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Ask Dr. S. Attili Your Own Question
Dr. S. Attili
Dr. S. Attili, Dermatologist & Dermatopathologist
Category: Dermatology
Satisfied Customers: 5175
Experience:  MRCP (Dermatology), Int. Board Certification in Dermatopathology
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I have been experiencing extremely small, localized, itchy

Customer Question

I have been experiencing extremely small, localized, itchy bumps on various parts of my body for years that my dermatologist and allergist have been unable (or unwilling) to investigate or treat sufficiently. They occur most frequently on my face, neck and arms, but I have had them on my torso, legs, hands, pretty much everywhere. They seem to crop up out of nowhere, always in the form of one single bump that itches intensely for a few days, then fades away. Sometimes they appear to form around hair follicles, but not always. I have ruled out insect bites as no one I live or work with has had the same experience, including my husband who I have shared a bed with for years, so bed bugs are also out. I am generally a healthy eater, am somewhat active though could definitely exercise more, and my home, clothing and bedding are kept very clean... am at a loss for what could be causing this and how to treat it. I was diagnosed with eczema last year and am on a regimen of two steroid creams (one for face/neck/sensitive areas and one for any other parts of my body, typically elbows) and Elidel to control the rashes, and have found that the steroid cream helps the bumps somewhat, but these are clearly not eczema rashes. Aloe also helps temporarily, as does cold/ice, but the itch comes back in moments; no other topical treatment that I've tried has helped. I feel like I'm constantly uncomfortable, and the bumps on my face and neck can be very embarrassing. Open to suggestions/ideas!!
Submitted: 1 year ago.
Category: Dermatology
Expert:  Dr. S. Attili replied 1 year ago.
Hello. I am Dr. Venkat Attili, Dermatologist and Dermatopathologist with over 10 years of experience in this field. I am here to assist you and will answer your questions to your complete satisfaction. Can you please upload a picture at your convenience?
Customer: replied 1 year ago.
Hello Dr. Attili. I've tried to take a couple of photos, it's difficult to get clear shots but hopefully these are somewhat helpful. These are spots I currently have on my neck, chin, and the side of my nose; the first one (on my neck) is probably the most typical example of the type of bumps I described, but the other two are close.
Expert:  Dr. S. Attili replied 1 year ago.
Thank you for the pictures. Can you tell me how often you might get a new bump? Do they always occur one at a time? Is there a particular time of the day when they appear? Have you ever stayed away from your house for a week or more and still experienced the bumps?
Customer: replied 1 year ago.
It's pretty irregular when they show up, but if I had to estimate I'd say I have one or more crop up every 3-4 days on average, and they usually fade within about 3 days/ They can crop up one at a time or several at a time, and it's often staggered. (This week I had 3 or 4 show up all within hours of each other, but last week Ii had only one that appeared, and in the past I've had weeks where I might get one, then another one or two a day or two later, etc.) It definitely happens when I'm away from home, though it usually seems like I have a day or two of fairly normal skin before they start cropping up again. Have always assumed that maybe a change in air/environment was making my body behave differently until it adjusts and goes back to normal operations, as it were.
Expert:  Dr. S. Attili replied 1 year ago.
Ok. Have you noticed any relation to your diet? In particular eating sweets? What about sun exposure?
Customer: replied 1 year ago.
I don't believe so - no obvious commonalities as far as I've noticed, and the sun doesn't seem to hurt or help. I don't ingest a lot of sugar generally, just a small amount in my coffee or tea in the morning (usually tea, and usually herbal - I try to limit my caffeine intake as well) and occasionally a small dessert in the evenings. I rarely eat very rich foods or sweets.I do have a lot of allergies and I have taken measures to limit my exposure to allergens. I take Xyzal daily, use detergents, cleaners and skin/ hair products that are free of additives and as natural as possible - made a lot of these changes over the last year and they made a significant difference in eliminating some overall itchiness and discomfort that I'd previously been experiencing, but these bumps persist.
Expert:  Dr. S. Attili replied 1 year ago.

Ok. Have to admit, yours is an extremely interesting and unique case. Almost always when I have encountered similar cases, it is related to food intake. May I request you to please maintain a strict food diary and avoid sugars (particularly the dessert in the evening- coffee/ tea shouldn't be a problem) and gluten for 10 days and get back to me. With the food diary I am sure we would be able to get to the bottom of the problem.

Hope this helps. Do keep me posted & get back if you have any further questions or feel that I have missed out anything. Best wishes.

Customer: replied 1 year ago.
Ok, luckily I've just started tracking my food again for calorie-counting purposes, so I'll start keeping symptom notes and will do as you suggest to eliminate sugars and gluten and will get back to you.
Customer: replied 1 year ago.
Should I try to avoid things like fruit or natural sweeteners like honey as well, or just actual sugar (white/brown/etc.)?
Expert:  Dr. S. Attili replied 1 year ago.

I would suggest avoiding sugars in all forms including honey. Natural fruit sugars however should be ok. We can consider avoiding them at a later stage, if we do not find a solution.

Customer: replied 1 year ago.
OK, I'll do my best!
Expert:  Dr. S. Attili replied 1 year ago.