Edition #146 – est 3/2020

                                  (Chronic, itchy skin)

Itching is an irritating sensation that makes you want to scratch your skin and is a common complaint during colder weather. Dry skin is one of the most common reasons people have itchy skin or pruitis. As people age, their skin also becomes thinner and drier.

Our skin serves as the barrier that protects the inside of our body. Skin is filled with special cells from the immune system that protects us from viruses, bacteria, and environmental toxins. Once the skin cells detect any type of suspicious substance, they trigger a reaction that causes the area to become inflamed. This inflamed area presents as a rash or dermatitis. Some rashes are red, painful, and irritated, while others can lead to blisters or patches of raw skin. If a person has itching and does not see any bright red bumps or notice a sudden change to their skin, then dry skin is a likely problem.

Itching can also be a sign of an internal problem. For example, itching is common in people who have a disease that affects their blood, such as Hodgkin’s lymphoma. It can also be a sign of advanced kidney disease and often develops in people who are close to needing dialysis or currently receiving dialysis. In these people, the itch can be widespread and especially intense on the back, arms, and legs. Itching is also common in people who have liver disease, such as hepatitis C, cirrhosis, or an obstructed bile duct. When itching is a sign of liver disease, the itch often starts on the palms and soles and spreads to other parts of the body.

People get hives from stress and some mental health conditions make a person feel as if their skin is crawling, which then creates an urge to scratch. Excessive scratching usually leads to skin damage and infection Compulsive scratching may be the result of the following conditions:

Besides dry skin, other common causes of itching are:

  • Environmental factors such as excessively hot or cold weather with low humidity.
  • Allergies to foods, medicines, insect bites and plants
  • Eczema and psoriasis
  • Irritating chemicals found in spas, pools, cosmetics, detergents, soaps, lotions
  • Parasites such as pinworms, scabies and lice
  • Pregnancy

Treatment for itching depends on the cause and the severity. Underlying medical conditions need to be treated accordingly. Allergy testing needs to be done and whatever you’re allergic to should be avoided. Your doctor may prescribe medication to treat pruritus, including:

  • Antihistamines
  • Topical steroids
  • Oral steroids.
  • Other topical treatments such as cooling gels, antihistamine creams or capsaicin.
  • Antidepressant medications at low doses
  • Immunosuppressant medications, such as cyclosporine A.

In some cases, alternative therapies are suggested, including:

In general, certain lifestyle habits can help your itchy skin be less itchy:

  • Use hypoallergenic moisturizers: The best moisturizers are also the most “greasy.” Ointments (or oils) are best, followed by creams, and then lotions. Apply your moisturizer 3 or 4 times during the day. Put it on right after you wash or bathe. This will hold in the moisture from the water. If you have very dry hands, put petroleum jelly (Vaseline) on them before you go to bed at night and sleep with your hands in cotton-lined gloves. Some people use bath oils to help make their skin less dry. However, these oils can make your tub slippery. To avoid slipping and falling, put the oil on your skin after you get out of the bathtub.
  • Changing your bathing habits: If you bathe too often, it may dry out your skin. Try to take short, lukewarm baths or showers. Colloidal oatmeal baths in lukewarm water are soothing to dry skin. Use a mild soap every day to clean your genital area and under your arms. Use soap on other parts of your body 2-3x a week only.
  • Apply cold compresses or ice to itchy areas: This provides relief and is less damaging than scratching
  • Keep the thermostat in your house down and use a humidifier. Warm, dry air can make your skin dry.
  • Avoid certain fabrics, such as wool and synthetics: Switch to cotton clothing and bed sheets.
  • Regular use of sunscreen: Prevents skin damage and sunburns.
  • Use mild laundry detergents: use the rinse cycle twice to get out all the detergent
  • Philadelphia-area hospitals are jammed with patients, but not always because they are truly sick enough to be there. Staff shortages at nursing homes and home-care companies, difficulty finding dialysis slots for COVID-19 patients, and even a lack of space in city homeless shelters are forcing hospitals to keep patients who should be discharged. The Pennsylvania Health Care Association, a Harrisburg trade group for nursing homes and other long-term care providers, this week issued a set of proposals for increasing staffing levels in nursing homes to relieve pressure on hospitals.
  • The Children’s Hospital of Philadelphia’s PolicyLab updated their COVID-19 in-school guidance to reflect their understanding of omicron as a “milder” infection compared to other variants of COVID-19 and because all people aged 5 and above are eligible for vaccination while booster shots are also available for people aged 12 and older.
  1. COVID-exposed, asymptomatic staff and students should be allowed to continue attending school in-person but would have to wear a mask for a 7-day period.
  2. Weekly testing requirements of asymptomatic people can be discontinued.
  3. For those who want to be tested regularly — those whose loved ones are immunocompromised or work in high-risk professions — CHOP says that optional testing should remain available while supplies last.
  4. Those who are sick should stay home
  5. Encourage masking requirements for all schools regardless of vaccination status
  • As classes start up around the city, here’s how the colleges are handling in-person learning, vaccinations, masking and other safety precautions:

University of Pennsylvania

  1. Classes: First two weeks of classes online, with undergraduate campus housing opening Jan. 15 and return to in-person learning scheduled for Jan. 24
  2. Vaccination: Students, faculty, and staff must receive a booster shot by Jan. 31 or within 30 days of becoming eligible
  3. Masking: Anyone inside campus buildings must double-mask using a cloth mask over a disposable mask, or wear an N95 or KN95

LaSalle University

  1. Classes: The first week of classes — Jan. 18 to 21 — will be remote, and residential move-in will continue as planned starting Jan. 16
  2. Vaccination: All campus community members must receive a booster shot within 30 days of eligibility
  3. Masking: Masks are required in all indoor settings, with surgical-grade or KN95 masks recommended

Temple University

  1. Classes: Two weeks of virtual classes through Jan. 21, with residential move-in starting Jan. 22
  2. Vaccination: Full vaccination required, and booster shots are strongly recommended-but not mandatory-for eligible community members
  3. Masking: Masks are required indoors and in enclosed spaces, including all public areas of residence halls

Drexel University

  1. Classes: First two weeks online, with return to in-person classes expected the week of Jan. 17 and students asked to delay return to residences to Jan. 13 or later
  2. Vaccination: Booster shot required for eligible faculty, staff and students before returning to campus for the winter term
  3. Masking: Masks required in indoor public, shared, instructional, and research settings, with double-masking, KF94s, KN95s, or other NIOSH-approved valveless masks encouraged
  • Philadelphia’s COVID-19 vaccine mandate for 22,000 municipal employees takes effect today, Jan 14th, but thousands of city workers aren’t yet fully vaccinated. About 78% of all city employees are already fully vaccinated, according to the city. The rest could risk losing their jobs due to the mandate, under which workers will be put on unpaid leave for 15 days and then face dismissal if they don’t get a shot.


  • Postal workers at 43 facilities across the United States, including Philadelphia, Harrisburg, and Pittsburgh, will build and label millions of testing kits for mail delivery for a pilot program to deliver COVID home testing kits. The White House and the USPS and American Postal Workers Union agreed to deliver 500 million coronavirus testing kits to American households. Deputy press secretary Karine Jean-Pierre told reporters last Friday that the Biden administration was “actively finalizing the details of the distribution mechanism, including a website,” and that the kits would be sent through the mail.
  • Hospitals stretched thin caring for a surge of COVID-19 patients with a depleted staff — many out sick or quarantining with the virus themselves — have found a lifeline in the National Guard. Thousands of National Guard members have deployed across the country, including in the Philadelphia region, to ease staff shortages at hospitals and assist with vaccination clinics and COVID-19 testing.
  • Two brand-new COVID-19 pills that were supposed to be an important weapon against the pandemic in the U.S. are in short supply and have played little role in the fight against the omicron wave of infections. The problem, in part, is that production is still being ramped up and the medicines can take anywhere from five to eight months to manufacture. The Food and Drug Administration authorized the two pills from Pfizer and Merck late last month based on studies showing they cut the risk of severe disease and death when given shortly after symptoms appear. They are the first COVID-19 treatments patients can take at home, and thus could reduce the burden on hospitals. Unfortunately, the U.S. didn’t make the kind of mass purchases in advance that it did with vaccines. The U.S. has ordered enough Paxlovid to treat 20 million people, but the first 10 million orders won’t be delivered until June.
  • The Biden administration will incentivize health insurance providers to create programs where people can get over-the-counter at-home tests through a list of preferred pharmacies and retailers, with no out-of-pocket costs. This way, insurers would cover any costs upfront and patients would not need to submit reimbursement claims. Health insurers will still need to reimburse tests people buy that are outside of these networks, at a rate of up to $12 per individual test, or the cost of the test if it’s less than $12.
  • Wills Eye surgeon Jurij Bilyk says he and colleagues have noticed an increase in styes during the pandemic, and a 2021 study led by a UCLA Stein Eye Institute physician found a similar trend. The theory is that a loose-fitting mask results in the upward flow of exhaled breath, thereby drying out the eye. That dryness may in turn lead to blocked glands in the eyelid, ultimately resulting in a stye, Bilyk said. Ophthalmologists at Wills Eye Hospital are stressing the importance of making sure the face coverings fit snugly.
  • According to the latest data from the Centers for Disease Control and Prevention, nearly 208 million people in the US — or 62.6 percent of the total population — is fully vaccinated against COVID-19. Since the beginning of the pandemic, the US has recorded more than 835,000 COVID-19 deaths, according to the CDC.
  • Many Americans, including people who need rapid testing to attend work or school in person, are facing empty pharmacy shelves and “no inventory” banners on e-commerce sites. But hundreds of thousands of accurate at-home testing solutions are held by wealthy companies with the money and motivation to provide them to their workforces — whether employees work in the office or not.
  1. Workers at corporate giants such as Google and JPMorgan Chase can request tests be sent to them free.
  2. At Google, employees can receive as many as 20 tests per month, even if they’re not going into the office.
  3. Delta Air Lines allows its flight staff and corporate employees to order sets of six antigen tests every three weeks.
  4. Sports leagues like the National Basketball Association and the National Football League provide frequent testing to players to ensure they can travel and play for their teams.
  5. Other companies such as Microsoft and Mastercard offer a combination of at-home and in-person testing.
  6. Many companies, including Wells Fargo and American Airlines, also offer on-site testing for employees who must interact with customers in person
  7. JPMorgan Chase provides rapid tests and PCR tests for workers free, either mailed to employees at home or provided in person at the office.
  • While conditions are not as dire as at the start of the pandemic nearly two years ago due to the availability of vaccines and other treatment options, the staffing shortages in hospitals are a real concern during this latest surge, said Dr. Craig Spencer, director of global health in emergency medicine at New York-Presbyterian/Columbia University Medical Center. “The problem is that right now we have hospitals where there’s not enough nurses to take care of the patients who are coming in, both the Covid patients and the non-Covid patients,” Spencer told CNN’s Laura Coates on Wednesday.


  • The omicron coronavirus variant will infect “just about everybody” regardless of vaccination status, top U.S. infectious-disease expert Anthony S. Fauci said Tuesday. But those who have been vaccinated will “very likely, with some exceptions, do reasonably well,” and avoid hospitalization and death, said Fauci, speaking at a virtual “fireside chat” with the Center for Strategic and International Studies. A World Health Organization official on Tuesday predicted that the omicron variant will have infected more than half of the population in the European region in the next six to eight weeks, if current trends hold.


Bralow Medical Group Office Information

Our first priority is your health and safety

If you are my patient then you know to contact me directly on my cell phone 24/7 if you have any  medical concerns. You can also email me at drbralow@mdvip.com with general questions.

Click here if you’d like to subscribe to this newsletter.

Please stay safe and be smart,
Dr Bralow