Itching or pruritus can be associated with several disorders, such as skin disease, dry skin, pregnancy, and in some cases, cancer.
Itching is a very irritating sensation that makes you feel like scratching your skin. There are times when itching feels like pain, but they are not the same. In most cases, you feel itchy only in an area of the body, but there are times when you feel itching all over. Along with itching, you may also have hives or a rash.
Itchy skin can be caused or made worse by dry skin. The condition is quite common among older adults as their skin tends to become drier.
Depending on the cause of the itchy skin, it may appear normal, rough, red, or bumpy. Repeated scratching can lead to raised thick areas of the skin that could become infected or bleed.
Many people get relief from itching using self-care measures such as a daily use of moisturizer, bathing with lukewarm water, or using gentle cleansers. Long-term relief for the condition requires identification and treatment of the underlying cause of itchy skin. Common treatments include medicated lotions, oral anti-itch medicines, and moist dressings.
Your itching may affect certain small areas, such as on an arm or leg, or over the whole body. Itchy skin may occur without any other noticeable changes on the skin. Your itching may be associated with:
- Bumps, blisters, or spots
- Leathery or scaly skin
- Dry and cracked skin
Itchiness may last a long time and can be very intense. It gets itchier as you scratch or rub the area. And the more you scratch as the more it itches. Breaking the cycle of itch-scratch is very difficult.
Causes of itchy skin or pruritus include:
- Skin conditions - Many skin conditions are itchy, such as xerosis or dry skin, psoriasis, dermatitis or eczema, burns, scabies, insect bites, scars, and hives.
- Internal diseases - Itchy skin could be a symptom of an underlying condition or illness. These include kidney failure, liver disease, anemia, iron deficiency, certain cancers such as lymphoma and multiple myeloma, and thyroid problems.
- Nerve disorders - They are conditions affecting the nervous system, such as diabetes, multiple sclerosis, shingles, pinched nerves, all of which can cause itching.
- Psychiatric diseases - Certain psychiatric diseases that may cause itching are depression, anxiety, and obsessive-compulsive disorder.
- Allergic reactions and irritation - There substances that cause an allergic reaction, such as cosmetics, parasites, or poison ivy. Reactions to certain drugs, such as opioids can result in itchy skin. Some substances, such as soaps, wool, chemicals, and other substances can irritate the skin and cause itching.
- Pregnancy - Some pregnant women may experience itchy skin.
There are instances when the cause of itching cannot be determined.
Complications of pruritus or itching
Chronic pruritus or itching that lasts beyond six weeks can affect the quality of life. It may interrupt your sleep or cause depression or anxiety. Prolonged itching and scratching can increase the intensity of the itch, leading to skin infection, injury, and scarring.
Diagnosis and Treatment
Identifying the cause of your pruritus may take time and could involve questions about your medical history and a physical exam.
After your doctor gave you a physical examination, he will ask you several questions about your symptoms, such as:
- How long have you had the irritation or itching?
- Have you been in contact with any irritating substances?
- Does the itch come and go?
- Where is the itchy skin most severe?
- What medications are you taking or have recently taken?
If your doctor suspects that your itchy skin results from a medical condition, he might order you to undergo some tests including:
- Blood test - A complete blood count may provide evidence of certain internal conditions that cause your itch, such as iron deficiency.
- Chest X-rays - A chest X-ray will show if your lymph nodes are enlarged, which can cause itchy skin.
- Tests of kidney, liver, and thyroid function - Itching may be caused by thyroid abnormalities or liver or kidney disorders.
- Biopsy or scraping of your skin - This test will determine if you have an infection.
Once your doctor has identified the cause of your itchy skin, he will start the treatment. If the underlying cause is an infection or a disease, your doctor will recommend the best course of treatment for such a problem. When the cause of the itchy skin or pruritus is more superficial, your doctor may prescribe a cream or ointment that will relieve your itchy skin.
The treatment of itchy skin or pruritus is focused on identifying the cause of the itch and resolving it. If home remedies do not relieve your itchy skin, your doctor may prescribe some medications or other modalities of treatment. His options include:
- Corticosteroid ointments and creams - For your red and itchy skin, your doctor may recommend the application of a medicated ointment or cream to the affected areas. He might use a damp cloth to cover the treated skin. The moisture from the damp cloth can help the skin absorb the medication. It also has a cooling effect that will ease the itching.
- Oral medications - Certain oral medications, such as antidepressants known as serotonin reuptake inhibitors, such as Prozac or fluoxetine, and Zoloft or sertraline, could help ease some types of chronic itch.
- Other creams and ointments - Other topical treatments that may be applied to your skin include calcineurin inhibitors, including pimecrolimus or Elidel and Protopic or tacrolimus. Topical anesthetics such as doxepin and capsaicin can provide some relief to itchy skin.
- Phototherapy or light therapy - Phototherapy exposes your skin to a specific type of light. The itching can be put under control after multiple sessions of phototherapy.
Most itching can be treated and may not always indicate a serious problem. It is always best to check with your doctor so he can confirm a diagnosis and treatment.
Lifestyle and home remedies
The following self-care measures may provide temporary relief of itchy skin:
- Moisturize daily - The daily application of fragrance-free and hypoallergenic moisturizers such as CeraVe, Cetaphil, Eucerin, and others can provide relief to itchy skin.
- Avoiding situations or items that cause you to itch - You must identify the cause of your symptoms and avoid it. The cause could be an overly heated room, heavy and rough clothing, exposure to a cleaning product, or too many hot baths.
- Avoid scratching whenever it is possible - Try covering the itchy area if you can’t stop yourself from scratching. Wear gloves at night or trim your nails.
- Use lotions, creams, or gels that cool and soothe the skin - The short-term use of over-the-counter corticosteroid cream can provide temporary relief to an itchy skin that is accompanied by redness and inflammation. You can also try applying calamine lotion or creams with capsaicin or menthol, or a topical anesthetic such as pramoxine.
- Reduce stress or avoid stressful situations - Stress can cause or worsen itching. Behavior modification therapy, counseling, meditation, acupuncture, or yoga are some of the proven ways to relieve stress.
- Take a shower or a bath - Use lukewarm water and sprinkle in some baking soda, Epsom salts, colloidal oatmeal for bathing, or uncooked oatmeal. Many people who have chronic pruritus experienced an easing of symptoms for many hours after taking a hot shower. Some people claim that it is cold showers that ease itchy skin. Whatever method of easing itchy skin you prefer, always use a mild cleanser and do not scrub your skin too hard. After bathing or showering, make sure to thoroughly rinse your skin, dry it gently, and apply moisturizer.
- Use over-the-counter allergy medicine - Some of the over-the-counter drugs, such as Benadryl or diphenhydramine can cause drowsiness. They can help you fall asleep at night even if your itchy skin keeps you awake.
- Wear lightweight clothing - Lightweight clothing can help the skin cool and reduce the itching sensation.
- Use a humidifier - If home heating causes the air inside your home to be dry and cause your itching, a humidifier may provide some degree of relief.
Risks of Having Itching
Anyone can get itching or pruritus but certain groups of people are more susceptible to the condition, such as:
- People with diabetes
- People with hay fever, asthma, seasonal allergies, and eczema
- Pregnant women
- The elderly
- People with HIV/AIDS and some types of cancer, such as leukemia or lymphoma
When to Seek Medical Attention
You need to see a doctor or a dermatologist when the itchy skin:
- Lasts more than 2 weeks with no improvements after using self-care measures
- Comes on suddenly without any explanations
- Is severe and prevent you from sleeping or distracts you from your daily routines
- Affects the whole body
- Is accompanied by signs and symptoms such as weight loss, extreme tiredness, urinary frequency, changes in bowel habits, redness of the skin, or fever
If the condition lasts for more than three months after treatment, you should see a dermatologist for evaluation for skin disease and an internist to be evaluated for other diseases.