Skin Itching : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 15/08/2022

Skin itching is a common symptom of skin, allergic, infectious, metabolic, hematological, psychogenic diseases. It can be localized or spread to a significant part of the skin. Itching is accompanied by scratching and inflammation of the skin, rash, increased irritability, sleep disturbance. The etiofactors of pruritus are determined by dermatological examination (luminescent diagnostics, trichoscopy), allergy tests, laboratory tests (scraping microscopy), and skin biopsy. Treatment includes topical and systemic pharmacotherapy, physiotherapy, psychotherapy.

General information

Skin pruritus is one of the interdisciplinary problems relevant for both dermatovenereology and allergology, endocrinology, infectology, and oncology. Some forms of itching (itching of the anus, itching of the scrotum, itching of the vulva) in the ICD-1 are considered as independent nosologies. Itchy conditions are more commonly diagnosed in women. Frequent background factors are low socioeconomic status, depression, constant stress, periods of hormonal changes (pregnancy, menopause).

Depending on the course, pruritus can be acute (sudden, short-term) and chronic (long-term, debilitating), according to the area of ​​the itchy surface - localized (local) and generalized (diffuse). According to the mechanism of occurrence, pruritus is divided into:

  • pruritoceptive (due to skin diseases);
  • systemic (due to common diseases);
  • psychogenic (due to mental disorders);
  • neurogenic (due to damage to the nervous system).

Causes of itching

Itching of the scalp

It is caused by diseases of the hair and scalp. It is accompanied by a feeling of tightness of the skin, scaly desquamation of the epidermis (dandruff), increased oiliness of the hair, excessive production of sebum, brittleness, and sometimes hair loss. Itching of the scalp can be provoked by improperly selected care and styling products (shampoo, conditioner, hairspray). The most common pathological causes of itchy scalp include:

  • pathology of the sebaceous glands: dandruff, seborrhea (oily, dry, mixed);
  • parasitic diseases: head lice, demodicosis, flea bites, bedbugs;
  • mycoses: favus, trichophytosis, microsporia;
  • hair shaft anomalies: idiopathic trichoclasia, knotty hair;
  • autoimmune pathologies: psoriasis, SLE, scleroderma;
  • other dermatoses: pityriasis versicolor pilaris (Devergy's disease), allergic dermatitis of the scalp;
  • common diseases: hypovitaminosis A, heavy metal intoxication, hypothyroidism.

Skin itching

 

Body itching

Skin itching can be caused by dermatological and systemic diseases. In some cases, itching of the body is due to elementary non-compliance with personal hygiene: a rare bath or shower, wearing dirty clothes. On the other hand, itching of the skin can occur with infectious and parasitic dermatoses that are contagious to others. Itching dermatoses are often found in the elderly (senile itching) and pregnant women. Dermatological conditions most commonly associated with itchy skin include:

  • inflammatory lesions: prickly heat, seborrheic dermatitis, eczema, lichen planus, acne;
  • skin infections: herpes, pyoderma, folliculitis, dermatophytosis;
  • acariasis and entomosis: scabies, demodicosis, pediculosis, insect allergy;
  • chronic autoimmune dermatoses: psoriasis, dermatomyositis, Dühring's herpetiform dermatitis, pemphigoid, pemphigus vulgaris;
  • allergic dermatosis: urticaria, prurigo, allergic contact dermatitis, neurodermatitis;
  • genodermatoses: ichthyosis, Darier's disease, Hailey-Hailey's disease;
  • skin tumors: leukemids, Sezary's syndrome, mycosis fungoides and other T-cell lymphomas of the skin.

Itching of the whole body can be a side effect of taking certain drugs: ACE inhibitors, anti-gout, antiarrhythmic, hormonal drugs, opioids. Systemic diseases occurring with chronic pruritus:

  • endocrinopathy: diabetes, hypothyroidism, thyrotoxicosis;
  • diseases of the hepatobiliary system and kidneys: cholestasis, cirrhosis of the liver, chronic hepatitis, chronic renal failure;
  • infections: HIV, helminthiases;
  • hematological diseases: mastocytosis, leukemia, polycythemia, myeloma, lymphogranulomatosis;
  • Psychiatric Disorders: OCD, depression, dermatozoic delusions.

Itching in the eye area

Eyelids can itch with any of the listed skin, infectious and general somatic pathologies. However, more often the causes of itching in the eyes are ophthalmic diseases and visual strain. At risk of developing such a problem are people who use contact lenses, work in contact with dust and chemicals without proper eye protection, patients with allergies and immunodeficiencies. Causes of itchy eyes:

  • injuries: foreign bodies, burns, mechanical damage;
  • inflammatory diseases: blepharitis, conjunctivitis, meibomitis, barley, keratitis;
  • parasitic lesions: demodicosis, dirofilariasis;
  • allergies: eyelid dermatitis, hay fever;
  • other eye diseases: dry eye syndrome, computer vision syndrome, glaucoma, cataract.

Diagnostics

Since pruritus is caused by a variety of reasons, specialists from various medical fields are engaged in their clarification: dermatologists, parasitologists, trichologists, allergologists-immunologists, ophthalmologists, endocrinologists. The nature of itching can be assumed on the basis of the collected history, localization, the presence of skin elements (vesicles, papules, pustules, scales, excoriations, crusts). Depending on the suspected etiology, the examination may include:

  • Examination of the skin and scalp. It is carried out using a Wood's lamp, a dermatoscope, a trichoscope. Allows you to conduct a visual assessment of the skin elements, the condition of the hair, to identify the presence of parasites. Scales and questionnaires are used to measure the severity of itching.
  • Laboratory diagnostics. If a systemic nature of pruritus is suspected, the level of thyroid hormones, glucose, liver enzymes, urea and creatinine in the blood is determined. Perform microscopy of skin scrapings, analysis of feces for helminth eggs, spectral analysis of hair for the content of vitamins and heavy metals. Investigate markers of viral hepatitis, HIV infection.
  • Ophthalmic diagnostics. The basic examination includes biomicroscopy of the eye, examination of the fundus, tonometry. As an additional method, an instillation test with fluorescein is used.
  • Allergy diagnostics. The main methods for detecting allergies are blood tests (individual allergens, histamine, total IgE) and skin allergological tests for atopy antigens (prick test, prick tests).
  • Other surveys. To exclude damage to internal organs as the cause of skin itching, ultrasound of the hepatobiliary system and kidneys is performed. In unclear cases, a skin biopsy is required.

Dermatologist's examination

 

Treatment

Skin itching treatment

Therapy for pruritus is carried out taking into account the established causes and concomitant factors. For this, pharmacotherapy, local therapy, physiotherapy, psychotherapy are used. Patients with pruritus need to change their eating and daily living habits: give up sugary foods, wear clothes made of synthetic and coarse fabrics, and use detergents that dry the skin. It is recommended to avoid stress, avoid scratching the skin, use neutral moisturizers.

Direct treatment of pruritus consists of the following components:

  • topical therapy. Of the local antipruritic drugs, topical steroids, cooling lotions, local anesthetics, antihistamines, and calcineurin inhibitors are recommended. Preparations are available in the form of creams, solutions, powders, ointments.
  • Systemic pharmacotherapy. Taking into account the etiological factor of pruritus, antihistamine drugs, glucocorticosteroids, vitamins, immunosuppressants, antimicrobials, and in some cases antidepressants, opioid analgesics are prescribed.
  • Physiotherapy. Of the methods of physiotherapy for various forms of pruritus, PUVA therapy and PUVA baths, UVI, laser therapy, ultraphonophoresis, electrosleep, etc. can be effective. Exercise therapy, acupuncture, general baths with a sedative effect (pearl, coniferous, valerian) are useful.
  • Psychotherapy. Psychotherapeutic techniques (autogenic training, group psychotherapy, cognitive behavioral therapy) help reduce the subjective perception of the severity of itching, stop scratching the skin, improve sleep and quality of life.

Head Itching Treatment

The problem of itching of the scalp often resolves when the underlying disease is in remission. In all cases, the selection of pharmacy cosmeceutical hair care products is important: shampoos, masks, oils. For complex therapy of the identified problem, a trichologist can offer mesotherapy, cryomassage, darsonvalization, laser treatment of the scalp. With dandruff, seborrheic dermatitis, antifungal shampoos are used. With pediculosis, the scalp is treated with special means.

Treatment for itchy eyes

Treatment of itching in the eye area has its own specifics, it is carried out mainly using local remedies. At the time of treatment, it is necessary to abandon the use of cosmetics, wearing lenses in favor of glasses. To eliminate the causes of itching are prescribed:

  • instillation of eye drops: antihistamine, steroid, antibacterial, "artificial tear" preparations;
  • laying ointments behind the eyelid;
  • quenching of the conjunctiva with antiseptic and astringent agents (for conjunctivitis);
  • processing of the ciliary edge of the eyelids (with demodicosis, blepharitis);
  • washing the conjunctival sac (for eye burns, foreign bodies);
  • physiotherapy: UHF, magnetotherapy, magnetophoresis, laser therapy.

If necessary, surgical interventions are performed: opening of the stye of the eyelid, removal of foreign bodies of the conjunctiva and cornea, antiglaucoma operations, cataract phacoemulsification, etc.

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