The itch that's hard to reach

Notalgia paresthetica is a complicated name describing a harmless but very annoying condition that could be called “itching of the back."

Patients with N.P. experience itching on their back, often between their shoulder blades, with no detectable skin rash or infection that would cause itchiness. The itching felt in this condition is real, and may be due to sensitive nerve endings in the skin.

Because many other conditions of the skin -- most commonly dryness and rashes -- can cause itching, dermatologists make sure there is no other explanation for the itching before treating patients for N.P.

It's not known why some people get N.P. and others don’t. But this condition is not a sign of internal disease, cancer, or allergies. This condition is not progressive, and does not predispose patients to any other skin problems.

A small number of patients with N.P. may develop a darker patch of skin on their back, but this is not dangerous and is not present in most forms of the condition. Because the dark patch of skin is thought to develop after frequent scratching, early treatment of this condition may help prevent it from developing.

This condition is usually treated with topical creams that make the nerves less sensitive. The creams prescribed have very few side effects, are very safe, and can be used on an “as needed” basis for itch relief.

Sources: Buffalo Medical Group (buffalomedicalgroup.com)