Itching without rash

One of the most common complaints that patients come to a dermatologist with is itchy skin. As a rule, this symptom is accompanied by a rash, but in some cases there is a so-called isolated itching, which is not accompanied by a rash.

About what can cause itching without a rash, what diseases can manifest in this way and how to get rid of discomfort, will be discussed in this article.

What is itching

Itching is a sensation of intense sensation or tingling in the upper layer of the epidermis. It can occur both on the surface of the skin and on the mucous membranes. Chronic itching can have an extremely negative impact on the quality of life: it causes sleep disorders, worsens mood, reduces performance, and can provoke depression. Places of scratching can become inflamed, which causes a further deterioration in well-being.

Itching is local if it occurs in certain areas of the body, as well as generalized if discomfort is felt over the entire surface of the body. Itching often accompanies systemic diseases and can be one of the early symptoms of a range of serious health problems.

Depending on how severe the process is, itching can be acute or chronic. The acute manifestation of the symptom is usually provoked by allergens: pet hair, plant pollen, food, dust, medicines. Chronic itching is most often a manifestation of diseases that are not related to dermatology. Therefore, if the discomfort persists and becomes more intense, medical advice should be sought. In particular, it is imperative to visit a doctor if itching lasts more than fourteen days, disrupts night sleep, occurs for no reason, is accompanied by other symptoms (weight loss, fatigue, fever).

Possible causes of itching without rashes

There are many possible causes of itching. Discomfort can be caused by dry skin, the use of low-quality cosmetics, neurological disorders, and pregnancy.

The cause of skin manifestations can be old age, allergies, as well as a number of diseases of the internal organs.

Itching as a symptom of diseases

In the event that the sensation of itching bothers you for a long time, but there are no other signs of allergy (rashes, lacrimation, runny nose), it is necessary to check the condition of the internal organs. Sometimes, in order to get rid of discomfort, it is enough to make adjustments to the diet or stop using certain medications. However, in some cases, itching can be a symptom of a serious illness, and therefore you should not delay visiting a doctor.

cirrhosis and hepatitis

More than one hundred thousand people become victims of cirrhosis of the liver every year. The prognosis of this disease is extremely unfavorable, especially if not only the liver is affected, but also the nervous system. With progressive cirrhosis, the expected life expectancy is about five years, and if the patient ignores the doctor’s prescriptions, death can occur much earlier.

The danger of cirrhosis is that in the early stages it is almost asymptomatic. The only sign that makes it possible to suspect that something is not right with the liver is generalized itching. The reason for its occurrence is a condition when liver cells are gradually destroyed, as a result of which the body loses the ability to fully cleanse the blood of poisons, toxins and substances that provoke allergies.

Doctors say that with cirrhosis, itching begins suddenly. Most often, the palms and soles of the feet begin to itch, and in the later stages of the disease, itching “spreads” throughout the body.

Note that itching can also be one of the first signs of hepatitis, which manifests itself long before the yellowing of the skin and sclera. Therefore, when itching of an incomprehensible etiology appears, it is necessary first of all to exclude liver diseases, having passed all the necessary studies.

Diabetes

Itching caused by diabetes is localized. It occurs most often in the area of ​​​​the elbows, palms, feet, and also on the genitals. Often a similar symptom is diagnosed in young patients. Another group of patients in whom diabetes mellitus often manifests itself as a burning sensation is women of retirement age. In men, this symptom is less common.

It is worth noting that increased discomfort in diabetes may indicate that the level of glucose in the blood has risen sharply. Therefore, if the desire to itch becomes irresistible, it is urgent to measure the blood sugar.

Kidney

Unpleasant skin manifestations often accompany chronic renal failure. The intensity of itching increases with impaired renal function. In this case, itching can be either generalized or limited to the back and forearms.

depression and psychosis

Psycho-emotional disorders are another common cause of itching. In people with increased lability of the nervous system, exacerbation of skin manifestations can cause the slightest stress.

Itching is often one of the symptoms of a depressive disorder. In this case, you should not delay a visit to the doctor. It has been proven that depression is not just a “disorder” and “bad mood”, but a serious disease that needs treatment. In a depressive disorder, itching is accompanied by frequent mood swings, sleep problems, anxiety, panic attacks, obsessive thoughts.

In depression, itching is generalized. Skin manifestations can be detected at any time, both on the skin and on the mucous membranes.

In psychosis, itching is a common symptom in women over forty years of age. It usually occurs on the scalp. Patients complain of sensations similar to “bug crawling”. Clinicians call this phenomenon “tactile hallucination.”

Oncological diseases

Malignant tumors are the most formidable disease that can manifest itself as itching without rashes. Therefore, people who have a genetic predisposition to oncology should be very careful about all skin manifestations.

In the early stages, cancer is often completely asymptomatic. Itching may be the only sign of malignancy. Medicine knows cases when pruritus appeared five to six years before the discovery of a tumor.

Itching that accompanies tumors can occur with any malignant tumors, but most often occurs with cancer of the pancreas and intestines, as well as the organs of the genitourinary system. The whole body can itch, but in some areas the discomfort is more pronounced. So, local itching can be felt on the front surface of the legs, on the chest and on the inner surface of the thighs. When the tumor is removed, the itching may disappear, but doctors know of cases when the itching persisted when the oncological disease was cured.

Itching in malignant tumors can occur as a result of radiation therapy, symptomatic treatment, and also as a result of the action of toxic products of tumor cell necrosis. Metabolic changes accompanying the tumor process can also manifest themselves in a similar way: dry skin, iron deficiency, etc.

Parasite infestation

About a third of cases of itching without rashes are provoked by helminthic invasion. It is believed that children are more likely to become infected with helminths, but this disease is diagnosed in patients of any age. Worms enter the body from dirty hands, through contaminated water and spoiled food. The burning sensation in this case can be either localized in the anus and genitals, or generalized throughout the body.

Blood diseases

A decrease in the level of iron in the blood and iron deficiency anemia can also be accompanied by itching. As a rule, it occurs in those areas where blood circulation is increased. It can be the chest, genitals, the area of ​​the pelvic organs. In the case of anemia, itching is accompanied by other characteristic symptoms – frequent migraines, dizziness, pallor, change in taste.

Thyroid disease

Generalized itching for a long time may be a manifestation of thyrotoxicosis. As a rule, patients complain of burning sensation who have been diagnosed with diffuse thyrotoxic goiter, which has not been treated for a long time. It is believed that in the case of an endocrine system failure, the cause of itching is more intense blood flow in the skin and an increase in skin temperature.

With hypothyroidism, intense “itching” occurs due to dry skin.

Diseases of the nervous system

Itching caused by neurological diseases is uncommon. One of the causes of neuropathic itching may be postherpetic neuralgia. In this case, burning is accompanied by pain.

Quite often, burning and discomfort are diagnosed at the medial edge of the scapula. This phenomenon is called paresthetic notalgia. This is one of the varieties of peripheral neuropathy.

Short-term, but very intense itching is often recorded in patients with multiple sclerosis. Its duration can be from a few seconds to a couple of minutes.

Itching during pregnancy

Often expectant mothers complain about itching. Skin manifestations during pregnancy are provoked by hormonal changes. This is considered normal, so in the absence of other symptoms, there is no cause for concern.

A number of pregnant women complain of itching on the abdomen, especially in the last trimester. This is provoked by stretching of the skin, because the discomfort will completely disappear only after childbirth, when the stomach returns to its previous size.

The cause of itching in pregnant women is also cholestasis. As a rule, bile begins to flow into the lumen of the duodenum in smaller quantities already in the second or third month of pregnancy. In the later stages, its manifestations become more intense. The exact mechanism of cholestasis in pregnancy has not been established.

Senile (senile) itching

Age-related itching is considered a very common phenomenon. About half of the people who celebrated their seventieth birthday complain of skin manifestations. This is due to a number of reasons, the main of which is the loss of moisture and dryness of the skin, which loses the ability to retain fluid, as well as a decrease in the function of the sweat and sebaceous glands. Senile itching is provoked by changes in the hormonal background, as well as a decrease in the production of elastin and collagen.

In addition, older people are often diagnosed with disorders in the liver and kidneys, as a result of which the blood is not sufficiently cleansed of toxins and allergens. They begin to accumulate in the body, provoking including skin manifestations.

Senile itching is usually characterized by moderate intensity. It does not cause any particular discomfort.

Changing your diet can help reduce discomfort. In particular, it is recommended to add meat, fish, fruits and greens, as well as dairy products to the menu. In addition, the use of cosmetics for especially sensitive skin is recommended.

It should be noted that senile itching is the so-called “diagnosis of exclusion”. In other words, before attributing unpleasant skin manifestations to the age of the patient, the doctor must make sure that there are no pathologies that could cause this symptom.

Itching at night

Some patients complain of itching of unknown etiology, which is felt in the afternoon. As a rule, discomfort overtakes immediately before bedtime or at night. Doctors explain itching at night by the fact that in the evening blood circulation increases due to vasodilation. As a result, the temperature of the skin rises and irritants begin to act on it more strongly. Sleeping in a ventilated cool room will help solve the problem.

Other reasons

Other reasons can provoke itching without the manifestation of rashes and other symptoms.

Aquagenic itch

Doctors consider the so-called aquagenic itching to be a fairly common phenomenon. This is the name given to the tingling and burning sensations that occur after contact of human skin with water.

As a rule, aquagenic itching occurs two to five minutes after taking a shower or bath and lasts from ten minutes to an hour. This condition is chronic and extremely unpleasant for the patient.

So far, specialists have not been able to establish the pathogenesis of aquagenic pruritus. Notably, antihistamines do not relieve this symptom.

Incorrectly selected cosmetics

Often the cause of itching without other symptoms is improperly selected cosmetics. Unpleasant skin manifestations can be caused by products in which the content of flavorings and dyes “rolls over”. Doctors are aware of cases when even flavored toilet paper became the cause of skin irritation, let alone soap, shower gels, shampoos and creams. Therefore, dermatologists recommend choosing fragrance-free products designed for very sensitive skin.

Taking medications

Sometimes itching can be provoked by certain medications. The peculiarity of such skin manifestations is that they can be very intense and are poorly stopped by antihistamines. As a rule, itching can be caused by certain antibiotics, antifungals, and narcotic pain medications. Also, “scratching” can be provoked by drugs containing estrogens and anabolic steroids. In addition, contraceptives in tablet form can be the “culprit” of unpleasant skin sensations.

Diagnosis of itching without rashes

In order for the treatment to be as effective as possible, the root cause of the itching should first be established. The optimal solution for the patient is a visit to a dermatologist. The doctor will conduct a survey, determine which examinations need to be completed, and may also recommend consultations of narrow specialists, for example, an allergist, endocrinologist, oncologist, etc.

The first step is to collect an anamnesis. The specialist will need to obtain detailed information about the following nuances:

1. How did the symptom first appear: acutely or gradually.
2. Is the itching localized or does the patient itch from head to toe?
3. How severe is the symptom.
4. Are there any daily or seasonal fluctuations at what time the sensations are most intense.
5. Is there a relationship between skin manifestations and contact with water.
6. What factors increase discomfort.
7. Is there a connection between the symptom and the patient’s activities, profession, hobbies and lifestyle.
8. Has the patient experienced any traumatic situations recently?
9. What medications is the patient taking?
10. What illnesses did the patient have?

The next stage of diagnosis is a visual examination of the patient and the appointment of medical studies. The specialist will examine the skin, check if there is a “icteric” shade characteristic of hepatitis, a fungus on the nails, and if the color of the sclera of the eyes has changed. The doctor will assess the state of the endocrine system by the presence or absence of tremor of the limbs, a possible violation of thermoregulation. Without fail, the doctor must find out if the lymph nodes are enlarged.

The list of tests your doctor may recommend for you varies. Most often, we are talking about a clinical blood test, a general urinalysis and a biochemical blood test. Also in the list of analyzes there are liver tests, checking the level of glucose and cholesterol, urea, total protein and protein fractions. It is mandatory to check the saturation of red blood cells with iron and the level of iron in the blood.

A chest x-ray, thyroid examination, and fecal parasite analysis are performed.

To exclude certain diseases, the doctor may prescribe a variety of specific studies:

1. Ultrasound and biopsy to rule out liver disease.
2. Biopsy and pyelography to rule out kidney problems.
3. A study of the level of vitamin B12, a biopsy of the lymph nodes, an X-ray of the spine to rule out blood diseases.
4. Ultrasound of the abdominal organs to exclude malignant tumors.
5. Consultation with a psychiatrist to rule out mental problems.

Treating itching without a rash

After the underlying cause of the burning sensation is established, the doctor prescribes treatment. Given the fact that the pathogenesis of a symptom is complex and the causes can be varied, there is no single approach. Therefore, ideally, each patient should have a differentiated and strictly individual approach.

If during the diagnosis it was found that itching is one of the manifestations of diseases of organs and systems, the goal of treatment is to eliminate the pathological condition. In this case, skin manifestations will go away on their own.

If itching is not caused by any specific disease, the main task is to relieve the patient of physical discomfort. To do this, the doctor may recommend a variety of means of external and internal use.

So, the affected areas can be treated with corticosteroid creams, which will get rid of discomfort. Periodically, the skin can be treated with a solution of vinegar. Unpleasant symptoms will help remove powders based on talc.

Also, the patient may be recommended to take antihistamines, which will help get rid of allergic manifestations.

Patients may also be prescribed antidepressants and mild sedatives to help relieve excessive nervousness.

In addition, patients are advised to carefully approach personal hygiene. Moisturize your skin regularly to prevent it from drying out. It is recommended to refuse to include in the diet products that promote vasodilation: spices, strong tea, etc. Room temperature and humidity must be carefully controlled to avoid overheating. It is also necessary to minimize stressful situations and nervous strain.

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