What’s Itching You?
Do you itch and feel like you are at your wit’s end? You are not alone. Itching is one of the most common complaints we see at the dermatology office. Itching, also called pruritis, can come from a variety of causes. You can have a skin condition like bug bites, hives, eczema or psoriasis, that makes you itch. Some medications can cause itching and there are also certain chemicals, like those in personal hygiene products or laundry detergents, that can make you itch.
You can also feel that need to scratch due to underlying conditions inside the body like thyroid problems, infections like hepatitis C, liver or kidney disease, diabetes and neurological conditions such as multiple sclerosis. Even pregnancy can trigger itching. While not common, an underlying cancer can also present with itching. And nerves can make you itch too! Not just “nerves” like you’re anxious. We know anxiety can make itching worse but what I’m talking about is the nerves in your skin. These nerves can get confused over time or due to another condition like arthritis in the spine and can send itch signals to the brain. This is often the case when patients itch without rash or when itch is very localized to a certain area of the skin.
Typically, itching is considered either acute or chronic. When itching is acute, it has a sudden onset and often goes away with treatment of the cause. Think again of poison ivy. If you’ve ever had it, you know how terrible the itching can be and you can’t wait for it to stop. However, after you treat the poison ivy, the itching usually goes away. Sometimes itching is more chronic in nature, meaning it lasts great than 6 weeks. Often patients may have a skin condition, like eczema or psoriasis to explain their chronic itching. However, sometimes itching is present but the skin looks relatively normal. Some patients may have scratch marks, called excoriations, or thickening of the skin, called lichenification. Chronically scratching can also lead to open areas of the skin and make someone prone to infection.
Itch isn’t something to take lightly. It can significantly disrupt someone’s life and can be as uncomfortable as pain. If you have experienced itching, you know what I am talking about. You can’t sleep and itch distracts you from work and spending time with your family and friends. Itching can be socially isolating, and patients are often embarrassed to be caught scratching, especially in a sensitive area like the privates or the scalp.
To help manage itchy skin, it’s important to make sure that your skin is healthy. That means addressing dry skin and following a simple bathing routine with gentle cleaners and lukewarm water. You should moisturize daily to help rebuild your skin barrier. Treating the underlying skin condition can also help itching. Newer medications meant to treat psoriasis and eczema also target the itching associated with these conditions. There are a variety of treatment options for itching and the choice of treatment depends on what’s driving the itch. The good news is that you don’t have to simply live with itching.
Trotter’s Take: If something is itching you, your dermatologist can identify the cause and tailor a treatment regimen to provide relief that goes beyond a satisfying scratch.
Listen to my latest podcast with Dr. Diego Ruiz Dasilva, who specializes in pruritis, as we leave you itching for more.
