Itchy back: causes, symptoms & treatment of itchy back

An itchy back is an annoying complaint. The medical term for itching is pruritus. Infections, insect bites and stings, chronic diseases, atopic eczema, heat rash, psoriasis, allergic reactions, sun exposure and dry skin are among the numerous and most common causes of itching on the back. Anti-itch creams and lotions containing camphor, menthol, phenol, pramoxine, diphenhydramine or benzocaine can provide relief from the symptoms. Some cases of itching on the back respond to corticosteroids. It is important to avoid scratching an itchy back, as this can worsen the symptoms and cause wounds that can lead to bacterial infections. If itching on the back persists, worsens or is associated with visible skin abnormalities, it is advisable to consult your doctor.

  • What is itching?
  • Symptoms of an itchy back
  • Causes of an itchy back
  • Poor hygiene
  • Allergic reaction
  • Hives, hives or urticaria
  • Chemicals
  • Clothing
  • Dry skin
  • Eczema
  • Heat rash
  • Acne on the back
  • Infections and infestations
  • Notalgia paresthetica
  • Other causes of itching on the back
  • Examination and diagnosis
  • Specialists who treat itching
  • Treatment of an itchy back

 Itching / Source: JPC-PROD/Shutterstock.com

What is itching?

Itching is sometimes described as a sensation in the skin that causes the urge to scratch, rub or tap. Itching can sometimes be worse than pain. Itching is a sensation that everyone experiences from time to time, and itching can be local (confined to one part of the body) or generalized (over the whole body or in different areas). Depending on the underlying cause, itching may be worse at night. The medical term for itching is pruritus.Generalized itching that occurs anywhere in the body is often more difficult to treat than localized itching. Itching can occur with or without skin abnormalities or rashes (bumps, spots, blisters, sores, redness or other abnormalities visible on the skin). An itch that is accompanied by a visible skin abnormality should be assessed by your doctor and, in some cases, even by a dermatologist.

Symptoms of an itchy back

Depending on the underlying cause, itching may be accompanied by other symptoms and complaints. This usually involves a rash, blisters, bumps or redness of the affected area. Dry skin is a common cause of itching. An itchy back can lead to excoriations or scratching effects. Generalized itching all over the body (including the back) may indicate a chronic condition such as liver disease. Itching complaints due to liver disease is not a rare phenomenon. In these situations, there may be no changes in the appearance of the skin.

Causes of an itchy back

The most common causes of an itchy back are:

Poor hygiene

A back that has not been properly washed can be very itchy, especially if you continue to walk for a few hours in sportswear after an intensive workout.

Allergic reaction

An allergic reaction can cause an itchy back. The result of the skin allergy is a red, itchy rash that may consist of small blisters or bumps. The rash occurs when the skin comes into contact with the allergen, a substance that causes allergic reactions in people who are sensitive to it. Often there is a time delay between exposure to the allergen and when the rash occurs. Allergic reactions can be caused by skin contact with substances in clothing, pets, chemicals, soaps or cosmetics. Food allergies can also cause the skin to itch.Itchy back due to hives / Source: DLdoubleE, Wikimedia Commons (Public domain)

Hives, hives or urticaria

Urticaria is the medical term for hives or hives. Hives may or may not indicate an allergic reaction. Two types of hives are distinguished. Acute hives usually occur after coming into contact with an allergic trigger, such as a certain food or drug. The non-allergic form is induced by physical stimuli, such as contact with heat, cold, sunlight, water, vibrations on the skin or prolonged pressure. About 20 percent of people will experience hives at some point in their lives.

Chemicals

Usually, the shampoos and soaps we use contain strong chemicals that can damage the skin of the back. Chemicals present in shampoo throw your hair’s natural sebum production out of balance. And with soap with a pH value that is too high, the skin barrier needs to recover for hours. Preferably use soap with a low pH.

Clothing

Many people wear synthetic fabrics and these often have a texture that is not suitable for your skin. A label or perhaps the rough texture of the clothes can be the reason for an itchy back. It can also be due to perspiration, which keeps the clothes damp for a long time and ultimately causes itching. Preferably wear clothing made of natural materials, such as cotton or linen.

Dry skin

Dry skin is one of the most common causes of itchy skin, including an itchy back. If people don’t see bright red bumps or notice a sudden change in their skin, chances are you’re suffering from dry skin. This may be accompanied by flaking. Environmental factors that can lead to dry skin include excessively hot or cold weather with low humidity and excessive washing (with soap). Dry skin can affect any age group, but as people age, their skin becomes thinner and drier. A good moisturizer can usually help repair dry skin. In addition, it is important to drink enough every day and installing a humidifier in the house is also useful.Common signs and symptoms of dry skin are:

  • rough, flaky or flaky skin
  • excessive itching
  • grayish skin in people with darker skin
  • cracks in the skin that are prone to bleeding
  • chapped or cracked skin or lips

 Atopic eczema in a child with scratch effects / Source: Eisfelder, Wikimedia Commons (CC BY-SA-3.0)

Eczema

Eczema affects 1 in 5 infants or babies, but often improves over time. Eczema is a superficial, itchy skin rash characterized by redness, swelling, flakes, bumps, cracks or crusts. Eczema often improves over time. However, people with eczema should be careful as they are more prone to skin infections.

Heat rash

Heat rash is an itchy skin rash (bumps) that occurs after exposure to (extreme) heat. This rash is caused by clogged sweat glands, which prevent sweat from escaping. It can manifest itself on the back, among other places.

Acne on the back

Acne often presents itself on the face and on the chest and shoulders. Acne is an inflammatory disease of the sebaceous glands of the skin, which leads to other symptoms such as itching, pimples and in the worst case it can even take the form of the cysts. It can also occur on the back, and often on the upper back.Scabies / Source: Cixia, Wikimedia Commons (Public domain)

Infections and infestations

There are many infections that can cause itchy skin. An itchy back due to an infection is also possible. Some of the most common infections that can cause itching are:body lice (closely related to head lice, the body lice cause red swellings where they have sucked blood, especially on the back)scabies (a contagious skin condition caused by the scabies mite ) shingles (herpes zoster, a viral infection caused by the chickenpox virus) cellulitis (a bacterial infection of the subcutaneous connective tissue)Notalgia paresthetica / Source: Maroliver, Wikimedia Commons (CC BY-SA-4.0)

Notalgia paresthetica

Notalgia paresthetica is a common form of itching in the shoulder blades, between the spine and one of the shoulder blades. It is commonly seen in people aged 40 – 80 years. The exact cause is not yet known in 2023, but it probably has to do with damage to the sensory nerves in the skin that come from the spinal cord. Keeping the skin well hydrated and not scratching can reduce the symptoms.

Other causes of itching on the back

Itching can also be related to insect bites, for example from bed bugs or mosquitoes. Itchy skin can also be due to more serious medical conditions. Nervous disorders caused by diabetes and pinched nerves can cause severe itching. Itching may occur in chronic renal insufficiency or renal failure (uremia). With uremia, the itching is usually worse at night. The itching usually occurs on the back, arms and stomach.Blood tests may sometimes be necessary / Source: Istock.com/anna1311

Examination and diagnosis

The GP will ask questions about the complaints you are experiencing and will examine your medical history. This is followed by a physical examination. If necessary, the doctor will suggest specific diagnostic tests to determine the cause of an itchy back. Some common causes such as dry skin or sunburn may be obvious without further investigation, while causes such as chronic systemic diseases or other conditions may require blood tests or imaging studies to identify them. If a skin condition is responsible for the itching, a scraping or biopsy can sometimes be taken to identify the condition.

Specialists who treat itching

Because the causes of itchy skin are so varied, many different doctors may be involved in treating an itchy back. Itching is often treated by the general practitioner, and sometimes by specialists: internal medicine (focuses on diseases of the internal organs), pediatrics or dermatology. Itching associated with allergy can be treated by an allergist or an immunologist. People with itching due to chronic diseases can be treated by the specialists who treat these conditions, such as endocrinologists, gastroenterologists, nephrologists, oncologists, hematologists, neurologists, and infectious disease specialists. Some causes of itching are treated by emergency room specialists.

Treatment of an itchy back

An itchy back can be treated in various ways: cold compresses, creams and lotions. Because cold and itch travel along the same nerve fibers, using cold compresses can “block” the circuits and reduce itching. Naturally, if there is an underlying (systemic) condition, treatment will also focus on that.

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