes get yellow as well, so dark urine without yellow skin or eyes is very likely due to you not drinking enough water than due to liver problems.

The skin rash is very likely due to allergy/eczema (the most common and most likely) or infection. Having a picture uploaded might be very helpful.
Infections most of the cases are viral and self limiting (no treatment is needed) other than if they are fungal or bacterial.

Fungal infection is not expected to be so acute, it takes a while to cause the symptoms, still you can use some local antifungal cream like miconazole or clotrimazole cream together with the betamethasone mentioned below.

If you have fever or pain in the area or the redness is spreading too fast you need to let me know as this increases the risk for bacterial infection and in this case antibiotics are needed.

In cases of allergy/eczema some local betamethasone cream (thin layers before the antifungal cream) twice a day on the red itchy area might be helpful to reduce inflammation and help with itchiness and reduce redness.

So to conclude:
- use a combination of the antifungal and betamethasone twice a day for 7-10 days
- oral loratadine 10 mg at night might help with the itchiness
- use cotton wear to help absorb sweat and reduce local irritation
- make sure you avoid strong soap or other cleaning materials or deodorants in the area to avoid any skin drying or reaction.
- if the redness and the itchiness is not better in 3-4 days with the betamethasone/antifungal treatment or you get any worse then you will need to see a doctor to carefully examine you.
- pain in the area, fever, general feeling of being unwell or quick spread of the rash might increase the risk of this being a bacterial infection (especially if local trauma in the area) and a doctor should be seen soon in this case.

I hope this answers to your query, let me know if I can assist further.

Regards,

Dr. Antoneta Zotaj

---

Brief Answer:
Possible causes explained and some advises given

Detailed Answer:
Hello,

Thank you for the information provided.

I am not worried about liver problems at the moment, generally liver problems cause itchiness without a skin rash and the urine is dark but the skin is yellow and the eyes get yellow as well, so dark urine without yellow skin or eyes is very likely due to you not drinking enough water than due to liver problems.

The skin rash is very likely due to allergy/eczema (the most common and most likely) or infection. Having a picture uploaded might be very helpful.
Infections most of the cases are viral and self limiting (no treatment is needed) other than if they are fungal or bacterial.

Fungal infection is not expected to be so acute, it takes a while to cause the symptoms, still you can use some local antifungal cream like miconazole or clotrimazole cream together with the betamethasone mentioned below.

If you have fever or pain in the area or the redness is spreading too fast you need to let me know as this increases the risk for bacterial infection and in this case antibiotics are needed.

In cases of allergy/eczema some local betamethasone cream (thin layers before the antifungal cream) twice a day on the red itchy area might be helpful to reduce inflammation and help with itchiness and reduce redness.

So to conclude:
- use a combination of the antifungal and betamethasone twice a day for 7-10 days
- oral loratadine 10 mg at night might help with the itchiness
- use cotton wear to help absorb sweat and reduce local irritation
- make sure you avoid strong soap or other cleaning materials or deodorants in the area to avoid any skin drying or reaction.
- if the redness and the itchiness is not better in 3-4 days with the betamethasone/antifungal treatment or you get any worse then you will need to see a doctor to carefully examine you.
- pain in the area, fever, general feeling of being unwell or quick spread of the rash might increase the risk of this being a bacterial infection (especially if local trauma in the area) and a doctor should be seen soon in this case.

I hope this answers to your query, let me know if I can assist further.

Regards,

Dr. Antoneta Zotaj

---

Brief Answer:
Blood tests are normal; kindly asked for some more information on the numbness

Detailed Answer:
Hello,

Great to know that the itchiness is getting better.

Thank you for the uploaded reports. I carefully checked them and here is my conclusion:
- all the indexes checked in your blood count and your ERS are normal. There is no abnormality so there is nothing to worry.

As for the numbness, it seems you are having it recently and it is important to follow it on time. It is important to know where exactly on the hands is the numbness, which fingers, palmar or dorsal side of the fingers and hand, does the arm get involved and if so the inner sides or outer ones?

How long does the numbness last and do you get it every time you hold something?

Do you have other neurological signs (numbness or weakness) localized on your feet, face, trunk, etc?

Any problem with vision, balance or speech?

Do you have any other complaint?

Do you use alcohol or have chronic problems with your bowel?

Please let me know of the above information so I can better assist you. Waiting to hear from you.

Regards,

Dr. Antoneta Zotaj

---

Brief Answer:
Blood tests are normal; kindly asked for some more information on the numbness

Detailed Answer:
Hello,

Great to know that the itchiness is getting better.

Thank you for the uploaded reports. I carefully checked them and here is my conclusion:
- all the indexes checked in your blood count and your ERS are normal. There is no abnormality so there is nothing to worry.

As for the numbness, it seems you are having it recently and it is important to follow it on time. It is important to know where exactly on the hands is the numbness, which fingers, palmar or dorsal side of the fingers and hand, does the arm get involved and if so the inner sides or outer ones?

How long does the numbness last and do you get it every time you hold something?

Do you have other neurological signs (numbness or weakness) localized on your feet, face, trunk, etc?

Any problem with vision, balance or speech?

Do you have any other complaint?

Do you use alcohol or have chronic problems with your bowel?

Please let me know of the above information so I can better assist you. Waiting to hear from you.

Regards,

Dr. Antoneta Zotaj

---

Brief Answer:
Numbness as you explain is normal, further explanation for the rest of the symptoms

Detailed Answer:
Hello,

Thank you for the extra information provided.

It seems you get numbness when you get pressure on the areas, like pressure on the arm or legs with certain position or actions and the numbness goes within a few minutes- all these sound normal and there is nothing to worry.
As for the neurological issues they need to be confirmed with a neurological examination, for example the patient may feel week but if the neurological examination is normal it is not due to muscle or nerve... etc so it is important for you to have a visit and confirm the findings and also the cause.

Sometimes when symptoms are so spread, bowel, hair, neurological symptoms, anxiety might be the reason for them all especially if examinations and tests come out normal.

To conclude:
- you will need to confirm with a consultation with your doctor if you have abnormal findings in the examination (neurological examination) or other tests that the doctor might order.
- if all the examinations come out normal, anxiety might be a cause of them all and might be considered with your doctor and treatment for it can be tried.

I hope this answers your query. Let me know if I can assist you further.

Regards,

Dr. Antoneta Zotaj,
General and Family Physician

---

Brief Answer:
Numbness as you explain is normal, further explanation for the rest of the symptoms

Detailed Answer:
Hello,

Thank you for the extra information provided.

It seems you get numbness when you get pressure on the areas, like pressure on the arm or legs with certain position or actions and the numbness goes within a few minutes- all these sound normal and there is nothing to worry.
As for the neurological issues they need to be confirmed with a neurological examination, for example the patient may feel week but if the neurological examination is normal it is not due to muscle or nerve... etc so it is important for you to have a visit and confirm the findings and also the cause.

Sometimes when symptoms are so spread, bowel, hair, neurological symptoms, anxiety might be the reason for them all especially if examinations and tests come out normal.

To conclude:
- you will need to confirm with a consultation with your doctor if you have abnormal findings in the examination (neurological examination) or other tests that the doctor might order.
- if all the examinations come out normal, anxiety might be a cause of them all and might be considered with your doctor and treatment for it can be tried.

I hope this answers your query. Let me know if I can assist you further.

Regards,

Dr. Antoneta Zotaj,
General and Family Physician

---