I have suffered from BP for about ten years. I live in Florida and I've found the symptoms almost entirely cease in the winter months, starting in late September/early October. Then, starting around mid-March my symptoms gradually creep back until by June I'm in full-blown itch mode. So it's obvious that UV exposure is at least partly to blame for my case. I've had itching so bad that I've used a dinner fork to scratch myself bloody; the pain is preferable to the itch. Scalding water has a similar effect. Ice packs help too but, Florida. I've long since resigned myself to blood spots on my sheets.

You name it, I've probably tried it. Traditional itch remedies don't work; even corticosteroids do nothing: I graduated from Triamcinolone to Clobetasol and even THAT didn't work. Capsaicin does help but I have to be SO careful not to use too much, and to be diligent about washing up after applying it. And it only lasts a few minutes anyway. My hometown dermatologist prescribed gabapentin and a custom-compounded medicated jelly which included lidocaine and amitriptyline. This was the best treatment yet but I still had great difficulty during the summer months, in spite of heavy sunscreen use and wearing SPF clothing.

As luck would have it, my dermatologist's niece recently joined the practice, and she knew exactly who I needed to see: Dr. Gil Yosipovitch. Just Google his name and you will discover that he is internationally renowned for his work in itch. Turns out she did her residency at the University of Miami, where Dr. Yosipovitch is a tenured Professor of Dermatology at the Miller School of Medicine, and director of the Miami Itch Center. I thought it unlikely that I would be able to see him, but it turns out he takes my insurance (Tricare Prime) so I started the work to obtain a referral. It's a 3.5-hour, 190-mile trip one way but I only have to see him in person once a year. His treatment, while not perfect, is the best thing I've yet found: he has prescribed Lyrica (pregabalin), 100mg capsules four times per day along with a different compounded jelly that includes lidocaine and amitriptyline (like the other stuff) but with the addition of ketamine. This treatment makes it possible for me to enjoy the summer, but I have to be VERY CAREFUL about sun exposure.

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