The never ending itch

Not sure if my situation is similar coz I have the itching on the places you don’t- face and scalp. But I’ve gone through months of testing and different meds and creams like you.  I’m waiting on a skin biopsy and have been on a food elimination diet for 10 days. Two interesting routes for you to look at if you haven’t already. Do you have a high carb/sugar diet? Where you are itching is well known for that when in a Candida overgrowth. Secondly, are you allergic to any pollen? I haven’t been before this year but this weekend made the connection with intermittent watery eyes, runny nose etc and tree pollen allergy. When I read up on pollen you can get food allergies from plants and fruits from the same pollen strain and if you are eating a lot of these it can cause the food allergies to spread - itching is common. I’ve realised I’m eating food daily that I may be allergic to. I’ll be pushing for allergy testing when I see my derm next- if I hadn’t made a chance connection I wouldn’t know this. It may not be the right answer but I’m finding the medical profession just want to treat the symptoms and not find the cause. Both of these might not be helpful to you but having researched all of this for months I’ve tried lots of things! 

I have suffered with urticaria for almost 40 years, my current episode is 6 years and counting. Before that it had been dormant with no medication for 12 years. Mine is so bad I get it in my mouth, ears, nose and it makes my eyes itch. Like you, I have similar symptoms around the groin and genital area and have tried every medication offered. Right now the only ones working for me are fexofenidine and amitriptyline. The amitriptyline doesn't actually treat the urticaria, it actually treats neuropathic symptoms, I get a sensation of my skin crawling and it reduces that sensation.

Have you talked to a dermatologist about taking H1 and H2 Suppressors? Things like tranexemic acid, ranitidine. There are also leukocyte suppressor that could ease your symptoms like montelukast, these are all medication names for the uk, but I'm sure some research will help you find the US names. For extreme and long lasting cases doctors can also resort to hydroxychloroquine, azothioprine and cyclosprine. I have tried all of these and sadly the results were not successful, but that doesn't mean they won't be for you. I had a bad reaction to azothioprine and cyclosporine. I would say educate yourself as much as you can before you see the next dermatologist, steroids are not always the best or only treatment for urticaria. One thing I can advise is oatmeal baths, it sounds horrible, but it does work. Sometimes medication is not always the answer. Also, I have found I have a reduction in my symptoms after I started drinking aloe Vera water/ juice daily. I drink 500ml every day.

Also, have you considered changing your body soap to a PH balanced soap? I have so many problems with soap that it took me years to find one that didn't make things worse. In the uk we have glycerine soap called pears or simple that are great, also a brand called dove and E45. Search your stores and pharmacies for brands that are ph balanced. I also ensure my soap is perfume free as well. You might also want to consider that your laundry detergent and/or fabric softener could also be the catalyst. I know I break out if I use certain brands or accidentally use too much. Lastly and most significantly, urticaria can be exacerbated by stress, so I would advise, if you don't do this already, to set aside 1 hour a day where you do something that is relaxing for you, for me this is going in the bath to soak and read a book.

Oh, something else as well... You might consider seeking a referral to an immunologist. Urticaria is actually an immunological illness not a dermatological one. It manifests on the skin, but it actually is caused by the body overproducing histamine. This is caused by the body's H1 and H2 producing cells getting a false signal telling them you are having an allergic reaction, they go into overdrive and voila, you are covered in hives. Most dermatologists don't understand the mechanics of urticaria and they are not specialists in this illness, immunologists are. If you are lucky you will get a dermatologist and an immunologist who will work together to treat you, the dermatologist can treat the symptoms, but only after the immunologist has got you on a working drug combination to control the every day symptoms and issues that are caused by your immune system attacking your body. Ask your dermatologist about light therapy, it's where they stand you in a medical grade sun booth and give you controlled measures of uv light. It can help immensely, it has helped me a little.