Extreme itching in elderly DF

[surreyisik]

Hello everyone,
My poor 86 year old DF has been suffering from extreme itching since a few months. It's so bad that he wakes up in the middle of the night and itches himself so much that there are wide bruises on his arms.
He has been to the GP and a few different specialists and they pretty much ran all tests that can be run - they all came out normal (he is pretty healthy for his age otherwise). None of the medication / creams worked more than a few days, it always comes back with vengeance.
Anyone had a similar problem with inexplicable itching - did anything work? I'm so desperate to help him.
Thank you!

Is he on any medication... does he self medicate with vitamins supplements or similar?
Any change in medications?

Some liver conditions can cause itching . I would definitely contact GP. They can treat itch, antihistamine, steroid cream , emollient to start with anyway.

My df had the same n his 80s. He used to say it felt like itching under, rather than on, the skin. My mum used to slather him in aqueous cream to try and help but we never did get to the bottom of it I'm afraid. Sorry - that's no help whatsoever 🤷‍♀️

He may have had something but has now entered the scratch-itch cycle. Scratching damages the skin which makes you itchy which makes you scratch which damages the skin, and round and round you go.

He needs to stop scratching, cover up any particularly sore parts with thin cotton or bamboo clothing, keep it moisturised, oat baths, use steroid creams and keep nails well trimmed and filed.

I would also look at the detergent his clothes and bedding are washed in. Thin elderly skin is a lot more sensitive so I would run everything he puts next to his skin on the rinse cycle and buy a detergent suitable for babies/ sensitive skin

Did the blood tests cover liver, kidney, pancreas? Does he usually wake up around 3 am? This is when the immune system releases histamines . Is he on any medication?
If dry skin and allergens have been excluded, it could be systemic. Which specialist did he go to? Allergist / Immunologist?

Scabies? Bed bugs?

My DF had very itchy skin when he was in his late 70s. He realised that actually he had to use the cream he was prescribed all the time, not just until the itching stopped. If he left it a few days it would start again. Your DF needs to use whatever cream hes been given all the time.

I’d definitely push for his GP to investigate possible liver related issues OP. Hope you get some answers soon.

Scabies? - incredibly contagious and if he is in a care home can be around staff, residents and visitors before you can blink. Also very, very difficult to get on top of. Hope you find his answer.

Is he taking statins? They can cause intense itching in some people

I also came to ask if he has had a liver function test..

My DFIL had similar when 88 and hospitalized. All over his body. I think it was due to his immune system . He was bathed daily and slathered in cortisone creme and then had his arms and legs wrapped so he couldn't scratch at night.

I'm so sorry for your DF , OP.

My dad had this in his late 70s/early 80s. In his case it was bullous pemphigoid - quite rare, but occurs more often in elderly people

Bullous pemphigoid

Great advice so far.

Have you ruled out any new allergies? My DF developed one for garlic, at the age of 70! It causes him exactly the same symptoms...he'd eaten it all his life with no issues previously .

No cats or dogs cuddling up to him? Lots of flea treatments don't work anymore, and bites don't always come up in a spot or a bump!

Dfil had this when he had really high potassium levels due to kidney issues.
I'd get him to see the gp asap

About three years ago I developed chronic spontaneous urticaria, I think the blood thinners I was taking after surgery triggered it, and then I was put on ramipril which can also cause pruritus. Urticaria is always worse at night. It has improved after I nagged the NHS to give me some very expensive injections, however I still take two antihistamines at night. When it was at its worst I was taking seven antihistamines a day. Have a look at his medication and see if they have side effects. I found that cream with 2% menthol helped more than the steroid creams. Hope ge gets some relief soon, I used to cry while I scratched!

Hi all, thank you so much for all your responses and kind messages.
He saw a dermatologist and allergist. The tests run were to check his liver, kidneys and pancreas, as well as to rule out blood cancers.
He is on a blood thinner and some blood pressure / heart medication which I think should be double checked for itching as a side effect!

If the itching is under the skin rather than on the skin, it could actually be nerve irritation. Itching is part of the "unusual sensation" family caused by nerves along with pain, numbness, tingling etc. which can explain why topical treatments aren't really helpful.

This doesn't mean it's a cause for concern, vitamin and mineral deficiencies etc. Can cause nerve disruption etc.

My friend used to suffer with severe itching and it was caused by Vitamin D deficiency, causing an electrolyte imbalance, impacting nerve function and was easily resolved once at the bottom of it

Good luck x