Sleuthing out the itch: Stress, cortisol and healing.
Q For several months I've had persistent itchiness on my back, arms and hands. I've tried lotions, antihistamines and cortisone cream, but nothing helps completely! What can I do? -- Charlie P., Davenport, Iowa
A There's good news for you, Charlie, and for millions of others who are afflicted. Researchers have started figuring out what chronic itching is all about. Washington University in St. Louis has even opened The Center for the Study of Itch, and they've made some surprising discoveries. Here's a brief rundown.
*Itches resulting from histamine reactions may be triggered by allergic contact dermatitis. Antihistamines and cortisone creams often are effective. But most of the time, chronic itching isn't caused by a histamine reaction: It's often associated with an overactive thyroid, eczema, psoriasis, dry skin, kidney or liver failure, certain cancers or a pinched or damaged nerve.
*Itch messages go from skin cells to your brain. Along the way, they can come in contact with pain pathways. If itching goes on long enough, it can take over neurons that transmit pain -- which may be why chronic itch is so agonizing.
*What stimulates the itch in psoriasis is likely different from what stimulates the itch associated with nerve damage. Each type calls for its own remedy.
So, first you and your doc have to ID the underlying cause of your itching: Are you anemic? Do you have undiagnosed or uncontrolled diabetes or thyroid disease? How's the health of your liver and kidneys? Get a thorough work-up.
We also know that certain medications used for other conditions may help, depending on your itch trigger. For example, some folks get relief from SSRIs, used to treat depression; gabapentin used to treat restless leg syndrome, seizures and nerve pain; pregabalin used to treat fibromyalgia and nerve pain; paroxetine used to treat obsessive compulsive disorder; and opioid antagonists used to counter opiate overdoses. We hope you and your doc can find the right solution to your itch soon!
Q My husband, 70, broke his ankle two years ago, and he still limps around in pain that keeps him awake at night. He's always under a lot of stress, so I was wondering, could stress be why he isn't healing properly? -- Susan D., Freeport, N.Y.
A Many factors, such as weight, poor nutrition, lack of exercise or physical therapy, and especially chronic stress, can contribute to a slow-healing ankle. Studies on skin repair following surgery show that stress slows down wound healing by as much as 40 percent. We also know that stress can worsen asthma, cardiovascular and heart disease, obesity, diabetes, headaches, depression and gut problems, and it can accelerate aging. So it seems very likely that stress is playing a part in your husband's slow ankle recovery.
Many scientists postulate the main culprit in this scenario is the stress hormone cortisol. At normal levels, cortisol is released by the adrenal gland to help maintain and balance blood pressure and blood sugar. And when something startles you, cortisol (and adrenalin) levels surge, but after they've made you alert and quick to respond, levels return to normal. When you're under chronic stress, however, the adrenal gland continually shoots out abnormal levels of cortisol. This can cause inflammation throughout your cardiovascular system, suppress your immune system and interfere with digestion, sleep and healing.
Fortunately, the damage from chronic stress can be controlled. How? First you want your husband to realize that it isn't an event or circumstance that's causing physical and psychological problems; it's his REACTION to the event. And he can reshape his reactions. Suggest he try daily mindful meditation, deep breathing exercises, Hatha yoga (there is no wrong position, just do what you can), biofeedback, listening to restful music or spending time with a pet. They can reduce his response to stressful events, make him more positive about doing physical therapy (we just guessed he's reluctant) and allow more and better quality sleep.
Dr. Mehmet Oz is host of "The Dr. Oz Show,'' and Dr. Mike Roizen is chief wellness officer and chairman of the Wellness Institute at Cleveland Clinic. Email questions to email@example.com.
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|Author:||Roizen, M.D. Michael; Oz, Mehmet|
|Publication:||Telegram & Gazette (Worcester, MA)|
|Date:||Mar 19, 2014|
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