Global Health: Pruritus
9.04.2019
Pruritus, also known as itchy skin, is an uncomfortable, tingling and irritating sensation that stimulates an individual to scratch. Pruritus or itchy skin can be associated with some disorders, including dry skin, skin disease, pregnancy, and rarely, cancer. It is also more common in older adults because the skin has a tendency to become drier with age. Itchy skin may appear normal, red, rough or bumpy depending on the cause or trigger. It may occur on certain small areas, such as on some parts of the arm or leg, or it can occur over the whole body. It can also occur with or without any other noticeable changes on the skin. In some cases, itchiness can last for a long time and can be intense- the more the itchy area is rubbed or scratched, the itchier it gets; And the more it itches, the more it is scratched causing an itch-scratch cycle can be very difficult to discontinue. Continuous itching can result in inflamed or swollen areas on the skin leading to wounds or infection.
Self-care and homemade measures such as moisturizing frequently, use of gentle cleansers and warm water bath can bring temporary relief. Permanent relief requires a diagnosis and treatment of the factor underlying the itchiness. The major characteristic of Pruritus is a continued urge to itch some or most parts of the body. Identified and common symptoms include redness, bumps or blisters, dry cracked skin and scaly skin.
Pruritus can be caused by pruritogens and several factors; however, it is sometimes difficult to determine the exact cause. Skin conditions such as dry skin (xerosis), eczema (dermatitis), psoriasis, scabies, insect bites, atopic dermatitis, urticaria, mastocytosis, dermatitis herpetiformis, pemphigoid and hives result in itchiness. Other factors include:
- Internal diseases: Liver disease, kidney failure, iron deficiency anemia, thyroid problems and certain cancers
- Nerve disorder: Multiple sclerosis, diabetes, pinched nerves and shingles
- Psychiatric problems: Anxiety, obsessive-compulsive disorder and depression
- Irritants and allergies: Poison ivy, parasites, cosmetics, opioids, wool, chemicals and some soap
It is important to see a dermatologist if:
- Itchy skin persists for over two weeks
- Doesn’t improve with self-care measures
- Doesn’t improve despite treatment
- Is severe and distracting
- Starts suddenly without cause
- Causes sleep interruptions
- Affects the whole body
- Is accompanied by signs and symptoms such as extreme tiredness, weight loss, changes in bowel habits, or urinary frequency, fever or redness of the skin
A physical examination and inquiries about a patient’s medical history are essential to diagnosing and treating Pruritus. Blood tests, x-rays, thyroid, liver and kidney function tests are important for diagnosis. Itchy skin treatment focuses on determining the underlying the cause of the itch and treating it. If self-care and homemade remedies don’t ease itchiness, medications may be used as prescribed by a doctor. Some medications include corticosteroid creams; ointments such as tacrolimus, pimecrolimus, capsaicin, doxepin and oral medications such as fluoxetine and sertraline. In addition to medications, light therapy (phototherapy) which involves exposing the skin to a specific type of light at several times may be used to treat Pruritus.