Neuropathic Itch: What You Should Know

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Neuropathic itch is a mysterious and frustrating condition that affects the nervous system and leads to chronic itching. Unlike regular itchiness caused by external irritants, neuropathic itch arises from nerve inflammation or damage. It is often described as a persistent, unrelenting itch that is difficult to satisfy, leading to scratching that provides little relief. The sensation can vary from a tingling or crawling feeling to a burning or stabbing sensation. Many of our patients describe an “under the skin” or “deep-seated” itch. 

Understanding neuropathic itch is crucial for identifying and managing this challenging condition that significantly impacts the quality of life for those affected.

HMGS Dermatology has experience in the diagnosis and treatment of various conditions that result in neuropathic itch. These include notalgia paresthetica, brachioradial pruritus, scalp dysesthesia, post-herpetic pruritus, trigeminal trophic syndrome, and anogenital pruritus.

Neuropathic Itch Treatment

Topical Medications

At HMGS Dermatology, topical medications are commonly first prescribed to treat neuropathic itch. These medications applied directly to the affected area, can provide localized relief by targeting the underlying nerve dysfunction. Various topical options, such as corticosteroids, local anesthetics, or numbing agents, may be recommended based on individual needs and the severity of symptoms.

Consultation with a dermatologist at HMGS Dermatology can help determine the most appropriate topical medication for effectively managing your neuropathic itch.


These medications work by blocking the action of histamine, a chemical involved in the body’s inflammatory response. By reducing histamine levels, antihistamines can help alleviate itching sensations. While they may not eliminate neuropathic itch, they can provide some relief and improve overall comfort. It is important to consult with a healthcare professional to determine the appropriate antihistamine and dosage for your specific condition and address any potential side effects.

Capsaicin Cream

Topical capsaicin cream has also been shown to be effective when treating and managing neuropathic itch. The cream is made of capsaicin, a substance found in chili peppers. It works by depleting substance P and thus decreases the activity of the nerves on the skin that are most associated with nerve inflammation. This reduces pain and the intense itchiness that comes with this condition.


Gabapentin, even at low doses, is often used by HMGS Dermatology providers to treat neuropathic pruritus when standard therapy is ineffective. This drug has been used safely for years to treat pain after shingles (postherpetic neuralgia).

Neuropathic Itch Symptoms

Persistent Itching

Neuropathic itch is characterized by a persistent itch. It can be relentless and difficult to relieve. Unlike transient itches, this type of itchiness persists for long periods and may not respond to traditional anti-itch remedies. The incessant need to scratch can be distressing and affect daily activities, causing significant discomfort. Managing and finding relief for this chronic itch remains challenging for individuals experiencing neuropathic itch.

Tingling or Crawling Sensation

This peculiar feeling is described as a constant, “under the skin”, prickling sensation that triggers an intense urge to scratch. It may be accompanied by a sense of something moving or crawling beneath the skin, creating a distressing and uncomfortable experience for individuals affected by the condition

Hypersensitivity to Touch

People experiencing this symptom may find that even gentle contact or light pressure on the affected area can trigger intense itching sensations. This heightened sensitivity to touch can further exacerbate the discomfort and frustration associated with neuropathic itch, making it challenging to find relief. It can significantly impact your daily activities and quality of life.

Schedule Your Consultation

Understanding neuropathic itch is crucial for those affected by this persistent and debilitating condition. If you or someone you know is experiencing symptoms of neuropathic itch,  we encourage you to take action and schedule a consultation at HMGS Dermatology. Call one of our New Jersey offices today and find the relief you’ve been looking for.