Dryness, ageing skin, excessive sweating, eczema (both in children and adults), lichen planus, psoriasis, seborrheic dermatitis and hidradenitis suppuritiva are some of the commonest skin diseases that cause itchy rashes in the armpits.
Itchy Armpit Rash Caused by Skin Conditions
The apposed surfaces of the axillary fold predisposes the underarm area to many skin conditions due to the heat and humidity produced by friction and sweat. Intertrigo, the inflammation of the body folds, commonly affects armpits also, causing a variety of skin rashes and itching in the area. Following is a list of the common, and some not so common, causes of itchy armpits and rashes in the underarm area:
- Axillary hyperhidrosis. Excessive sweating of the armpits is not caused by stress or anxiety, but by an increased sensitivity of the sweat glands to the autonomic nervous system which controls the sweating response in the body. Sweating can cause skin rashes which are macerated, flaky and itchy. The treatment of axillary hyperhidrosis includes, among others, use of antiperspirants, tap water iontophoresis and intradermal injection of botulinum toxin.
- Atopic dermatitis. All forms of atopic dermatitis, the infantile, childhood and adult types, can present with itchy rashes in the armpits, in addition to other classical sites in each. The presentation and treatment depends upon the stage of the atopic eczema.
- Neurodermatitis. Psychogenic itching can cause thickening and darkening of the skin of the armpits in some individuals. Also known as lichen simplex chronicus, neurodermatitis can cause a habitual itching pattern that can be an extremely uncomfortable and embarrassing problem. Treatment of neurodermatitis rash involves anti-anxiety medications and topical steroids.
- Urticaria. Urticaria presents with hives and is caused by a variety of allergic agents. The itching and wheals are usually generalized. the underarm area is a common site of involvement of the urticarial rash.
- Skin dryness. Dry skin due to various causes, including harsh soaps, aging and hormonal problems like hypothyroidism can be a cause for itchy rashes in the armpits. Use of mild soaps, treatment of the underlying cause and use of emollients will relieve the dryness and itching in most cases.
- Psoriasis. Inverse psoriasis or intertriginous psoriasis can involve the armpits along with other body folds. In contrast to other clinical types of psoriasis, where itching is not a prominent symptom most of the time, psoriasis of the axillary fold can cause itchy, red, painful rashes and fissures. Treatment of psoriasis involves life style changes in addition to topical and systemic medications. Intermittent application of topical steroid - calcipotriol combinations are useful in getting rid of the psoriasis of the underarm area.
- Lichen planus. Lichen planus can cause shiny, violaceous, flat topped bumps and rashes in the armpits which are usually intensely itchy. The typical appearance and lesions elsewhere on the body are diagnostic.
- Fox Fordyce’s Disease. Fox Fordyce’s disease is a very itchy skin disease, affecting areas like the armpits where the apocrine sweat glands are present. Usually seen in females, Fox Fordyce’s disease presents with dome shaped, skin colored or yellowish red rashes around the nipples, groin, around the umbilicus etc, in addition to the armpits, the commonest sites involved. The affected area shows reduced hair growth and apocrine sweating. Treatment of Fox Fordyce's disease is quite difficult with recurrences common. Topical clindamycin with propylene glycol, topical retinoids and oral contraceptive pills are effective in limiting the skin rashes in Fox Fordyce’s disease.
- Hidradenitis suppuritiva. Hidradenitis suppuritiva is the inflammation of apocrine glands. It has a chronic course, with patients getting painful, red, fibrotic swellings and rashes in the armpits and elsewhere. Drying up of the discharge and chronic discharging sinuses may cause persistent itching in the affected areas. The common areas affected are the armpits, groin and buttocks. Medications only provide temporary relief; surgical excision of the involved skin is curative in most cases.
- Seborrheic dermatitis. Seborrheic dermatitis, the eczematous type of dandruff, can affect body folds like the armpits and present with itchy, greasy, scales and rashes. Life style management, treatment of the associated yeast infection and steps to reduce the increased sebum activity are important steps in getting rid of the seborrheic dermatitis.
- Darier’s Disease or Keratosis follicularis is an intensely itchy skin condition presenting with dirty looking greasy scales, crusts and bumps, often malodorous in the axilla and other body folds. It is an inherited disease and appears in early childhood or adolescence. Friction and sunlight increases the itching and skin rashes.
- Familial Benign Pemphigus or Hailey Hailey disease is a rare genetic blistering disease which can present with itchy or painful red, oozing and erosive skin rashes in the body folds, especially the armpits and the groin. Other types of blistering diseases belonging to the Pemphigus vulgaris group, especially Pemphigus vegetans can also cause foul smelling blisters accompanied by itching and pain.
- Acanthosis nigricans. Acanthosis nigricans, presenting as dark, velvety and thick skin in body folds may be due to obesity, certain endocrine disturbances, medications and, at times caused by more sinister internal diseases. Treatment of acanthosis nigricans involves finding the exact cause and eliminating it.
Other skin diseases, with rashes elsewhere on the body, like pityriasis rosea, confluent and reticulated papillomatosis also can cause itchy rashes in the armpits. For more information on most of the conditions listed above, visit the Articles on Skin Diseases page.
Skin Diseases Causing Underarm Itching: Related Articles
- Itchy Armpits: Cause and Treatment of Underarm Itching
- Allergic Itchy Armpits: Causes and Treatment of Underarm Itching
- Itchy Armpits Caused by Skin Infections: Diagnosis and Treatment
Reference
- Fitzpatrick’s Dermatology in General Medicine. Seventh Edition, 2008
- Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology, Sixth Ed, 2009
Disclaimer
The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, Dr.Hanish Babu, MD or Suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.
Hanish Babu - Dr.Hanish Babu, MD is a dermatologist and a feature writer on Suite101.com with more than 200 articles related to skin diseases on the ...
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