Condition

Skin itch has always been a common dilemma for some people. Itches can be isolated at single parts of the body or generalized which can spread all over the body. The wider the infection of the itch is, the more difficult it is to treat. For other cases, itches can also occur even without apparent symptoms such as bumps, blisters, and other skin lesions. Skin lesions that accompany itches are directly examined by physicians or dermatologists to immediately determine the skin condition and provide its appropriate medical treatments.

Itch may also signify other skin complications or risk factors. Studies show that people enduring too much stress and anxiety are prone to skin itches and other relative skin problems. Not only does stress create the condition, it may also even aggravate the symptoms of skin itch. Other skin conditions related to itch are dry skin, endocrine and metabolic disorders, cancers, skin infestations, drug reactions, and other diseases of the blood.

The apparent danger in itching is the immediate reaction to scratching which usually recurs from time to time. As much as scratching relieves the patient of the itch, prolonging scratching can also lead to skin irritation and eventually breaking of the skin. Once this happens bacterial infection can easily set in. This often causes thickening of the skin or pigmentation.

Generalized itching or pruritus of the whole body can be caused by kidney, liver or any infectious diseases like chicken pox. Allergic reactions which are severe enough can spread to the whole body causing generalized itching also. If not tested beforehand, medications can sometimes lead to reactions all over the body. These causes may range from simple reactions to complex infections.

For usual cases of localized itching, common causes include insect bites and stings. Parasites of our body, particularly body lice, pubic lice, and head lice, are also contributors of localized itching. Chemical irritations due to direct contact of stinging nettle or poison ivy can often lead to isolated infection or itching.

Symptoms

Itching is a symptom; it is not the main disease or diagnosis. Itching of generalized character is considered as a “cardinal symptom of medical significance.” Therefore it should not be taken for granted and necessarily requires medical attention.

However it is important to know some of the diseases in relation to pruritus:

Polycythemia Vera

Almost half of the incidents of polycythemia vera has experienced a severe itching sensation upon contact with water. This usually happens right after taking a bath or otherwise known as “bath-itch”. This symptom may be prior to the development of polycythemia vera. There are no apparent signs such as skin lesions.

Cholestasis

Patients with liver diseases experience itching as an early and common symptom. Carcinoma of head of pancreas, primary sclerosing cholangitis, primary biliary cirrhosis, and obstructive gallstone disease are examples of liver diseases. Pregnancy or drug-induced cholestasis can also lead to severe itching. This is due to high levels of salt in the bile and other common compounds. The salt levels in the bile are not directly related to pruritus but the lowering of such compound results to itching relief.

Chronic Renal Disease

In chronic renal disease, pruritus can be on of the most upsetting symptoms. The patient may have generalized or localized itching which is persistent and stubborn. It does not relate to any apparent rash that may occur. Although dialysis may alleviate the discomfort of the itch, it happens rarely in patients. Emollients do not entirely give aid to the drying skin in chronic renal disease.  

Endocrine Disorders

Intractable generalized itching is one of the major symptoms present in thyrotoxicosis. This is due to high level in skin blood flow which eventually leads to the decrease in the threshold of itch and increase in the skin temperature. Patients with mucocutaneous candidiasis and thyrotoxicosis will have local areas of itching in their genital areas.

Iron Deficiency Anemia

Iron deficiency as a cause of itching is a debatable issue. The cure of iron deficiency in patients with severe cases and polycythemia vera have resulted to minimizing pruritus. It is somehow different in cases of iatrogenic iron deficiency because itching does not exist. This leads to the conclusion of health experts that pruritus in iron deficiency cases may be attributed to other factors.

Pruritus In Human Immunodeficiency Virus Disease

Human immunodeficiency virus disease (HIV) patients are at great risk in developing a number of skin problems that are often associated with pruritus. Skin conditions such as drug eruptions, scabies, candidiasis, seborrhoeic dermatitis, and pediculosis are only few of the possible problems that may arise at the onset of HIV disease.

Diagnosis

If itching is coupled with other unexplained symptoms that may be prolonged, or severe, seek medical attention immediately. Usually, medical evaluation is not necessary in cases of pruritus. The core objective in treatment is to eliminate the root cause of the itching.

For pruritus that comes back more often without apparent causes, it is an indication that medical assistance is needed. Recurrent itching can be a symptom of an undetermined skin condition or a serious disease.

Most of the times, it is easy to determine the cause of itching in plain view. Physical examination of the skin will tell you that dry skin, stings, bites or rashes caused the itching. However, health professionals will have to consider the medical history of the patient. Although physical examination and history may be sufficient for diagnosis, other tests might be needed for other skin conditions.

The types and the number of tests will depend entirely on the major cause of the itching. For example, in skin rashes, skin biopsy may be essential in diagnosing the condition. In cases of kidney failure, blood cancers, and hormonal imbalances, blood tests may be required.

Health professionals will also determine other factors including:

• Extent of the itching – Systemic diseases will usually have generalized pruritus. While diabetes can be associated with intractable local areas of itching in the scalp.

• Onset of the itch – Systemic disorders will have a delay in the onset of progressive pruritus. While skin inflammation present an immediate onset of itching.

• Quality - Dermatitis herpetiformis will have a burning quality of itch.

• Severity – The severity of the itch will depend on the individual.

Treatment

It is strongly recommended that you see your dermatologist or doctor immediately on cases of severe and recurring skin itch. Some cases need specific medical treatment which only your physicians can prescribe.

As much as possible avoid persistent scratching or rubbing of the skin. Long fingernails are always a no-no as it can cause skin damage with scratching.

During bedtime, be sure to wear loose, cool, and light clothes. Rough materials like wool can create friction around the itchy area and can pretty much lead to skin infection. Lukewarm baths before sleep are also good to relax your skin. Be sure to use non-allergenic soaps or try to treat yourself with cornstarch or oatmeal baths. Follow it up with soothing skin lotion to provide smoothness and cooling effect.

Cold compresses can alleviate the discomfort cause by the skin itch. Do not expose the affected area with too much heat or moisture.

It is advisable to indulge yourself in activities that can distract you from itching or scratching. That way you can tire yourself and be able to sleep and forget about the itching at night.

Over-the-counter (OTC) medications such as antihistamines are proven to be effective for skin itch arising from allergies. However patients must be aware of its side effect of drowsiness. OTC hydrocortisone may be administered in cases of isolated skin itchy areas.