Pruritus (Itch)

Pruritus is the medical term for itch. Itching is a common problem that can affect one area of the body or multiple areas at once.

Usually, an itch only lasts for a limited period of time. If an itch lasts for more than six weeks, it is considered a chronic itch, which is more likely to disrupt your life. Board-certified dermatologists are trained to evaluate itching, identify the cause and provide treatment.

Itchy skin

See a board-certified dermatologist if you have any of the following:

• An itchy rash.
• A growth on your skin that itches.
• Itching without an obvious cause.
• Head-to-toe itching that begins suddenly.
• An itch that is nonstop or disrupts your life (e.g., keeps you awake, makes concentrating difficult).
• Itching that makes you feel anxious or depressed.

WHAT CAUSES ITCHING?

There are many reasons for itchy skin. As people age, itch becomes a common complaint. Dry skin, often related to changes in weather, can lead to itching.

Other causes of itchy skin include reactions to medication and bites from mosquitoes or other bugs. You also may experience itching as the result of irritation caused by items like clothing, jewelry, soap, cosmetics or over-the-counter products.

Many skin diseases, including eczema, hives and psoriasis, can begin with an itch. The most common cause of itching in babies and children is eczema. Itch may also be a sign of a contagious disease like scabies or ringworm. If you had chickenpox earlier in life, an itchy rash could be the first sign of shingles; damage to nerve fibers after a shingles outbreak can cause itching as well.

An itch also may be the first symptom of a disease occurring inside the body, including kidney or liver disease, diabetes, and some cancers, such as lymphoma. The sooner these diseases are diagnosed and treated, the better the prognosis will be.

HOW CAN I RELIEVE ITCHY SKIN?

Follow these tips from board-certified dermatologists to soothe itchy skin:

• Apply a cold compress to itchy skin for five or 10 minutes, or until the itch subsides.
• Moisturize your skin regularly. Choose a moisturizer in a form (i.e., cream, ointment, gel or lotion) that you prefer and will use regularly, and make sure it is free of additives, fragrances and perfumes.
• Take an oatmeal bath. This can be especially soothing for blisters or oozing skin caused by chickenpox, hives, poison ivy or sunburn.
• Use wet wraps, which involve moisturizing the skin, wrapping it in a layer of wet bandages and applying a layer of dry bandages over the wet bandages. This can be particularly helpful for children with eczema.
• Apply cooling agents such as menthol or calamine. You also can achieve a cooling effect by putting your moisturizer in the refrigerator.
• Apply an over-the-counter hydrocortisone cream once daily to the itchy area. Do not use this cream for more than two weeks continuously without seeking professional medical advice.
• Consider using products that contain topical capsaicin, which can be found in over-the-counter medications for muscle/joint pain or arthritis pain. These products can be particularly effective for itch caused by shingles, psoriasis or chronic kidney disease. It may be painful to apply capsaicin to itchy skin or skin that has cuts or scrapes due to itching.

HOW CAN I PREVENT ITCH FROM FLARING?

Avoid scratching as much as possible, as this will further irritate your skin and could increase your risk of infection. You also can take the following dermatologist-recommended steps to prevent itching:

• Use lukewarm, not hot, water when bathing and showering, and use a nonirritating, fragrance-free, mild cleansing bar or body wash with a low pH, rather than soap. When you’re done bathing, dry your skin by gently patting it. Do not bathe more than once a day.
• Apply a fragrance-free moisturizing lotion, cream or ointment to your skin immediately after bathing. If your dermatologist has prescribed a topical medication to help treat your itch, apply this before the moisturizer.
• Wear loose-fitting cotton clothes. Wool and other rough fabrics can irritate your skin and cause itching.
• Use fragrance-free, dye-free laundry products.
• Keep your fingernails cut short to reduce the effects of scratching.
• Try to avoid extreme changes of temperature. Maintain a relatively cool environment with neutral humidity in your house. Use a humidifier during winter if you are prone to dry skin and eczema.
• Keep cool. Dressing in layers allows you to cool down quickly. Lowering the thermostat as needed or taking a cool shower can also help.
• Reduce stress.

SHOULD I SEE A DOCTOR ABOUT MY ITCH?

If your itch does not go away with home treatment, see a board-certified dermatologist. Your dermatologist can determine the cause of your itching and help you relieve it.

HOW DOES A BOARD-CERTIFIED DERMATOLOGIST DIAGNOSE PRURITUS?

To find out what is causing your itch, your dermatologist will ask you some questions and examine your skin. He or she may use a special lighted magnifier. In some cases, additional testing, such as a blood test or skin biopsy, may be necessary.

Your dermatologist also may scrape your skin and examine the scraping under a microscope to help make a diagnosis of a contagious skin disease, such as ringworm or scabies.

If your dermatologist suspects that your itching is caused by an underlying disease, he or she may refer you to another doctor for further evaluation.

HOW DOES A BOARD-CERTIFIED DERMATOLOGIST TREAT PRURITUS?

The treatment your dermatologist recommends will depend on what is causing your itch. It is usually best to treat the underlying cause of the itch, rather than just taking steps to relieve the symptoms.

If you have a skin condition that is causing your itch, your dermatologist will prescribe medicine to treat that skin condition. This may include oral medications that you take by mouth, topical medications that you apply to your skin or medications that are injected via a shot. Ultra-violet light therapy may be recommended as a treatment for some conditions.

Oral antihistamines can relieve the itch caused by some skin conditions, particularly hives. These medications, which sometimes cause sleepiness, are not helpful for all types of itch. Your dermatologist can tell you if they’re right for you.

Your dermatologist also may recommend medications that target the nerves or neurotransmitters that are involved in itch. These may include antiepileptic/anti-seizure drugs or antidepressants.

Pruritus treatment can take time to work, so your dermatologist also may recommend a home skin care regimen to help relieve your itch. For additional help and education, ask your dermatologist about patient advocacy organizations that can provide additional tips and resources for your specific types of itch.

A board-certified dermatologist is a medical doctor who specializes in the diagnosis and medical, surgical and cosmetic treatment of skin, hair and nail conditions. To learn more about pruritus or to find a board-certified dermatologist in your area, visit aad.org/itch or call toll-free (888) 462-DERM (3376).

All content solely developed by the American Academy of Dermatology.

Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides

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