Why is my itching worse at night on my back and arms?

Hello,

Welcome to icliniq.com.

Thank you for sharing your concerns. Here is a breakdown:

Main symptoms include itching mostly at night (arms, back, chest, stomach, even scalp), and dark spots are scattered on the chest and stomach (not a typical rash). Treated with steroid cream and Benadryl (Diphenhydramine) for what was diagnosed as eczema. No laboratory tests have been performed so far.

Here is the list of possible causes to consider:

1. Eczema (atopic dermatitis): Often causes itching, sometimes worse at night. But usually involves red, inflamed patches, not just dark spots.

2. Post-inflammatory hyperpigmentation: The dark spots may be due to scratching or previous inflammation (like eczema, even if healed).

3. Scabies: Itching is worse at night, and can involve the whole body (including the scalp in older adults). It may not always have an obvious rash and is highly contagious.

4. Liver or kidney issues: Can cause generalized itching, especially in older adults.

5. Medication side effects or allergies: Some medications can cause itching.

Here is what you can do next:

Laboratory tests to consider:

1. CBC (complete blood count) to check for infections or other causes.

2. Liver function tests (LFTs) to see if liver issues might be causing itching.

3. Kidney function tests (creatinine, eGFR (estimated glomerular filtration rate)) to check for kidney disease.

4. Fasting blood sugar to rule out diabetes (which can cause itching).

Reconsider scabies if itching is mostly at night, involves the scalp, and if others in the house also have itching. Treatment requires a scabicide (like Permethrin cream), not just steroids.

For relief, it is important to keep the skin well moisturized using fragrance-free moisturizers. Avoid hot showers and opt for lukewarm water instead. Use a gentle, non-soap cleanser to reduce irritation, and wear loose cotton clothing to help keep the skin comfortable.

I hope this helps.

Thank you and take care.

Regards.