Itching: Causes, Treatment & Help

Itching, itching or pruritus is a discomfort in the skin, which is unpleasant for the affected person and often tempts to scratch or chafe. However, most of the time itching is harmless, although very annoying.

What is pruritus?

The primary purpose of itching is to alert people to parasites or foreign bodies on and in the skin so that they can then remove them. Itching may be localizable to the skin or may extend indefinably over larger areas of the skin. If the itch is precisely localizable, it is called epicritic pruritus. However, if the itch is rather poorly localizable, its technical term is protopathic pruritus. Prurigo is referred to when the itch occurs in association with changes on the skin.

Causes

Itching serves the function of protection, similar to pain, cold, touch, or heat. It is primarily intended to alert people to parasites or foreign bodies on and in the skin so that they can then remove them. Longer lasting, mostly chronic itching, in contrast to rather short lasting, acute itching, should always be considered as a symptom of a possible disease. The itch itself, is triggered by the body’s own agents, such as cytokines, histamine or opioids and then transmitted via the nerve fibers. Thus, itching is one of the most common appearing symptoms of the skin. Nearly eight percent of adults struggle with itching. If the itching occurs more often or lasts longer, a pathological cause can be assumed. Skin diseases are the most frequent triggers. However, the rather well localized itching is often related to underlying diseases, such as metabolic disorders, liver diseases or infections by certain pathogens.

Diseases with this symptom

  • Allergy
  • Hives
  • Candidiasis
  • Bullous pemphigoid
  • Diabetes mellitus
  • Food intolerance
  • Hemorrhoids
  • Psoriasis
  • Scabies
  • Diseases of the thyroid gland
  • Shingles
  • Chickenpox
  • Chickenpox
  • Neurodermatitis
  • Nodular lichen
  • Liver disease
  • Hodgkin’s disease
  • HIV infection

Diagnosis and course

Itching can be due to a variety of causes and accordingly take a different course. As a basis for a diagnosis, the doctor asks about the intensity of itching, the timing, the body sites and any situational dependence of its occurrence, the use of medication and the presence of allergies or other underlying diseases. During the physical examination, the physician checks for the presence of scratch marks, colored skin changes, and dry skin areas. He also looks for evidence of pathogens, which can be detected by a smear test. By palpation, the physician detects abnormalities of the spleen, liver or lymph nodes. Depending on the suspected cause, stool, blood, X-ray or ultrasound examinations, computer tomographies or colonoscopies are performed.

Complications

Itching (pruritus) is common and usually a harmless temporary phenomenon. Sometimes, however, it can be a symptom of a more serious condition. It becomes problematic if the pruritus lasts longer than six weeks. Then it indicates that something is wrong with the body. Often, severe liver diseases, jaundice, infectious diseases, thyroid dysfunction, diabetes or, in rarer cases, even cancer are behind it. Especially if the itching occurs together with other complaints such as fatigue, night sweats or weight loss, it can be considered a warning sign of serious underlying diseases. In these cases, direct treatments for the itch will not help. It will continue as long as the causative disease has not been cured. Persistent and agonizing itching can also be the cause of severe sleep disorders, depression or general irritability. Furthermore, the skin is severely damaged in the long term by constant scratching. Therefore, if itching has not already developed on the basis of eczematous skin diseases, its persistent existence nevertheless causes skin changes that resemble eczema. A vicious circle is formed. Scratching wounds the skin in the itchy place.Inflammation and crust formation occur on these sores, which increase the itching even more. In addition, the skin may discolor and form itchy nodules that, when scratched, further aggravate any underlying disease.

When should you go to the doctor?

Before itching is treated with home remedies or medical preparations, the cause should be clarified by a doctor. Possibly there is an acute contact allergy, which can lead to unbearable skin irritation and pain after only a short time. A visit to the doctor is also recommended if the complaints do not subside after two to three days at the latest or even increase in the course of time. Accompanying symptoms such as pain, redness or inflammation indicate a serious underlying condition that requires immediate diagnosis and treatment. Itching as a result of eczema must be treated in any case. Especially if it occurs on the eye or involves large areas of skin. If there is also inflammation and a greasy yellowish coating, there may be a serious infection that needs to be investigated quickly. Itching in infants and young children always requires a visit to the doctor. Allergy sufferers should keep a detailed record of their symptoms in a diary. If skin diseases such as neurodermatitis or acne are already present, a specialist should be consulted at the first signs. In the case of allergic reactions, an emergency doctor must be called in immediately or a hospital visited, depending on the severity.

Treatment and therapy

If one goes to the doctor with the symptom of itching, one is first questioned deeply. Thereby the intensity and the localized place of the itching as well as the intake of medication are the most important questions of the doctor to be able to establish a diagnosis. Furthermore, existing diseases or allergies can also play a role. In addition, a cause of the itching by certain situations could also be inquired. Once the questioning is completed, an examination of the body takes place. The physician will pay special attention to color changes, conspicuous skin areas and possible pathogens. Furthermore, the liver, spleen, kidneys and lymph nodes are examined. A stool and blood test, as well as an ultrasound and X-ray examination are also part of the standard diagnosis. If pathogens are suspected as the cause, a smear is taken in order to create a pathogen culture. If further causes are found, computer tomography, small intestine endoscopy and other medical examinations may be performed. Therapy of the itching is usually carried out by the use of active ingredient-free fatty ointments. Likewise, only alkali-free soap should be used in personal hygiene. Lotions with urea, tanning agents or menthol have a soothing effect. Medications prescribed by the doctor could be antihistamines. If the cause of the itching is psychological, tranquilizers and neuroleptics are often prescribed. Similarly, ointments with cayenne pepper have proven effective. UV-B rays are also helpful in cases of severe itching. If diseases are the cause of itching, they should be treated first.

Outlook and prognosis

In most cases, itching is a relatively unpleasant symptom for the patient. Itching usually causes the skin to become red. The affected person should refrain from scratching the affected area in any case. Scratching usually only intensifies the itching and can lead to bleeding, sores and scars. If the itching is due to intolerance or allergy, no special treatment is necessary. The symptom disappears after a short time, when the body has broken down the causing substance. If itching occurs after an insect bite, it will usually disappear after a short time without the need for treatment. Treatments by the doctor are necessary if the itching does not disappear and leads to severe pain or rashes on the skin. In this case, treatment can often take place with the help of antibiotics and quickly leads to success in most people. In the case of intolerance, medications that allow the digestion of a certain ingredient and thus avoid the itching stimuli can be used as well.

What you can do yourself

In most cases, itching irritations can also be treated at home and do not necessarily have to be examined by a doctor.In most cases, itching occurs in cases of intolerance and allergic reactions. In this case, the patient must abstain from the triggering food or the specific ingredient. It usually takes a few days for the body to completely break down the ingredient. After that, the itching disappears on its own. For supportive treatment, itching irritations can always be creamed with creams and gentle care products. Under no circumstances should the affected person scratch the affected areas when itching. This only intensifies the itching and can cause sores and blisters. Especially with children, parents should be careful that they do not scratch the areas. Cooling with cooling compresses or ice packs can also bring about relief from the itching. In the case of insect bites, the affected regions must also not be scratched. In most cases, the itching disappears after a few hours. If itching occurs due to poor hygiene, the patient should wash more often and use skin care products. In this way, itching can be avoided right away. If the itching persists for a longer period of time and is associated with more severe pain, it is advisable to consult a doctor. Medical treatment may be necessary in this case.