Shamard Charles, MD, is a physician-journalist and public health doctor who advances health policy through health communication and health promotion.
Susan Bard, MD, is a board-certified dermatologist in New York City.
“Pruritus” is the clinical name for the symptom of itching. There are many causes of pruritus. They include dry skin (xerosis) and skin conditions such as eczema (an inflammatory skin disease also called atopic dermatitis), allergic skin reactions (contact dermatitis), and systemic conditions, such as diabetes and blood cancers.
This article will discuss what causes pruritus, symptoms, diagnosis, treatment, and prevention.
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There are many causes of pruritus. A common cause of pruritus is xerosis, especially in older adults and in people who live in colder climates. Other causes include:
Pruritus can occur as a localized or systemic symptom based on the underlying cause. The underlying mechanism of your pruritus depends on the precipitating cause, and no single mechanism explains all forms of pruritus.
In allergic reactions, the chemical histamine is released by mast cells and triggers itchiness. But in nonallergic causes of pruritus, it may be due to other chemicals. For example, serotonin appears to be a key component of pruritus in systemic conditions such as polycythemia vera, uremia, cholestasis, and lymphoma.
Pruritus is a symptom in and of itself and may be accompanied by other symptoms, including:
Your accompanying symptoms are largely dependent on the underlying conditions that are causing your pruritus.
Some of the groups at higher risk of developing pruritus include:
A thorough history and a complete physical examination must be performed to determine the underlying cause of your pruritus. A proper diagnosis is key, as treating the underlying condition is the most effective treatment for pruritus.
Some questions you might be asked by a healthcare provider include:
A careful skin exam will be performed to look at the characteristics of any skin rash or lesions and signs of infection or allergic reaction. Suspicious skin lesions may be biopsied (a sample of skin is removed to be examined under a microscope).
If your symptoms do not resolve after two weeks of treatment your symptoms, your healthcare provider may order a series of labs and refer you to a specialist to determine the cause of your pruritus symptoms.
When you're trying to pacify a nagging itch, using a moisturizer (preferably one approved by a healthcare provider), calamine lotion, or even a cool compress can be incredibly soothing. Some lifestyle modifications like wearing loose, light clothing and using unscented aloe-based lotions may also be helpful.
But these anti-itch methods usually only provide temporary relief. Treating the underlying condition at the root of your pruritus is the most definitive way to get rid of your itch.
If your itch is due to an allergic reaction, using an antihistamine is a mainstay treatment that has proven to be effective. For local pruritus, a corticosteroid cream might help.
If you have systemic pruritus from conditions such as polycythemia vera, uremia, cholestasis, and lymphoma, serotonin inhibitors such as Periactin (cyproheptadine), Paxil (paroxetine), and Zofran (ondansetron) are proven anti-itch treatments.
Phototherapy uses natural or artificial light to treat itchy skin conditions, including eczema and psoriasis.
Sometimes pruritus is simply unavoidable, especially if the cause of your itch is due to a systemic condition, meaning one that affects your entire body. Fortunately, most cases of pruritus are benign (noncancerous), localized (staying in a single spot), and can be prevented. The following tip may help you prevent pruritus:
Pruritus, known simply as itching, can be caused by many conditions ranging from dry skin (xerosis) and infections to dermatologic skin conditions such as eczema (atopic dermatitis), infections, allergic reactions, and systemic conditions such as diabetes.
Localized itching is usually benign and can be well managed with the use of lotions. Oftentimes, these mild cases resolve on their own without the need for any treatment at all.
Still, widespread pruritus that lasts for more than a few days should not be ignored. Itching that occurs all over your body may be a sign of an underlying condition. If you experience itching that does not resolve with symptomatic treatment within two weeks, check in with your healthcare provider,
The most common cause of pruritus (especially in older adults) is dry skin. Dry skin is usually benign and can be resolved with the use of lotions and a humidifier.
Dermatologic skin conditions such as eczema (dermatitis), psoriasis (atopic dermatitis), food allergies, and allergic reaction to a foreign substance (contact dermatitis) are also common causes of itchy skin.
Yes. In most cases, pruritus will go away on its own. Taking OTC medications like antihistamines, using unscented lotions, and wearing loose, light clothing may also relieve your acute symptoms and help you to feel more comfortable throughout the day.
Yes. Chronic pruritus and anxiety can feed off one another in a vicious cycle. Some people itch because they are anxious, while others are anxious because they itch.
Itching can make you more anxious because high stress levels can create a hormonal imbalance in the body, causing systemic changes, including changes to the nervous system, which may manifest as pain or pruritis.
American Academy of Dermatology Association. 10 reasons your skin itches uncontrollably and how to get relief.
American Academy of Allergy Asthma and Immunology. What makes us itch?
Tarikci N, Kocatürk E, Güngör Ş, et al. Pruritus in systemic diseases: a review of etiological factors and new treatment modalities. ScientificWorldJournal. 2015;2015:803752. doi:10.1155/2015/803752
American Academy of Family Physicians. Pruritis.
Bernstein JA, Lang DM, Khan DA, et al. The diagnosis and management of acute and chronic urticaria: 2014 update. J Allergy Clin Immunol. 2014;133(5):1270-7. doi:10.1016/j.jaci.2014.02.036
Kaur R, Sinha VR. Antidepressants as antipruritic agents: A review. Eur Neuropsychopharmacol. 2018;28(3):341-352. doi:10.1016/j.euroneuro.2018.01.007
American Academy of Dermatology Association. How to relieve itchy skin.
Sanders KM, Akiyama T. The vicious cycle of itch and anxiety. Neurosci Biobehav Rev. 2018;87:17-26. doi:10.1016/j.neubiorev.2018.01.009
Shamard Charles, MD, MPH is a public health physician and journalist. He has held positions with major news networks like NBC reporting on health policy, public health initiatives, diversity in medicine, and new developments in health care research and medical treatments.
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