The skin (lat. Cutis) covers the entire body and is therefore considered the largest organ in anatomy as well as in medicine. The skin can be divided anatomically into three large layers, of which the so-called epidermis is the outermost.
Towards the inside of the body, the epidermis is followed by the dermis (dermis or corium) and the subcutis (subcutis). In many textbooks the skin as an organ is divided into two layers, the cutis (consisting of epidermis and dermis) and the subcutis. The individual skin layers can also be divided into different subcutaneous compartments.
The upper skin layers therefore consist only of dead cells that are detached by scaling. The subcutaneous tissue in turn contains large blood vessels and nerve fibers that send out small spurs into the upper layers of the skin. In addition, the lower skin layer contains many sensory cells that absorb and transmit strong pressure stimuli.
This layer is also responsible for the itching of the skin. Itching and burning of the skin can be an expression of various causes or diseases. Depending on its intensity, itching in particular is perceived as a very distressing symptom that is difficult to ignore or fade out.
A possible cause for burning and itching of the skin is the widespread disease neurodermatitis, also known as atopic dermatitis. Nearly 10 – 15% of all children suffer from neurodermatitis, which often disappears again in adulthood. Typical are sensitive, very dry skin areas on the flexor sides of the joints, which itch, burn and hurt.
Also typical are redness, scratch marks and a crust formation on the affected areas. However, the itching and burning are limited to the affected skin areas and are not spread over the entire body. A less frequent, but symptomatically very impressive disease is meadow grass dermatitis.
This disease occurs mainly in spring and summer in people who have had contact with plants and have subsequently been in the sun. The skin reacts phototoxically to various plant extracts in combination in a UV-A irradiation. About 2 days after exposure to the sun, red blisters, streaky and leafy redness – corresponding to the pattern of the plant with which the skin was in contact – appear, especially on the arms and legs, and the skin becomes extremely itchy and painful.
Another disease from the field of photodermatoses, which can also cause itching and burning of the skin, is polymorphic light dermatosis – often called light allergy. Typically, various reddish skin changes often occur in the early spring months after the first exposure to the sun, which follows the long winter months, and can be accompanied by severe itching and burning. These skin changes usually heal after a week if you consistently avoid the sun during this time.
A very common cause of itching and burning skin is also sunburn (dermatitis solaris). About 6 to 8 hours after exposure to the sun, the skin is subject to extensive burning and itching redness, which in severe burns can be accompanied by fever and blistering. A rather rare cause of itching and burning of the skin is the so-called “erythema exsudativum multiforme”.
This inflammatory skin disease, the cause of which has not been conclusively clarified, often occurs after viral infection – especially with herpes viruses – and is characterized by shooting disk-shaped, reddish skin symptoms. These spread slowly from the palms of the hands and soles of the feet over the entire body. Itching and burning of the affected skin areas, as well as sometimes fever and general exhaustion are typical symptoms.
The disease usually heals by itself after 2 to 3 weeks. Finally, the allergic reaction is a rather unspecific but frequent cause of itching and burning of the skin. Such urticaria causes reddish wheals all over the body.
This can be caused by various allergens, such as food or fragrances. More information on this topic: Burning scalpShaving can be an extreme strain, especially for sensitive and dry skin.In addition, shaving sensitive skin areas is often not done carefully and carefully due to rush or carelessness and can therefore quickly lead to irritation. Proper skin care after shaving is also very important to prevent itching and a painful burning sensation.
Impurities and small injuries of the skin caused by shaving can lead to inflammatory processes in the skin, which result in symptoms such as itching, pain, burning and redness. But also the use of the wrong care and shaving products can irritate the skin. Especially shaving foam or after-shave lotions containing fragrances or preservatives can cause irritation in sensitive skin.
If itching and burning sensations occur after repeated use of a certain product, for example a shaving foam or body lotion, it is recommended to change the product once. Especially those who tend to dry and sensitive skin should attach importance to the use of gentle products. Otherwise, always make sure to use fresh razor blades.
Sunburn is a frequent photodermatosis, which occurs mainly in the summer and spring months. Careless and long sunbaths, lack of sun protection and the aggressive midday sun can quickly cause sunburn – especially for sensitive skin and light skin types. But artificial sunbathing in solariums also plays a major role in the development of sunburn.
This is an acute inflammatory reaction of the skin, which shows its maximum manifestation about 12 to 24 hours after exposure to the sun. Typically, redness, itching and burning pain occur in the affected skin areas. More severe burns can also cause general symptoms such as fever and nausea.
In addition, blistering of the skin may also occur in this case. The symptoms usually subside within a week and are felt by those affected as very distressing, especially in the first few days. Cooling and moist compresses, as well as lotions, gels or creams containing betamethasone are suitable for relieving the itching and pain.
For severe sunburn, additional anti-inflammatory and pain-relieving medications such as diclofenac and ibuprofen are used. Severe sunburn in particular should be treated by a physician, as it can be life-threatening if it spreads over a large area. Many people complain of itching immediately after showering, which is sometimes accompanied by a usually slight burning of the skin.
In some people, only specific areas of the skin are affected, in others even the entire skin. In most cases the cause of such itching after showering is dry skin. Especially through frequent and hot showers the skin tends to dryness and shows symptoms of irritation.
Therefore, some people experience a short-lasting itching after showering. The use of aggressive shower gels and soaps can also contribute to this. Especially people with sensitive skin should use gentle, pH-neutral products.
These can be found both in the drugstore and in the pharmacy. Also refatting products, as they are often available for neurodermatitis patients, can help to alleviate itching. After showering, the skin should be dabbed as dry as possible and not rubbed, as this is also a mechanical strain on the skin.
Moisturizing creams and refatting body lotions also help to care for the skin and make it more resistant. Apart from dryness, intolerance can also be the cause of burning and itching. Nowadays many shower gels are perfumed and contain ingredients that can irritate the skin.
The easiest way to find out if you cannot tolerate a product is to change the product or to try to get rid of it. Increased itching in bed, which can sometimes be accompanied by a burning sensation, is possibly an expression of a house dust or mite allergy. Typical accompanying symptoms are rhinitis, coughing, burning and watering eyes and asthma.
An allergy test can provide certainty if a house dust allergy is suspected. Other causes of itching and burning in bed are textile intolerances or neurodermatitis. Especially the latter is aggravated by the warmth of the bed.
This lowers the itching threshold and increases the symptoms. Neurodermatitis sufferers should therefore avoid heat accumulation and attach importance to non-scratching textiles. A frequent and often overlooked reason for itching and burning in bed is evening showers.People with dry skin tend to itch after a hot shower.
To avoid this, it is recommended to treat the skin with moisturizing creams and to use gentle shower gels. Evening itching and burning of the skin can have many causes. In principle, all basic diseases are conceivable, which lead to itching and burning skin anyway (see above).
But why does the skin itch in some people, especially in the evening? A possible explanation is the evening shower. People with sensitive skin tend to get skin irritations after a hot shower.
Supposed care products, such as body lotions, which many people apply in the evening, can also be the cause. They are often perfumed and are not well tolerated by some people. Pregnancy is a state of emergency for the woman’s body.
It is something completely natural and yet a rare event for the organism. During pregnancy the woman is exposed to a physically special situation. There is a hormonal shift for the woman.
The levels of estrogen and progesterone rise sharply, especially in early pregnancy. The skin over the abdomen is increasingly stretched during pregnancy. Weight gain and the resulting stretching of the skin usually occurs in other parts of the body as well.
About 20 percent of pregnant women suffer from general itching, which is based on exactly these causes. Many women also complain of itchy palms of the hands and soles of the feet. The reason for this could be the high oestrogen level.
These symptoms are generally physiological and do not require further treatment. Those affected can obtain relief by moisturizing creams and airy clothing. The symptoms usually subside quickly after birth.
In the last trimester of pregnancy, however, itching can also be pathological in nature. This is called pregnancy cholestasis. This is an obstruction in the flow of bile acid from the liver to the small intestine.
The causes can be hormonal, but it is also possible that it is a predisposition. This leads to severe itching. In addition, nausea, loss of appetite and jaundice can also occur.
The icterus (jaundice) is caused by the breakdown products deposited in the skin, which could not be metabolized because of the bile stasis. There is a risk of premature birth (in 20-60% of affected women). The therapy of choice is the administration of ursodeoxycholic acid, as this relieves the itching.
Obviously, the drug can also reduce the risk of miscarriage. After birth, the symptoms usually subside without further consequences. Skin rashes, also called exanthema, are very common and can have many different causes.
Their appearance can also be different. Characteristically, red, brownish or even white spots appear on the skin. Larger areas of skin may be affected.
Exanthema is most often found on elbows and bends, fingers (rash on the finger), hands (see also rash on the hands), feet, forearms, legs, in the groin and genital region, and on the chest. Swelling and blisters may develop. The most prominent accompanying symptom of a rash is itching, which is often still characterized by a burning or warming of the affected skin areas.
If the itching is very severe and painful, a doctor should be consulted immediately. The causes of the itchy rash can be very different. As a rule, rashes are an expression of viral and bacterial infections, inflammatory and non-inflammatory skin diseases, allergies and drug side effects.
Possible causes of itchy rashes include infection with herpes simplex viruses, glandular fever or hepatitis. Itchy rashes can also occur as a drug-related side effect. Drugs that cause such a rash are mainly antibiotics, diuretics, non-steroidal anti-inflammatory drugs, cortisone preparations and antiepileptics.
Allergens are another cause of itchy skin rashes. Chronic skin diseases such as psoriasis (psoriasis) and nodular lichen (Lichen ruber planus) are accompanied by severe itching. Also a parasitic skin disease (for example the scabies) leads to very itchy skin.
Other causes of itchy skin rashes are fungal infections of all kinds, chronic inflammatory diseases and viral infections.The therapy here is very different, as the causes are manifold and the course of the disease can often be atypical. For prophylaxis a good skin care is recommended. One should consider in which situation the rash first appeared, this can facilitate the diagnosis.
Allergens are another cause of itchy skin rashes. Chronic skin diseases such as psoriasis and lichen (lichen ruber planus) are accompanied by severe itching. Also a parasitic skin disease (for example the scabies) leads to very itchy skin.
Other causes of itchy skin rashes are fungal infections of all kinds, chronic inflammatory diseases and viral infections. The therapy here is very different, as the causes are manifold and the course of the disease can often be atypical. For prophylaxis a good skin care is recommended.
One should consider in which situation the rash first appeared, this can facilitate the diagnosis. Red blotchy skin lesions are also called maculae in technical terminology. By definition, they are not elevated above the skin level.
In colloquial language, however, red skin spots are often also referred to as skin changes that are slightly raised above the skin level. These can be hives, for example, which are often the expression of an allergic reaction. The causes of red spots can be very diverse.
A very common cause, which is accompanied by itching and a burning sensation, is an allergic reaction. Typical allergens are for example food, fragrances, plant components, animal hair and many more. Some people get red spots in stressful situations, especially in the décolleté and neck, which are accompanied by a kind of burning and itching feeling.
The sensation of itching and burning can vary greatly from person to person, making it difficult for many people to distinguish between a burning and an itching sensation. A rash that initially presents itself as patchy and reddish is herpes zoster – also known as shingles. Typically, the skin is segmental, especially on the chest and back, and burns severely.
Itching is rather rare, but can also occur. In the course of time, the red spots change and become blisters. Accompanying symptoms such as fever and general exhaustion are typical.
Another cause of an itching and burning rash with red spots is a fungal infection of the skin. Typically, the red spots are brighter in the center than on the outside and flake off in the course of time. Itching of the anus is not only unpleasant for most people, but also extremely shameful.
This is usually due to a very common infection: Oxyuriasis (enterobiosis). This worm infection, which is caused by the pinworm, is the most common worm disease in Europe. About 50% of people worldwide contract oxyuriasis at least once in their lives.
A typical symptom is severe itching of the anus at night, which can also be accompanied by a burning sensation. This can also be accompanied by abdominal pain. The disease can be considered harmless and can be easily controlled by medication that kills the worms and hygiene measures.
However, the risk of infection is particularly high within a shared apartment or family, as the worm is transmitted by smear infections. Another quite common cause of itching and burning of the anus is a hemorrhoidal disease. This is often accompanied by light bleeding, which is mainly caused by mechanical stress – toilet paper or tight underwear.
Mucilaginous secretions and weeping are also very common. Hemorrhoids hurt less frequently, contrary to frequent assumptions. In advanced stages, a foreign body sensation may occur.
Other causes of burning and itching of the anus can be underlying diseases such as neurodermatitis, diabetes mellitus or a fungal infection. Itchy skin can be very unpleasant, especially if the itching extends over the entire skin and lasts for a very long time. This situation represents a high degree of suffering and leads to stress for those affected.
The result can be insomnia and restlessness. Therefore, it is necessary to provide relief to the affected persons as soon as possible. Itching has many sides, there is not only one type and one cause.
Possible causes
- Allergies A permanent, extensive itching is clearly distinguishable from localized skin symptoms such as itchy eczema. A constant itching, which occurs everywhere, is less frequent than local complaints. Frequently, sensitive areas such as the elbows (rash on the elbow), palms, genital area, face and, for example, the scalp are affected.
- If itching occurs over such a large area, it can be a pronounced allergic reaction.
The triggering allergens can be, for example, textiles or body care products such as shower gels that are applied to large areas. If the itching occurs mainly after wearing certain items of clothing, eating certain foods or showering, you should inform your treating physician in order to carry out an allergy test if necessary.
- Dry skin – Xeroderma In general, however, a constant itching is based on very dry skin. Especially mature skin, which loses its elasticity and resilience with age, tends to dry out quickly.
Environmental factors, such as allergens, parasites, UV radiation and mechanical stress further increase the drying of the skin. Especially in old age, the skin is no longer capable of producing sufficient sebum and lipids to protect itself from drying out. But also lifestyle can worsen the condition.
Alcohol, smoking, insufficient fluid intake, frequent sunbathing and a lack of/exaggerated personal hygiene additionally dry out the skin. But hormonal changes in age also intensify this effect. Due to its lack of elasticity, the skin is covered with micro cracks, which makes it more susceptible to irritation.
According to current knowledge, free nerve endings in the skin are responsible for this itching. They are stimulated by certain tissue hormones, for example. Cold, heat or mechanical irritations such as scratching can make the itching stimulus more pleasant or transform it into another more bearable perception of pain, which is why patients sometimes feel the need to scratch themselves, even bloody.
It is particularly frustrating when there are complaints but no reason to expect them.
Especially in the case of itching, this can be felt as very tormenting. Often the reason is not directly visible – for example, in the form of dry skin or an intolerance – but it is still there. But what happens if there is no physical reason?
The skin is often called the mirror of the soul and there is a lot of truth in this saying. Unresolved psychological conflicts, stress and strain can result in the most bizarre skin reactions. Thus, even bad sensations like burning or itching can be partly attributed to psychological causes.
- Pregnancy Hormonal changes during pregnancy can cause generalized itching. This can be harmless and may pass after a certain time. However, if it persists, it can also be an expression of an internal disease or a complication (e.g. a disease of the bile ducts).
- Internal diseases Internal diseases can manifest themselves in an extensive itching.
These diseases are mainly kidney and liver complaints. Especially patients requiring dialysis with severe renal insufficiency suffer from itching. Dialysis can have a soothing effect.
Liver diseases and diseases of the gall bladder, for example with an accompanying icterus (jaundice), often lead to a generalized agonizing itching. Itching is often one of the early symptoms of such diseases. Jaundice due to bile stasis is often accompanied by itching, but it can also occur without jaundice, for example in viral hepatitis.
Systemic diseases such as HIV, hepatitis but also diabetes mellitus can manifest themselves in itching.
- Cancer A concomitant symptom of malignant cancer can sometimes be generalized itching. Such cancers include Hodgkin’s lymphoma (lymph gland cancer) and chronic lymphatic leukemia. As a result of these diseases, a so-called erythrodermia, a reddening of the entire skin with an agonizing itching, often occurs.
Other types of cancer can also cause itching.
- Psyche A generalized itching that occurs constantly does not always have to have an organic cause. Very often it is the psyche that causes it.Mental states and conditions very often express themselves in the condition of our skin. A lot of stress and worries can result in itchy skin.
Hypochondria can also be a factor that causes the feeling of constant itching. But also manifested mental illnesses such as anorexia (due to deficiency symptoms and mental instability) or schizophrenic delusions can lead to this. Schizophrenia can manifest itself in various delusions, some of which can be tactile.
This means that they affect the sense of touch. For example, people with schizophrenia report having vermin on or under their skin that cause excruciating itching. This is called “vermin madness”.
Itchy and burning skin without signs of a rash can occur in neurodermatitis.
In some people, neurodermatitis manifests itself only through dry skin areas, which are not always noticeable as a rash. Another conceivable, albeit rarer, cause is an organ dysfunction. Both liver and kidney dysfunction can cause metabolic products to accumulate, leading to itching.
In this case, however, a real burning sensation of the skin is unlikely to occur. By far the most common cause of itching and burning skin without a rash is dry skin. Especially in the winter months many people suffer from dry skin.
Almost everyone finds it highly unpleasant when the skin itches. Of course, if the problem persists, the cause should first be clarified and if possible eliminated. However, since this search for the cause often takes a long time, affected patients can obtain relief with some aids.
Since the skin is often pre-damaged by prolonged stress and then reacts particularly sensitively to other stimuli, it can help to carry out targeted relaxation exercises. In addition, the skin is covered with a natural acid mantle, which makes it particularly resistant and hard-wearing. Since itching is often triggered by inflammatory processes that are accompanied by the development of heat, those affected can experience relief by specifically cooling the itchy areas of skin.
Both ice cubes and cool compresses work wonders. For dry and flaky skin, it is recommended to apply special oily skin care lotions and/or creams. These cause the dead skin cells to soften and detach themselves from healthy skin.
In addition, they strengthen the natural protective mantle of the skin and alleviate itching. Many affected people report that the use of soaps and fragrances aggravates the problem and causes the skin to itch more. However, this should not force those affected to completely give up perfumes.
It is advisable, especially for these people, not to spray perfume directly on the skin, but rather on the hair or clothing. In addition, certain ingredients that promote itching should be avoided. The relevant substances for itching therapy include tea tree oil, camomile and arnica.
People suffering from itching should also keep an eye on the materials used when choosing their clothing. Fabrics such as wool and various synthetic fibres often cause a significant worsening of the problem and should therefore be avoided if possible. However, the most important, best and at the same time most difficult remedy against itchy skin is and remains to refrain from any scratching attempts.
In order to prevent yourself from scratching the already irritated skin, it is recommended to cut your fingernails as short as possible and (if at all) just to run your fingertips over the itchy areas. The therapy depends on the underlying causes. The tormenting itching can be treated with soothing ointments which provide moisture and contain active ingredients such as local anesthetics (painkillers) and anti-inflammatory drugs.
These have analgesic and anti-inflammatory effects. In all cases, however, an attempt should be made to eliminate the cause. In the case of chronically dry skin, it is recommended to cream the skin often with lipid-rich creams to better protect it.
Internal and systemic diseases require a much more comprehensive therapy which is specifically geared to their causes. Relaxation techniques and stress reduction can help a lot with psychological causes.However, manifest psychiatric illnesses such as schizophrenia cannot be controlled without psychotropic drugs. This is where the delusions have to be ended.