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3 Ways Gout Itches
3 Ways Gout Itches

Introduction to Is Gout Itchy

On reviewing an old gout forum discussion about itching[1], I realized that sufferers were experiencing itching in different circumstances. Then relevant research revealed 3 different ways that itching is linked to gout. Also, there are different personal factors that affect those 3 types of gout itch. So there is never a single, standard way to deal with gout itching. Because you need to work with your health professionals to determine which type of itch you are dealing with. Then work out a personal plan to ditch the itch.

Note: There are many other causes of itching beyond these 3 types of gout itch. Because many other events cause itching. Including many non-gout drugs. Which is why I emphasize that you consult your doctor about any itching that you experience.

Purpose of Is Gout Itchy

Dealing with itching isn't currently part of any professional gout guidance that I have seen. Yet, it is considered in many gout studies. Also, gout itch concerns are regularly discussed in gout forums. So, gout itch is one of many topics that gout sufferers need to discuss on a personal basis with their doctors.

To that end, I provide the GoutPal Student Plan to help gout sufferers learn about the topics that apply to them. Then they can discuss their relevant treatment options with their professional health advisers.

Is Gout Itchy?

Let's look at the 3 types of gout itch. Then you can identify which is most likely to apply to you. Remembering that these are not exclusive. So you can experience any combination of different types of itch.

Uric Acid Crystal Histamine Itch

UA Crystal ➜ Mast Cell ➜ Histamine ➜ Itch
UA Crystal ➜ Mast Cell ➜ Histamine ➜ Itch[2]
It is quite common for gout sufferers to experience itching before a gout attack. This is referred to in several gout studies. For example, Suresh in 2005[3]: Most patients know when an acute episode is imminent, describing itching (possibly caused by prodromal mast cell degranulation and release of histamine).

I can see that histamine research is frequently cited in other gout studies. But I haven't found any subsequent research into human gout models. However, in our gout and itching discussion, Kim shared the experience: I know I was pretty itchy before my first actual gouty toe episode, and when that happened, the itchiness abated.

As there is no standard guidance for histamine-related gout itch, my recommendation is to:

  • Check with your doctor about the best practical approach to confirming histamine-induced itching.
  • Take advantage of this early warning and discuss preventative pain relief in preparation for that imminent attack.

Gout Flare Desquamation Itch

Gout Desquamation Itch
Gout Desquamation Itch[4]
We've seen that uric acid crystals give some gout sufferers a histamine itch warning before a gout flare. In contrast, now I look at itching from skin damage after a gout flare. This type of skin peeling is known medically as desquamation, which affects many gout sufferers. As Hench noted[5]: Suspect gout when an acutely affected foot is warm and red or bluish red rather than cold and bluish white as in atrophie arthritis and when edema and later desquamation of the skin are present.

Uric Acid Treatment Itch

Allopurinol Itch
Allopurinol Itch[6]
Most of our itching and uric acid treatment discussions are about allopurinol itch. Though for most gout patients, the effects are never as severe as this image. Which Yin describes as[6]: itch, and small quantities of purplish-red rash with diffused distribution on four limbs

Anyway, I deal with this in Allopurinol Side Effects, so you can look there. But be aware that if you experience itch when taking allopurinol, you should consult your doctor immediately.

Is Gout Itchy Summary

During the forum discussions so far, I hadn't realized that there are at least these 3 types of gout itch. Similarly, the gout articles that I've published about itching don't recognize this distinction. So, I will review those articles to ensure they adequately distinguish the type of gout itch. Then, I will link them here, or on a new gout & itching index page.

In the meantime, you should use the Google Gout Search Engine to find articles and discussions that are most relevant to your gout itch concerns.

3 Ways Gout Itches
3 Ways Gout Itches

Is Your Gout Itchy?

You have learned that there are at least 3 different types of gout itch: -
  1. Before gout flare - Gout Histamine Itch
  2. After gout flare - Gout Skin Peeling Itch
  3. During uric acid treatment - Allopurinol Itch

So to help you distinguish these, it's a good idea to maintain a Gout Symptoms Log.

If you still have concerns about gout and itching, you should discuss those concerns with your professional health advisers. However, if you want help to prepare for that discussion, please contact me.

Leave "Is Gout Itchy" to browse the Gout and Uric Acid Blog.

Is Gout Itchy References

  1. GoutPal Forum Users. "Gout and Itching". GoutPal Forum (Aug 2008). Archived 21 Nov 2021.
  2. Yang, Ting-Lin B., and Brian S. Kim. "Pruritus in allergy and immunology." Journal of Allergy and Clinical Immunology 144, no. 2 (2019): 353-360.
  3. Suresh, E. "Diagnosis and management of gout: a rational approach." Postgraduate medical journal 81, no. 959 (2005): 572-579.
  4. Michael Pillinger, MD Division of Rheumatology NYU School of Medicine. "GOUT! (And Calcium Crystal Diseases) - Acute Gout--First MTP--With Desquamation." SlideServe (2014). Archived 15 Aug 2016
  5. HENCH, PHILIP S. "Diagnosis and treatment of gout and gouty arthritis." Journal of the American Medical Association 116, no. 6 (1941): 453-459.
  6. Yin, ZhiQiang, JiaLi Xu, YongQiang Li, JiPing Xia, and Dan Luo. "Transient hypofibrinogenemia due to allopurinol." Drug Design, Development and Therapy 8 (2014): 1231.

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