This condition is characterized by intense episodic sensations in the skin of the back, usually at the base of the shoulder blade. Constant scratching over a long period of time will cause the skin to thicken and darken, forming more itchy skin. This is exactly what happens when a callus forms on the foot because of ill-fitting shoes.
There are many treatments for this condition. We start by using capsaicin cream (zostrix brand and generics). This cream is an arthritis treatment and works by causing the release all the itch/pain/sting packets in the area, until the sensation stops. If this is not successful, we then try injections of antinflammatory medicine directly into the skin. Oral medicines such as lyrica and elavil may be tried when all else is unsuccessful.
Capsaicin using gloves, rub pea-sized amount completely into skin. Burning or stinging will occur. Use an ice pack to relieve the sensation. This means it is working. It will go away in under 10 minutes. Repeat up to 4 times a day.
If you do not experience relief within a week, please make a follow-up appointment for intralesional injections.