Expert: Dr Ian Jackson - please note UK based - 10/23/2008

Question
Hi,

I had abdominal surgery on Sept. 17.  On Sept. 25, I started experiencing itching.  It starts as a little itch however, once I begin to scratch, the itching magifies by 100, to the point that I have to scratch more and harder.  Eventually, the area becomes raised, almost appearing as a hive, it becomes very red and hot to the touch.  Only at this point does the itching sensation go away, and eventually everything disappears.  This occurs everywhere on my body; head, face, ears, arms, hands, trunk, legs, etc...  Now, the same thing occurred to me 2 years ago after surgery.  I went to an allergist who prescribed every histamine blocker available, steroids, along with benadryl....nothing helped!  After about 3 weeks, it subsided.  So here I am going thru the same thing again...I know that it can't be the anesthesia or pain medicine because those should have worked their way thru my system within 72 hours...could it be a mental thing that occurs to me when I get put under?  Have you ever heard of this before?  Any sugestions?  Thanks for your help!

Answer
Hi Nancy

Firstly you sound very sensible and no I do not believe this is a mental thing. You have a strange problem but I am sure there is an explanation somewhere!
However having said that I'm not convinced I can explain it.... but we can try.
The itching is obviously caused by histamine release under your skin, the scratching will increase this and lead to the redness and swelling. However you state that antihistamines didn't help though I wonder if they gave you both Histamine 1 and Histamine 2 type blockers. I suspect not. It might be that a combination of traditional antihistamine like chlorpheniramine plus ranitidine (both taken regularly) might help. They would need to be taken regularly for the next few weeks and then be weaned off - taking them after the itch starts is too late.
It does sound a bit like an immunological reaction - though a delayed one to something you have been given. As you say all the drugs should be well out of your system by now. That bit is beyond my knowledge but rest assured I believe that the above is posible.
I hope the advice is of some help, please let me know if it works.
Finally if it doesn't then the immediate use of cool packs on the itchy area (and not itching) will cool the skin and reduce blood flow to the area and hopefully reduce the amount of histamine released. This will give you symptomatic relief (hopefully)
Kind regards
Dr Ian Jackson