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Skin Care and Diseases

Skin rash/itch, which leaves scars

03/17/2003

Question:

I am a 56 year old male. i recently began to develop-(last few months), severe itching just above the ankles, later on the legs, later on the arms. Numerous red spots appeared and later left scars. It seems to come and go. Hydrocortisone does seem to help, but my physician shrugs it off as "dry skin". i`m not buying that. There`s more to this. i have never had it before. The itching is very severe, and even wakes me up at night. Believe me, that`s hard to do. Can you offer any suggestions?

Answer:

Your description might fit low-grade folliculitis and your dry skin since they are often combined. Treatment usually includes control of the low-grade bacterial infection along with use of non-irritating soaps to cleanse such as Dove, Cetaphil, Purpose, Lever 2000. There are even some preparations that are waterless cleaners that are even less irritating than these mentioned. Above all I would suggest that you not use real soap to cleanse the area since that can be very irritating to already irritated skin. If in fact the presumed diagnosis is correct, I would suggest that you cleanse your legs twice a day with a non-irritating cleanser of your choice which should be blotted dry and then I would apply hydrocortisone and polysporin ointment sparingly. Combine the two ointments in your hand using approximately half an inch of each medication. Once you have mixed them in your hands then gently apply it to your lower extremities. Do that at least twice a day. This regimen should probably continue for several weeks and then the hydrocortisone antibiotic should be substituted by a moisturizing cream of your choice. There are a number on the market and your pharmacist can lead you to those that are economically appropriate and will help seal in the moisture on your legs. You may use something as simple as Vaseline. Bear in mind that the skin should be moist before you apply the moisturizing cream or ointment. You may do that by simply wiping your extremity with a moist cloth and/or after showering. For severe itching you can get temporary relief by using Neutrogena soothing lotion which does contain 2% Lidocaine. This can be very helpful when the itching is very severe. In any event, if you have continued discomfort I would urge you to see your board certified dermatologist so that there can be a careful analysis made to be sure that there is not a major infection, dermatophyte infection, or other medical problem.

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Response by:

Charles L Heaton, MD
Professor
College of Medicine
University of Cincinnati