For some people, pruritus, which refers to itchy skin, is a constant battle. It can be difficult to understand exactly what is causing the skin to itch.
Itchy skin can be the result of a rash or another skin condition. It can also be a symptom of a more serious condition such as liver disease or kidney failure. To get relief, it is important to identify the problem and treat the underlying cause.
Skin serves a vital purpose as the barrier that protects the inside of the body. It is filled with special cells of the immune system that can protect the body and skin from viruses, bacteria, and other hidden threats.
Once the skin cells detect any type of suspicious substance, they trigger a reaction that causes the area to become inflamed. Medical professionals refer to this inflammation as a rash or dermatitis. This can lead to itching.
Immune cells can react to something that touches the skin, a whole-body infection, or an illness. Some rashes are red, painful, and irritated, while others can lead to blisters or patches of raw skin.
Itching is a symptom common to many skin complaints. Skin can itch all over the body or only in specific areas.
Here are some specific causes of pruritus:
Dry skin is one of the most common causes of itchy skin. If a person does not see any bright red bumps or notice a sudden change to their skin, dry skin is a likely cause.
Environmental factors that can lead to dry skin include excessively hot or cold weather with low humidity. Washing too much can also cause dry skin. It can affect any age group, but as people age, their skin becomes thinner and drier.
A good moisturizer can usually help repair dry skin. Extremely dry skin can be a warning sign of dermatitis, so it may be necessary to see a dermatologist to help get relief and keep the condition from becoming worse.
Common signs and symptoms of dry skin include:
- rough, scaly, or flaking skin
- excessive itching
- gray or ashy-looking skin in people with darker skin
- cracks in the skin that are prone to bleeding
- chapped or cracked skin or lips
It is important to seek help to treat dry skin because cracks in the skin can allow germs to enter. Once inside the skin, these germs can cause an infection. Red, sore spots on the skin are often an early sign of a potential infection.
A skin specialist may prescribe a special moisturizer to apply throughout the day or a topical medicine to apply directly to the skin.
Eczema, or atopic dermatitis, is the most common cause of skin rash in children.
The American College of Allergy, Asthma & Immunology (ACAAI) report that eczema affects 1 in 5 infants but only 1 in 50 adults.
The cause is linked to the leakiness of the skin barrier. This causes the area to dry out, putting it at risk of irritation and inflammation. It is vital to keep the skin moisturized.
Eczema often improves over time. People with eczema must be careful, however, as they are more vulnerable to skin infections.
Irritation and allergic reactions can also cause itchy skin. Allergic contact dermatitis occurs when the skin comes into direct contact with an allergen.
The result of the skin allergy is a red, itchy rash that can include small blisters or bumps. The rash arises whenever the skin comes into contact with the allergen, a substance that the immune system attacks. Often, there is a time delay between exposure to the allergen and when the rash occurs.
Touching clothing, pets, chemicals, soaps, and substances such as poison ivy or cosmetics can trigger allergic reactions.. Food allergies can also cause the skin to itch.
Nickel allergies are quite common. When a person come into contact with jewelry that contains even a small amount of nickel, they can develop red, bumpy, itchy, and swollen skin at the point of contact.
For a person with an allergic reaction to a particular substance, one of the easiest things to do is to avoid that product or substance. Over-the-counter creams or medicated creams can help clear up a rash.
Hives are a type of skin inflammation caused by the release of a chemical in the body called histamine. This release causes small blood vessels to leak, which causes the skin to swell.
There are two kinds of hives:
- Acute hives. These most commonly occur after coming into contact with an allergic trigger, such as a particular food or medication. Non-allergic causes, such as excessively hot or cold weather, sun exposure, or exercise, can also serve as a trigger.
- Chronic hives. Specific triggers do not cause these, which can make allergy tests unhelpful. They can last for months or even years. Hives can cause uncomfortable itching and be painful, but they are not contagious.
The ACAAI say that hives affect about 20 percent of people at some point in their life.
Bug bites often cause a person's skin to flare up, resulting in itchiness. Mosquito and spider bites will often produce a small bite mark that is surrounded by red patchiness on the skin. These bites should fade away within 7–14 days.
Bites from bed bugs and mites may produce a bigger rash and can cause itchiness all over the body. If a person suspects a bed bug infestation, they need to remove all furniture and clean the room thoroughly with repellent. All affected items should be washed at 60 ºC.
Professional help may be required if a person is unable to eliminate the infestation themselves.
People may experience an itching feeling that has no physical cause. Some mental health conditions can make a person feel as if their skin is crawling, which creates an urge to scratch. Excessive scratching can lead to skin damage.
Compulsive scratching may be the result of the following conditions:
Itching can also be related to parasites such as threadworms, insects such as bedbugs, mosquitoes, or lice. Fungal infections, such as athlete's foot, can also cause itching between and around the toes.
Doctors might also refer to uremic pruritus as renal itch or chronic kidney disease-associated pruritus. Uremia is a broad syndrome that occurs when the kidneys are severely damaged and cannot filter toxins from the body.
With uremia, itching tends to be worse at night. It most commonly affects the back, arms, and abdomen.
The following home remedies may help reduce itching:
- using a high-quality moisturizing cream on the skin and applying it at least once or twice each day
- applying an anti-itch cream, such as nonprescription hydrocortisone cream, to the area to help relieve the itching. Hydrocortisone cream is available for purchase online.
- applying a cool, wet compress to the affected area
- taking a lukewarm bath
- choosing mild soaps without dyes or perfumes and using mild or unscented laundry detergent when washing. Various products for sensitive skin are available for purchase online, including laundry detergent and soaps.
- avoiding substances that irritate the skin or cause an allergic reaction such as nickel, jewelry, and wool
Perhaps the most important self-care measure is to avoid scratching. Scratching can ultimately lead to further inflammation and damage to the skin and can worsen the itching.
If over-the-counter creams do not work, if a rash spreads, or if someone experiences additional symptoms beyond itching, they should see a physician or skin specialist to identify the cause and treat the particular problem.
The treatment plan will depend on the cause of itching. For people who are suffering from dry skin, a good moisturizer may be all that is needed.
Eczema, dermatitis, or hives: These and other skin conditions may be recommended corticosteroid creams by a skin specialist. These can be applied directly to the skin to help with itching. Topical calcineurin inhibitors and oral antihistamines can also help to relieve the itch.
Allergies: Oral antihistamines are common anti-allergy medications. They can be prescribed or purchased online. Examples include Zyrtec, Claritin, and Benadryl.
Fungal infections: Ringworm, athlete's foot, and other fungal infections can be treated with antifungal treatment. Topical treatments include creams and shampoos. For severe infections, the doctor may prescribe an oral medication. Terbinafine, or Lamisil, is commonly used.
Insect bites and stings: Topical antihistamines can relieve itching. To prevent bites, use an insect repellant, keep fly screens in good repair, and keep the body covered with clothing.
People who have psoriasis or kidney failure may be recommended alternative treatments if there are reasons to avoid medication therapy. Light therapy or phototherapy is one such treatment method. The treatment involves exposing the skin to certain wavelengths of ultraviolet light to help get the itching under control.