Imagine if you are bitten by hundreds of mosquitoes. And despite the fact that you chase them away and scratch intensely the places after bites, the itching does not stop or only for a moment. This is what life looks like for nearly 9 percent. society. A sign of the daily fight against itching is their skin, often covered with shame. Full of scratches, cuts and lichenification, it leaves no doubt as to how unequal this struggle is and how much suffering it entails.
More and more is known about the mechanisms responsible for inducing itching, the feeling that leads to intense scratching. It was once believed that it is not the skin lesions that itch, but that itching causes skin lesions. It is now known that the opposite is true, although it is not uncommon for unchanged skin to itch. However, scratching causes secondary skin lesions and infections, so it is still a preventive practice to wear fingerless gloves or clothes with blind sleeves in young children with itching. Despite the advances in medicine, itching still keeps patients awake at night, and in many cases doctors fail to relieve the ailments.
The causes of pathological itching
Brief pruritus, like pain, is the body’s natural defense mechanism. It protects us against dangerous environmental factors. It is felt by virtually all of us throughout our lives. But when the itching occurs for more than six weeks, it may indicate a systemic disease that requires proper treatment. There are many known causes of itching – dermatological or related to internal diseases.
Itchy skin is the primary symptom of atopic dermatitis (AD). It usually affects the lower limbs and elbow bends, less often the upper limbs and the neck. Most often it is very intense, especially in the evening and at night, which is often the cause of insomnia. In this group of patients, an increased feeling of itching occurs due to sweating, emotional exertion, stress, as well as exposure to hot water, certain foods and fabrics. Another common skin disease that manifests itself as itching is scabies. The symptoms intensify in the evening hours, when higher temperature causes more activity of scabies digging tunnels in the skin.
Itching also often occurs in the course of psoriasis, although it is usually not as troublesome as in scabies. It is estimated that 70-90 percent. sick people struggle with this problem. It does not depend on the age of the person or the type of psoriasis or the duration of the disease. Doctors more and more often emphasize the link between overweight or obesity and the appearance of pruritus. The pruritus most often intensifies in the evening hours and most often affects the trunk, arms and legs. For most people, it also affects unchanged skin.
The feeling of itching is well known to many acne sufferers. It does not depend on the severity of skin lesions. The pruritus is most often located within acne lesions. Its development is influenced by sweating, emotional stress, physical exertion, heat, dry air as well as fatigue, menstruation and the use of certain anti-acne preparations. It is characteristic that the feeling of itching decreases under the influence of cold.
Pruritus is also often a symptom of systemic diseases, including liver disease, and may indicate liver inflammation, cirrhosis, cholestasis (cholestasis), as well as primary sclerosing cholangitis. The itching typical of these diseases intensifies in the evening and most often affects the hands and feet.
This condition also occurs in people with extreme kidney failure who are undergoing dialysis. This is called uremic pruritus, which may be generalized or localized to the skin on the back, abdomen, arms or head. It usually worsens at night, causing sleep disturbance.
People suffering from certain lymphomas and leukemias also struggle with this troublesome ailment. Itching is also often a harbinger of an ongoing neoplastic process, usually ahead of symptoms from other systems and organs, even by many years. This generally includes breast, stomach, lung, vulva, prostate, rectal and colon cancer, and brain tumors.
Itching can also accompany both hyperthyroidism and hypothyroidism and diabetes. It also accompanies many neurological and mental diseases, including depression. It is a common symptom of burn healing. The pruritus may also be of a psychogenic nature. In some cases, it is associated with the so-called parasitic delusions, when the patient is convinced that parasites live in his skin despite the absence of any skin lesions, except those caused by the patient himself, and additional tests do not indicate a parasitic disease.
Despite extensive diagnostics, it is impossible to determine the causative factor in some patients, which makes it more difficult to help them. Research shows that the quality of life of these people is particularly low.
Itchy skin care
Proper skin care is also the most important thing. Therefore, instead of soap, use dermocosmetics that do not change the pH of the skin. It is necessary to moisturize and lubricate the skin. Regular use of emollients containing urea and substances regenerating epidermal lipids reduces skin dryness and protects against factors causing irritation. Oil baths and preparations with a cooling effect on the skin, e.g. containing menthol or anesthetics with benzocaine or lidocaine, also have a beneficial effect. Avoid wearing woolen and synthetic close-fitting clothing. Choose cotton and light, airy clothing. Follow a low spice diet. Avoid coffee and alcohol. In the case of severe and prolonged itching, it is necessary to contact a dermatologist who will try to find out the cause of the ailments and prescribe the appropriate treatment. Sometimes consultations with doctors of other specialties are required, especially internists, neurologists and psychiatrists.
Text: Leonard Loga