Itching is the most common symptom that might cause you to have to visit a dermatologist. You might be surprised to learn that Americans spend over five billion dollars each year on antihistamine pills alone to help with itching and allergy symptoms.
As you know, itching leads to scratching and if the source is not eliminated the itching and scratching can go on indefinitely.
At some point your skin responds to the friction of the chronic scratching or rubbing by becoming thickened and darkened.
You might experience this change on the scalp, in the groin area, mid back, or lower legs. What is amazing is that in certain individuals, this itching and scratching can go on and on for months or even years without subsiding. At some point you will eventually get treatment for the condition so that the itching stops and your skin can go back to normal.
Lichen Simplex Chronicus is the medical term associated with the itching, thickening, and oftentimes darkening of the skin. When the skin becomes thickened the crease lines are usually more prominent which is referred to lichenification due to a resemblance to the changes present on elephant’s skin.
So what should you do if you happen to have one of these chronically itchy spots of skin?
Here are a few examples of cases that can give you some guidance.
A significant number of men and women tend to develop lichen simplex chronicus in the groin area. One lady came in to the office at the age of 27 for an unrelated condition and happened to mention that she had experienced chronic itching of her groin area that started at the age of 13 and had persisted ever since. Her itching was oftentimes unbearable over the years, but she was reluctant to seek medical attention due to a traumatic experience earlier in life. Fortunately, it was possible to gain the trust of this individual and with treatment consisting of injections and topical and oral medication she was provided her with relief from the itching for the first time in years. Over a several month period, the thick irritated areas of skin healed and returned to normal.
Another individual came in for hair breakage covering the middle two thirds of the scalp. Upon questioning, it was learned that the scalp was very itchy and scratching was part of the normal routine. Again, this condition had been going on for several years with attempts to get relief made by using dandruff shampoos and a variety of over the counter products to no avail.
In this case, the area of the scalp that had been scratched for years was thickened and hardened compared to the areas with no itching.
The hair growing in this area was also short and broken off like stubble. In order to help this individual get relief, intralesional injections of cortisone medication into the affected areas, oral medication for itching, and topical anti-inflammatory preparations provided relief. With healing of the scalp and no itching, hair growth improves with return to normal over a 6 to 12 month period.
The other common location for this problem to occur is the lower legs. A gentleman came in for evaluation because he was bothered by itching in this area which caused him to develop dark brownish-black leather like patch of skin. Well, amazingly, he had tolerated this patch being present for 14 years before he decided to come in for treatment. When asked why it took so long for him to come in and get treatment, his answer was that he thought it would go away on its own. Four weeks after his treatment with the same regiment as mentioned for the scalp above, the itching was gone and the skin was smoothening out. His only comment was, “You mean I didn’t have to itch for all of those years?”
So, the chronic itchy spots due to lichen simplex chronicus can be long lasting and self-perpetuating once they get started. It’s not really clear what makes the process begin, but once it starts, it develops a life of its own. If you happen to find yourself with a chronic itchy spot, see your dermatologist and get relief. Don’t let it linger on and on and on.
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