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Armpit itching, or pruritus, is a sensation of unrelenting prickly irritation in the underarm area. It is not painful, per se, but can be intensely uncomfortable and even intolerable.
Itching is temporarily relieved by scratching but will recur soon after, creating a vicious cycle of itching and scratching. It is a truly miserable condition.
The armpit, which is medically known as the axilla, is an area of intertriginous skin. (1) This means that there is a skin fold that results in constant skin to skin contact. Due to this unique characteristic, the area is predisposed to more heat, sweat, and friction, making it susceptible to irritation.
Common Causes of Armpit Itching
The causes of axillary itching are diverse. It can arise from a simple irritation from heat, sweating, or friction. It can develop as a reaction to something environmental or chemical. It can even result from bacterial or fungal overgrowth.
Armpit itching can be present in the following conditions:
1. Contact dermatitis
Contact dermatitis can cause irritation, itching, or a rash, which can vary in presentation depending on the individual and amount of exposure. It is mediated by an allergic reaction to an allergen that comes in direct contact with the axillary skin. (2)
Contact dermatitis can be caused by deodorant, soap, or lotion, fabric texture, certain detergents, or fabric softeners. Poison ivy rash is a common form of contact dermatitis.
2. Irritant dermatitis
3. Atopic dermatitis or eczema
It is a recurring issue that is usually exacerbated by extremes in temperature, sweating, and stress. Although the presentation of atopic dermatitis can vary with age, the condition usually causes very itchy, dry, and flaky skin.
Folliculitis is an inflammation of the hair follicles. (3) It is common in the axillary area due to sweating, shaving, and deodorant use. The hair follicles become irritated and can even get infected. It usually produces red itchy bumps and blisters.
5. Heat rash
Heat rash, or miliaria, causes redness and irritation due to extreme heat and sweating. (4) It usually results in an itchy, bumpy rash with clear vesicles that can affect the armpits. Heat rash is more common in the summer, in warm, humid climates, or with strenuous activity.
Intertrigo is an inflammation that can affect any skin fold area, such as the armpits, under the breasts or the groin. Friction and moisture contribute to the condition.
It can also be triggered by a bacterial or fungal infection. Intertrigo usually results in itchy, moist red plaques and can have an unpleasant odor.
Symptoms of an Itchy Armpit
The symptoms of an itchy armpit generally include discomfort, irritation, and burning. Depending on the underlying cause, other symptoms can include:
- Bumpy skin
Self-Care Measures to Soothe Your Itchy Armpits
Several steps can be taken at home to relieve the itching, such as:
- Switch deodorants and detergents to all-natural, fragrance-free formulas.
- Stop shaving until the symptoms resolve, and use a new razor and shaving cream.
- Ice the area.
- Apply aloe vera or calamine lotion.
- Use OTC hydrocortisone cream.
- Use anti-chafing powder.
- Wear loose clothing.
- Take an antihistamine.
- Use an antifungal cream.
- Wash the area daily, especially after excessive sweating.
- Do not scratch.
How Is Armpit Itching Diagnosed?
Identifying the exact cause of your armpit itch will involve the following steps:
1. Medical history
The doctor will first inquire about:
- Your symptoms
- Any previous or preexisting conditions
- Medications that you are on
- Any new deodorant, soap, and lotion that you have started using
- Sun, heat, and other environmental exposures in the recent past
This information will help the doctor narrow down exacerbating factors for the itch and steer him/her toward the potential cause.
2. Physical exam
Examination of the armpit is very important as certain causes have a very specific appearance.
3. Additional tests
The following tests can be done if a diagnosis is still not clear:
- A potassium hydroxide preparation is used to detect fungal infections. (1)
- Wood’s light examination can be done to diagnose certain fungal and bacterial causes. (1)
- A bacterial culture is done to identify specific bacteria if an infection is suspected.
Can Armpit Itching Indicate a Severe Problem?
Armpit itching is usually due to a benign cause, but it can sometimes be a rare sign of a serious underlying issue, such as:
- Inverse psoriasis: It is a form of psoriasis that affects intertriginous areas, such as the armpit, the groin, and under the breasts. (5) It can cause itching, but some type of skin involvement may occur as well.
- Inflammatory breast cancer: It can manifest as breast redness, swelling, tenderness, or itching. (6) Due to its mechanism of local spread, it can be seen in the armpit as well. However, inflammatory breast cancer is rare and unlikely to produce axillary itching as the only symptom.
- Lymphomas: These are cancers of the lymphatic system and can result in itching. (7) Depending on the type, a rash may not be present. The itching can affect many parts of the body, especially areas with a high concentration of lymph nodes such as the axilla.
Complications Related to Itchy Armpits
Scratching can lead to cuts and abrasions. Open skin can increase the risk of developing a bacterial infection. The infection can be superficial or can affect the deeper tissues, known as cellulitis. It can also lead to an abscess.
When to See a Doctor
If armpit itching is acute and mild, it is perfectly acceptable to try some home treatments before seeking medical care. However, a medical opinion would be warranted if:
- The itching is persistent, lasting over 2 weeks.
- Home remedies are not working.
- There is pain or fever.
- Itching spreads to the entire body.
- Itching interferes with sleep or daily activities.
Armpit itching can be a challenging issue due to all the possible causes. The focus should be on alleviating the symptoms and preventing the problem from recurring. Although home remedies can be helpful, do not hesitate to seek professional help if relief seems elusive.