Itchy underarms

Due to the combination of heat and humidity in the armpits, and due to the peculiarities of their skin - thinner, with the presence of a large number of apocrine sweat and sebaceous glands and hair follicles - itching under the arms occurs quite often.

Causes of the itching under the arms

As one of the main symptoms, itching under the arms can have different causes, and it primarily occurs:

• if sweating appears as a red heat rash (miliria rubra); [1]
• at diaper rash with maceration; [2]
• at simple contact dermatitis in response to body care products, shaving hair, or clothing. And skin moisture and skin rubbing against fabric can cause symptoms such as irritation under the arms and itching or burning; [3]
• due to allergic contact dermatitis when the skin is exposed to harsh substances contained in certain antiperspirants and/or hair removal products; [4]
• due to atopic dermatitis, also known as eczema; [5]
• in cases of inflammation of the sweat glands - hidradenitis; [6]
• Fox-Fordeis disease (with congestion of axillary sweat and sebaceous glands and papular rashes). [7]

Dermatitis (allergic and atopic) and hidradenitis are characterized by itching and redness under the arms, while contact dermatitis and erythroderma are characterized by hyperemia, itching and flaking under the arms.

In addition, the pH of the skin in the axillae is lower than the pH of most skin on the body (around 6.5), meaning its acid mantle is weakened and the skin is less resistant to bacterial and fungal infections.

For example, the skin may be affected by streptococcal infection - streptoderma; inflammation of hair follicles in the form of pityrosporum folliculitis, which is caused by the fungus Pityrosporum orbicularer; candidiasis of the skin - when it is affected by the yeast fungus Candida. In all these cases, rashes appear - various sized red spots under the arms and itching, as well as burning sensation and soreness. [8]

Redness, reddish-brown rash, itching under the arms and in the groin, under the mammary glands, between the toes gives skin lesions with the bacteria Corynebacterium minutissimum with the development of erythrasma (also called chronic pseudomycosis).

Severe body sweating is often accompanied by a red rash and itching under the arms in men. In addition, there are more than two dozen lymph nodes in each axilla, which are part of the body's lymphatic system. The presence in the axillae of pinkish-black dense rounded nodules with slight itching may indicate benign lymphoplasia of the skin. But note that severe itching under the arms with reddening of the skin and flaky patches may be a symptom of the erythrodermic form of mycosis fungoides, [9] which is a form of peripheral T-cell lymphoma. [10]

Itching under the arms in women is possible not only because of all the above reasons, it can also be a sign of inflammatory (swelling-like) breast cancer, the symptomatology of which includes thickening and hyperemia of the skin on the breast, an increase in the size of the breast and a feeling of heaviness.

Risk factors

Risk factors for diaper rash include poor hygiene, heat and high humidity in the axillae, including excessive sweating - localized hyperhidrosis. [11]

Risk factors include taking antibiotics, synthetic clothing, laser depilation under the arms; obesity (leading to increased sweating and sweat retention in the axillae and thick skin folds of the groin), diabetes (in which patients are more susceptible to infections) and, of course, weakened body defenses due to a variety of reasons.

Pathogenesis

The pathogenesis of itching in this area, as well as in general itching of the skin (cutaneous itching), is explained by the release of endogenous mediator of allergic reactions histamine by mast cells of the dermis, which acts both on histamine H2-receptors of epithelial cells and lymphoid cells (B- and T-lymphocytes) providing cellular immunity, and on H1-receptors of blood vessel endothelial cells.

For more information see. - Pathogenesis of itchy skin

Given the interconnectedness of the functioning of all body systems, the psychosomatics of itching under the arms (and any other localization) is considered by neurophysiologists as an indicator of increased activity of the hypothalamus-pituitary-adrenal axis on stress, depression and high levels of anxiety (especially in patients with atopic dermatitis and chronic idiopathic urticaria).

Complications and consequences

If you do not treat diaper rash, it can be complicated by bacterial or fungal infection, and inflammation of the hair follicle can be transformed into furuncle under the arm.

In addition, severe or untreated fungal and bacterial infections can lead to life-threatening complications, including sepsis.

Frequent scratching can result in scarring of the skin.

Diagnostics of the itching under the arms

All the details are in the publications:

• Diagnosis of itchy skin
• Skin examination
• Ultrasound of skin and subcutaneous fatty tissue

Treatment of the itching under the arms

Treatment of skin itching, localized in the axillae, is carried out taking into account its etiology, and depending on the diagnosis of drugs are prescribed: systemic antihistamines, that is tablets that relieve itchy skin, as well as topical agents.

The latter include:

• antibacterial streptoderma ointments,
• different compositions dermatitis ointments,
• Itch ointment,
• itch creams,
• eczema ointments.

Read more:

• Treatment of diaper rash
• Allergic rash treatment

Physiotherapy treatment may be prescribed, see - Physiotherapy for dermatitis and dermatosis

Among the home remedies for rashes and itching under the arms is the use of cold compresses (with ice); smearing the skin with lemon juice (citric acid kills many bacteria); washing with water with the addition of apple cider vinegar or baking soda. From fungus helps to treat the affected skin with water with tea tree oil or lavender (5-8 drops per half a glass of water).

And treatment with herbs includes compresses and lotions with decoctions of flowers of calendula or chamomile, sage herb, plantain leaves, etc.

Prevention

The basis of prevention is careful hygienic care of the armpit (and groin) area. And dermatologists recommend using pastes, ointments and creams for underarm sweating and wearing loose clothing made of natural fabrics in hot weather.

Forecast

In general, itching under the arms can be cured, and in most cases the prognosis is good if the disease accompanied by this symptom is not chronic.

In general, itching under the arms can be cured, and in most cases the prognosis is good if the disease accompanied by this symptom is not chronic.