How to “Lightly” Scratch an Itch: Phototherapy, Pruritis & Me

I'm a 50+ year old professional woman. I've always been quite healthy. The only times I saw any doctor was for regular exams. When I turned 50, I ran headlong into menopause. This was no surprise, and I thought I knew what to expect; hot flashes, emotional changes and that sort of stuff. I did experience hot flashes and I certainly went through some mood swings, but it was hardly noticeable because my entire body suddenly (it seemed) became incredibly itchy. No amount of scratching would help. I thought it might be an allergy, and scheduled an appointment to see my regular doctor.

I was able to get an appointment later that afternoon. While waiting in the exam room, the itching was just unbearable. Even scratching only provided temporary relief; as soon as one area would feel better, another would start itching, and then back again. I was itchier than I had fingers for. When the doctor came in I was trying to scratch the center of my back by rubbing against the edge of a cabinet. I think I looked like a bear scratching against a tree trunk. He took one look at me and saw the look on my face, then smiled and asked, “So... what seems to be the problem?” I joked that I obviously had a sprained ankle and continued scratching my back. He told me to stop; it wasn't helping my "sprained ankle", but he had something that would.

He gave me an antihistamine nasal spray, which seemed odd to me; I had no problem breathing. He explained that “histamine” is what the body uses to help white blood cells reach foreign bodies, which often shows up in the sinuses. He said it should help with the itchiness and that I could take the antihistamines as needed until we determined the cause, but not to exceed the recommended dosage.

When I returned a month later, I was happy to tell him the antihistamines were helping. According to him, 'pruritis' sometimes happens with post-menopausal women, most likely due to the associated hormonal changes. Everything usually balances out again over time, but sometimes it won't (not what I hoped to hear). He said I should be patient, because 'pruritis' can be very difficult to treat. I said, “Wonderful. Now, what the heck is 'pruritis'??” As it turns out, pruritis is Latin for “itch” and is the term doctors use to describe “itchy skin”. If you ask me, “itchy skin” is a lot easier to say than “pruritis”... but I'm no doctor.

I told him that while the antihistamines were keeping the itching at bay, if I went more than a couple of days without them, the itchiness would come back with a vengeance. He said that probably meant it wasn't a temporary thing. He then told me that pruritis often responds well to something called 'phototherapy'. I said I was game to try, so he set up an appointment with a dermatologist on the other side of town who had a phototherapy system in his office.

When I first saw the dermatologist, he checked me out and agreed that I seemed to be a good candidate for UVB therapy. He showed me his systems and briefly how they worked. According to him, I should take a session 2-3 times each week and it would probably take a month or more before we'd know if it was helping. In the meantime, I could keep taking the antihistamines for the itching.

I paid almost $50 for each treatment. To make it worse, the sessions started off at just 10 seconds, with the time slowly increasing by 10 seconds per treatment until I got close to a sunburn. After about three weeks of driving to and from the dermatologist's office and my home, I was just about ready to give up on the whole thing... when I realized that I hadn't taken any antihistamines for the last few days and my skin wasn't itchy at all! I'd been dealing with it for so long, I had almost forgotten what non-itchy skin really felt like!

I told my dermatologist that while I was happy with the results, I didn't know how long I could afford the time & cost of running back and forth. He sort of shrugged and said that was up to me, but if I decided to stop the therapy I would revert to how I was before starting the treatments. I asked him how long I'd need to keep up this routine. He said it was considered a continuing therapy... meaning, the rest of my life! I had done some online searching and found out UVBioTek also sold home phototherapy systems by prescription only. I asked my dermatologist about such a home system. I already knew that it worked for me and I knew how simple it was to use (it was a UVBioTek system with “narrowband” lamps, just like the office system.)

While he acknowledged my frustration, he said he would prefer that I continue with the office treatments, so that they could monitor my progress and make sure I was using the system properly. It seemed clear that I wasn't leaving the office with the prescription I hoped for and that he wasn't listening when I explained what my problem was. I couldn't keep taking the time off to run back and forth between work and his office - most certainly not forever; that was ridiculous. The time required, the cost of each treatment and the travel expenses were simply too much to continue. What's more, I already knew how to properly use the system.

As far as I could see, phototherapy at home, rather than the doctor's office was about as 'risky' as taking aspirin at home, instead of going to a hospital for it. But I resigned myself to continue the office treatments. That is, until I went back to my regular doctor for my annual physical.

The first thing he asked me was how the phototherapy was going and if it had helped my itching. I told him it helped a lot, but it was a huge burden constantly running back and forth. I mentioned that I'd asked about a home system, but the dermatologist didn't 'believe in home phototherapy', so my only choice was to keep using the his office system or go back to the antihistamines.

My doctor didn't seem very happy about that and asked if I felt I could use one safely. I said I knew I could. He said he thought so too. I told him I was most interested in getting a UVBioTek home system because it was what I was used to using, plus it would look really nice in my bedroom. I went to show him their brochures, when I suddenly realized that the dermatologist never gave them back to me.

As I was finishing my comment, he brought up UVBioTek's web site. He skimmed through it and asked if I wanted a prescription for a home system. I said I thought only dermatologists could prescribe home phototherapy systems, but he assured me that he could prescribe anything that required a prescription – as long as he was convinced that it was effective for me. The positive results I'd seen from the dermatologist's system was enough for him. He printed a prescription form off their web site, checked off a couple of boxes, signed it and handed it to me. He said that it would take him a couple of days for him to get something called a “letter of medical necessity” for me, telling me that I would need it to file a claim with my insurance. I didn't care, as long as I could take treatments at home and remain itch-free.

As soon as I got home, I called UVBioTek and ordered my system. By using their “Smart Lease” program, I was able to buy the system for a lot less than what it was costing to use the dermatologist's system – by about half! I only had to email or fax a copy of the prescription to UVBioTek, submit a credit application and provide them with shipping and payment info. A week later my system arrived. I was expecting something less than the system I had been using – this was a home system after all. It actually turned out to be even nicer than the dermatologist's system (which was several years old).

I've now been using it regularly for a few years, and I couldn't be happier. I feel better overall, and I have remained totally itch-free, as long as you don't count mosquito bites. I still keep antihistamines around, but the last time I took any was about six months ago. What can I say? I had a stuffy nose.