OverviewKey FactsSymptomsTypesCausesRisk factorsDiagnosisPreventionSpecialist to visitTreatmentHome-careComplicationsAlternatives therapiesFAQsReferences
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Dr. Nitika Makhija
MDS, BDS
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Last updated on:
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Itching

Itching

Also known as Pruritus and Scratching

Overview

Itching is an irritating sensation that makes you scratch. It is a common and unpleasant sensation that can range from mild to severe. The most common causes of itching are contact with an allergen, dry skin, sunburn, fungal skin infection, or as a symptom of other underlying health conditions.

Some of the few signs of itching are skin irritation, a strong urge to scratch, skin breaks that open and bleed, and swollen skin. 

 

Treatment varies according to the cause of itching. General steps to treat itching are regular use of moisturizers or emollients, application of cold, wet cloth, and cooling agents like menthol or calamine to the affected area. OTC creams with anti-itch ingredients and mild-strength steroids are also available.

If the symptoms persist, further treatment is based on the cause of the symptoms and the health conditions associated with it.

Key Facts

Usually seen in
  • All age groups, common in the elderly
Gender affected
  • Both men and women. More common in women.
Mimicking Conditions
  • Contact dermatitis
  • Seborrheic dermatitis
  • Drug eruptions
  • Scabies
  • Psoriasis
  • Ectodermal dysplasia
  • Hyper IgE syndrome
  • Netherton's syndrome
  • Wiskott-Aldrich syndrome
Necessary health tests/imaging

1.Laboratory tests

2.Imaging tests 

 

3.Skin biopsy

Treatment

1. General treatment 

  • Moisturizers

  • Cooling agents, such as menthol or calamine. 

  • OTC creams with anti-itch ingredients such as crotamiton.

2. Topical treatment

3. Systemic treatment

Specialists to consult

  • General Physician

  • Dermatologist

Symptoms of Itching 


Itching can affect a small area, such as the scalp, arm, leg, or whole body of the individual. Itchy skin can occur without any noticeable changes on the skin however in some cases, associated symptoms may include: 

  • Skin irritation

  • Strong urge to scratch

  • Dry skin 

  • Pain at the site of itching

  • Skin discoloration              

  • Small bumps on the skin called papules 

  • Skin rash causing swelling or inflammation 

  • Broken skin leading to bleeding 

  • Yellow-to-white fluid leaking from broken skin

Tired of Itching? Explore our widest range of moisturizers and lotions to help ease itchy skin.

Types Of Itching 


1. Pruriceptive itch

The most common type is generated in the skin either by inflammation or skin damage. Many types of age-related changes in the barrier function of the skin can also lead to pruriceptive itch. 

2. Neurogenic and Systemic itch

Neurogenic and systemic itch originate from conditions affecting other organs than the skin. Some of these conditions include chronic kidney failure, liver disease, blood disorders, and cancers. These itches are transmitted via the central nervous system.

3. Psychogenic itch

This type of itching is associated with psychological abnormalities and is considered psychiatric in origin including depression, anxiety, mania, psychosis, and substance abuse have been associated with itch. 

4. Neuropathic itch

It specifically refers to itching that arises from dysfunction or damage to the nervous system, such as nerve injuries, compression, or diseases like neuropathy. 

Causes of Itching 


Itching can be a symptom of many health conditions. It occurs when certain nerve fibers called C-fibers are stimulated. These fibers transmit itch signals to the brain in response to various irritants, allergies, or skin conditions, leading to the sensation of itching. 

The next section explores the different risk factors associated with these causes.

Risk Factors For Itching


1. Age

For individuals above 65 years, the skin becomes thinner and loses moisture, which can lead to itching due to dryness.

2. Skin conditions


3. Fungal infections


4. Autoimmune disorders

5. Nerve disorders

  • Multiple sclerosis
  • Pinched nerves
  • Shingles (herpes zoster) 
  • Brain tumors
  • Brachioradial pruritus (Itching or burning around the outer forearm which is a nerve disorder)

6. Psychiatric conditions

7. Hormonal changes


8. Allergic reactions

  • Reactions from certain things like wool, chemicals, soaps, and cosmetics


9. Other conditions 

  • Chicken Pox
  • Liver disease
  • Kidney disease
  • Anemia
  • Certain cancers like blood cancer, skin cancer, and liver cancer.
  • Diabetes

Learn more about how Diabetes can cause several skin issues and ways to manage them.

10. Certain medications

  • Aspirin
  • Opioids
  • Blood-pressure-reducing drugs like amlodipine, atenolol, and hydrochlorothiazide.
  • Medications used for cancer treatment


11. Bug bites

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Diagnosis Of Itching 


1. History and physical examination

To diagnose itching, the doctor will physically examine the skin and gather more information about the symptoms and the medical health history.

2. Laboratory tests 

The doctor might suggest a few tests to reconfirm the diagnosis. Testing helps in determining the cause of the symptoms, whether it is due to a primary condition or it might be a symptom of another condition. 

Test include are: 

  • Total IgE test: The Total IgE test measures the total amount of immunoglobulin E (IgE) in the blood in response to an allergy.

  • Specific IgE test: Measures the level of IgE being made in the body in response to a single allergen. A separate test is done for each allergen.

  • Allergy panel: This constitutes more than 29 tests that help to identify certain allergens that can trigger a reaction and cause symptoms like itching.

  • Fasting glucose: High blood sugar levels over a prolonged period of time are one cause of itchy skin. Also, it can be used to diagnose underlying causes like diabetes.

  • Blood urea nitrogen (BUN): The BUN test measures the amount of urea nitrogen in the blood. This test is usually advised when a patient is showing signs of kidney disease, such as fatigue, itching, muscle cramps, and dark-colored urine.

  • Thyroid function tests: These tests measure levels of thyroid hormones in the blood. The overproduction or underproduction of thyroid hormones can lead to skin problems, thereby causing itching.

  • Stool analysis: During this test, the stool is analyzed for ova (eggs) and parasites. This is a simple test for determining parasitic infection which can cause itching.

Booking your lab tests just got easier. Get all the tests done in the comfort and safety of your home.

3. Imaging tests 

Chest Computed Tomography (CT) Scan: A CT scan is a diagnostic imaging exam that uses X-ray technology to produce images of the inside of the body. This test can show enlarged lymph nodes. This can help detect any conditions associated with itching.

4. Skin biopsy

This procedure can help in diagnosing skin disorders such as psoriasis, eczema, actinic keratosis (precancers), and warts, that can predispose to itching. It involves taking a small sample of skin and examining it under a microscope.

Prevention Of Itching 

  • Drink 8-10 glasses of water a day to keep the skin supple and hydrated.

  • Use lukewarm water for bathing. Do not exceed the shower time greater than 10 minutes. 

  • Always use gentle and skin-friendly soaps and body washes.

  • Moisturize the skin daily or multiple times a day. Try using an unperfumed moisturizer or emollient.

  • Prefer loose breathable clothing. Avoid wearing tight clothes, especially those made from synthetic fabrics.

  • Apply sunscreen and wear UV-protective clothing and accessories while going out.


Using a sunscreen with SPF of at least 30 helps prevent sunburn, dryness, and allergic reactions, thereby, reducing the risk of itching. Watch the video to choose the right sunscreen.

  • Use laundry liquids or powders that are not harsh for sensitive skin for washing clothes.

  • Use a humidifier to manage the moisture indoors to prevent dry skin.

  • Reduce stress, as stress can initiate itching and make it worse.

Explore our Mental wellness range to deal with stress.

Specialist To Visit


Doctors that can help you diagnose and treat itching include:

  • General Physician

  • Dermatologists

A general physician can diagnose and treat underlying medical conditions that cause itching and provide guidance on symptom management and preventive measures.

A dermatologist can diagnose and treat a wide range of skin conditions causing itching, offering specialized expertise in skin health and prescribing appropriate treatments.

Do not take itching lightly. Seek medical help from our trusted team of doctors.

Treatment Of Itching 

The treatment for itching focuses on managing the cause of itching along with symptomatic relief. 

1. First line of treatment 

  • Apply a cold, wet cloth or ice pack to the skin that itches preferably for 10 minutes till itching subsides. 

  • Creams containing moisturizing ingredients such as ceramides, glycerin, aloe, hyaluronic acid, vitamin E, petrolatum, and humectants can be used.

  • Apply cooling agents, such as menthol or calamine. These can be placed in the refrigerator to achieve a better cooling effect. 

  • OTC creams with anti-itch ingredients such as crotamiton can also provide relief.

  • Mild strength steroid creams are available over-the-counter. They should be used only for a few days for small, inflamed areas. eg. Topical hydrocortisone. 

Explore our wide range of moisturizers and lotions to help ease itchy skin.

In case itching does not subside after the first line of treatment, the following specific treatment is advised depending on the cause of itching:

2. Topical treatment

  • Antifungal creams or dusting powders are recommended for treatment of itching associated with fungal infections. Some common examples of antifungal medicines are:

Shop from our extensive range of antifungal creams and powders to deal with itching and rashes.

  • Topical steroids: Higher-strength steroid creams are prescription only and are to be used only under medical supervision.

  • Local anesthetics: These are used for the symptomatic treatment of localized forms of neuropathic itching, and chronic kidney disease (CKD)-associated itching. Most common examples include:

  • Topical calcineurin Inhibitors: These work by reducing inflammation and suppressing the immune response in the skin, providing relief for conditions like eczema. Examples includes: 

  • Tricyclic antidepressants: These work by blocking certain nerve signals and provide relief for chronic and neuropathic itching. Doxepin 5% cream is commonly used.

  • Capsaicin: It is used for localized areas of chronic itching and neuropathic itching. This cream should be applied regularly to achieve its full effect.

3. Systemic treatment

  • Antidepressants: Antidepressants also called selective serotonin reuptake inhibitors (SSRIs) may help ease some types of long-term itch. A few examples are:
  • Anticonvulsants: These drugs aid in treating neuropathic itch and chronic kidney disease-associated itching. Examples include: 
  • Immunosuppressants: These classes of drugs control or suppress the immune system and help in stopping the itch-scratch cycle that allows the skin to heal and reduce the risk of skin infection. Example of this class:

Get your medications online from India’s largest online pharmacy.

Home-care For Itching 

General tips that help relieve itching and prevent damage caused by scratching are: 

  1. Keep your nails clean, short, and smooth.

  2. Try tapping or patting the itchy area, rather than scratching it.

  3. Hold a cold compress over the affected area to cool it down.

  4. Wear cotton gloves at night to prevent damage from scratching in the sleep.

  5. Avoid alcohol, caffeine, and spicy foods that can affect the blood flow to the skin and worsen itching.

Some home remedies that can help relieve the symptoms include:

1. Oatmeal bath: Oats work wonders for dry, itchy skin and can be used on a variety of skin irritations like eczema and rashes as they help restore the moisture levels of the skin. 

How to use it? 

Grind rolled oats into a thin powder, mix the powder in the bath water, soak the body in it for 15 to 20 minutes and rinse. 

2. Aloe vera (Ghritkumari): Fresh aloe vera gel is useful in treating rashes or itching due to its anti-inflammatory, anti-microbial, anti-viral, and antioxidant properties. 

How to use it? 

Take a fresh aloe leaf, cut open the leaf, scrape out the gel, and gently directly on the affected skin. 

Here is a list of amazing health benefits of aloe vera.


3. Coconut oil (Nariyal Tel): Coconut oil has the natural ability to penetrate the skin quickly. The oil is good for boosting hydration, improving skin elasticity, fighting itch, and reducing the chances of infection from skin conditions.


4. Peppermint oil: It can reduce itching due to its antimicrobial and antiseptic properties.

How to use it? 

Peppermint oil can be used by mixing with a carrier oil like coconut oil and can be applied to the affected areas.


5. Apple cider vinegar (ACV): ACV contains antiseptic properties that can help in soothing itchy skin, especially for people who suffer from psoriasis.

How to use it? 

Dabbing diluted ACV on the affected area can help neutralize the itch while balancing the pH levels of the skin and hence speed up the healing process. 

 

6. Honey (shahad): It is loaded with humectants and anti-microbial and anti-inflammatory properties that can help with providing relief from dry skin and itching. 

How to use it? 

Apply by dipping a cotton ball in the itchy area and leaving it for 10 to 15 minutes. Rinse it with warm water.

Learn more about why honey is so good.


7. Neem: It is one of the most essential herbs used to treat a lot of skin ailments as it is rich in anti-inflammatory and anti-microbial properties that help in soothing itchy skin.

How to use it?

A paste of neem leaves with water can be made by grinding them. Apply the paste on irritated skin. Wash once dried. 

Know more about Neem’s healing powers.

Complications Of Itching 


Chronic pruritus or itching that lasts more than 6 weeks can affect the quality of life and cause the following complications:

  • Thickening and hardening of the skin

  • Redness of the skin

  • Continuous urge to scratch or pick at the skin

  • Deep cuts or tears in the skin

  • Scarring

  • Infections

  • Disturbed sleep

  • Anxiety and depression

Alternative Therapies For Itching

There are several different alternative therapies that can provide relief from itching. However, it is important to consult your doctor before trying anything new. Some of the commonly used therapies for itching include:

1. Light therapy (phototherapy)

This therapy involves exposing the skin to a specific type of light. This can be a good option for people who can't take oral medicines. An individual requires a few phototherapy sessions until the itching is under control.

2. Homeopathy

Studies have shown that homeopathy can be quite effective in managing skin rashes and itching. 

3. Chinese traditional therapy  

Traditional Chinese medicine can be beneficial in managing itching. It uses oral herbal medicine, herbal fumigation, and external washing as some of the ways to address it.

4. Acupuncture

In this therapy, very thin steel needles are inserted into the skin to relieve some health conditions and symptoms. This procedure can reduce the intensity of itching with the inhibition of brain activation. 

5. Behavioral Therapy 

This therapy is also effective in the management of itching from atopic dermatitis. In behavioral therapy, participants learn to intentionally suppress the reflex to scratch through diversion and habit reversal.

Frequently Asked Questions

References

  1. Thurmond RL, Kazerouni K, Chaplan SR, Greenspan AJ. Antihistamines and itch. Handb Exp Pharmacol. 2015. External Link
  2. Garibyan L, Rheingold CG, Lerner EA. Understanding the pathophysiology of itch. Dermatol Ther. 2013 Mar-Apr;26.External Link
  3. Ilnytska O, Kaur S, Chon S, Reynertson KA, Nebus J, Garay M, Mahmood K, Southall MD. Colloidal Oatmeal (Avena Sativa) Improves Skin Barrier Through Multi-Therapy Activity. J Drugs Dermatol. 2016 Jun 1.External Link
  4. Tang Y, Cheng S, Wang J, Jin Y, Yang H, Lin Q, Xu S, Hui L, Yin Q, Yang Y, Wu X. Acupuncture for the Treatment of Itch: Peripheral and Central Mechanisms. Front Neurosci. 2022 Mar 30.External Link
  5. Chee A, Branca L, Jeker F, Vogt DR, Schwegler S, Navarini A, Itin P, Mueller SM. When life is an itch: What harms, helps, and heals from the patients' perspective? Differences and similarities among skin diseases. Dermatol Ther. 2020 Jul.External Link
  6. Nemeth V, Evans J. Eczema. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. External Link
  7. Yosipovitch G, Greaves MW, Schmelz M. Itch. Lancet. 2003 Feb 22;External Link
  8. Tivoli YA, Rubenstein RM. Pruritus: an updated look at an old problem. J Clin Aesthet Dermatol. 2009 Jul;2.External Link
  9. Nowak DA, Yeung J. Diagnosis and treatment of pruritus. Can Fam Physician. 2017 Dec.External Link
  10. Itchy skin. National Health Service. 10 July 2020.External Link
  11. Song J, Xian D, Yang L, Xiong X, Lai R, Zhong J. Pruritus: Progress toward Pathogenesis and Treatment. Biomed Res Int. 2018 Apr 11.External Link
  12. Mahboub M, Aghazadeh Attari AM, Sheikhalipour Z, Mirza Aghazadeh Attari M, Davami B, Amidfar A, Lotfi M. A Comparative Study of the Impacts of Aloe vera Gel and Silver Sulfadiazine Cream 1% on Healing, Itching and Pain of Burn Wounds: A Randomized Clinical Trial. J Caring Sci. 2021 Oct 23.External Link
  13. 10 REASONS YOUR SKIN ITCHES UNCONTROLLABLY AND HOW TO GET RELIEF. American Academy of Dermatology.External Link
  14. Elsaie LT, El Mohsen AM, Ibrahim IM, Mohey-Eddin MH, Elsaie ML. Effectiveness of topical peppermint oil on symptomatic treatment of chronic pruritus. Clin Cosmet Investig Dermatol. 2016 Oct 11.External Link
  15. Luu LA, Flowers RH, Kellams AL, Zeichner S, Preston DC, Zlotoff BJ, Wisniewski JA. Apple cider vinegar soaks [0.5%] as a treatment for atopic dermatitis do not improve skin barrier integrity. Pediatr Dermatol. 2019 Sep.External Link
  16. McLoone P, Oluwadun A, Warnock M, Fyfe L. Honey: A Therapeutic Agent for Disorders of the Skin. Cent Asian J Glob Health. 2016 Aug 4.External Link
  17. Godse, Kiran & Sangolli, Prabhakar & De(2021). Management of Pruritus in Indian Settings.External Link
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