My arms are always itchy and it’s driving me crazy. What can I do?

I can’t stop itching my arms and it’s driving me crazy. I’ve tried moisturising them but that doesn’t help – what could be wrong with me?

Dr Philippa answers: The most likely cause of itchiness would be a skin condition. But there are other, more dangerous, problems that can trigger the symptom too.

Dry skin is probably the most common cause of the issue. It often gets worse in the autumn and winter as cold air and central heating dry out the skin. 

This can be counteracted by regularly using an emollient – an intensive moisturiser. These can be purchased from most high street pharmacies, and chemists should be able to advise on the best options for patients.

Psoriasis and eczema are two chronic skin conditions that lead to itchiness. These are usually accompanied by red patches. Both are treated using emollients and, if these don’t work, then prescription steroid creams that a GP can sign off.

Another cause of itchiness would be scabies – an infestation of mites in the skin that can be incredibly itchy and may not have an obvious rash. The itching of scabies tends to get worse at night or after a hot shower or bath.

A GP should be able to diagnose scabies by looking closely at the skin. The problem can be treated using a cream called permethrin or, if that fails, an anti-fungal drug called ivermectin.

There is also a skin condition called keratosis pilaris, that triggers raised small raised bumps on the skin and often itching too. Treatments include emollients and gently exfoliating the skin.

Itching can also be triggered by a medical problem inside the body too. Liver and kidney disease – where the crucial organs don’t work properly – both can lead to the issue. 

The blood sugar condition diabetes and thyroid disease – where the butterfly-shaped organ that produces hormones malfunctions – can also cause itching.

A GP should be able to work out whether one of these issues is to blame for the itching by carrying out blood tests.

A number of medicines can trigger itching as a side effect. These include certain antibiotics, high blood pressure medicines, antidepressants, and opioid-based painkillers. 

Itchy patients on one of these drugs should talk to their GP about whether there are any alternative treatments they could try that do not cause the problem.

There is also a rare nerve problem called brachoradial pruritis, where there is an intense itching or burning of the lower arms, generally between the wrist and the elbow.

It can be triggered by overexposure to UV radiation from the sun or damage to the spine.

Treatments tend to involve avoiding sun exposure, soothing anti-itching creams – such as one called capsaicin cream – nerve pain drugs like gabapentin or amitriptyline. 

Sometimes, if the condition is triggered by spinal issues, then surgery may be required.

Every month my sister suffers 4 days of hell. Her blood pressure nearly doubles as well as her pulse. Her mouth gets so dry she struggles to talk.

She’s had numerous blood tests but no answers. What should she do?

Dr Philippa answers: It’s possible that a women suffering with symptoms that return every month could have a condition linked to her menstrual cycle.

There is a severe and debilitating condition called premenstrual dysmorphic disorder (PMDD). 

It triggers mental health issues, like depression and suicidal thoughts, in the lead-up to a period.

Some patients also experience physical symptoms including raised blood pressure and pulse rate.

Treatment typically involves taking the contraceptive pill.

Another condition that could lead to these symptoms is episodic migraines. The problem is usually associated with headaches, but some patients don’t get these. 

Instead, they may other symptoms like vision or hearing problems or even high blood pressure and dry mouth.

Crucially, many women find that their migraines are brought on by their period, and report that taking the contraceptive pill appears to help reduce the attacks.

However, the contraceptive pill should not be given to women suffering with migraine with aura – a form of the condition that leads to visual changes. 

This is because research suggests that patients with this problem who also take the pill have an increased risk of stroke.

There are also prescription migraine drugs that a GP can offer.

Regardless of the cause, any patient who experiences a doubling of their blood pressure should be assessed by a doctor urgently as it can be a sign of serious medical emergency, like a heart attack.

• Write to Dr Philippa Kaye at Health, Daily Mail, 9 Derry Street, London, W8 5HY or email: health@mailonsunday.co.uk – include contact details. Dr Kaye cannot enter into personal correspondence. Replies should be taken in a general context. Consult your own GP with any health worries.