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Pruritus is a medical condition of an itchy skin. This is an uncomfortable feeling of itchiness that forces you to scratch in an attempt to relieve it. Pruritus may be uncomfortable or irritating, and it may only affect a single area of your body or multiple locations. Because aging tends to make skin drier, pruritus is frequently caused by dry skin and is typical in older persons.
Whether your skin appears normal or if it is inflamed, rough, or covered in bumps will depend on what is causing your itching. Scratching too often can result in thick, elevated patches of skin that might bleed or get infected.
According to the cause of pruritus and the area of your body where it occurs, there are several types of pruritus. Among the pruritus types that are most common are:
- Brachioradial pruritus: Upper arm itching due to injury to the nerves.
- Nocturnal pruritus: There are a number of reasons why you could experience nighttime itching, such as an adverse reaction to a medication, contact with a skin irritant, or your body’s normal processes.
- Pruritus ani: Skin irritants, infections, or hemorrhoids can all cause this itching around your anus.
- Uremic pruritus: Dialysis patients with renal dysfunction sometimes experience itching as a symptom.
Symptoms
Itching is the primary symptom of pruritus. An itchy feeling is one that makes you want to scratch your skin in order to relieve the discomfort. Skin itching can manifest in localized areas, like the scalp, an arm, or a leg, or it can encompass the entire body. It is possible for skin to become itchy in the absence of other obvious skin changes, or it may include the following
- Skin inflammation.
- Scratch marks
- Dry or cracked skin
- Leathery or scaly patches
- Bumps, spots or blisters
- Localized pain at the itchy skin.
- A yellow to white fluid oozes from broken skin, which also doesn’t heal and may have crusty or scaly texture (infection).
- Itching can occasionally be severe and long-lasting. The region becomes itchier as you rub or scratch it. Additionally, scratching can exacerbate the itch. Breaking this scratch-itch cycle can be challenging.
If you experience itching that persists beyond two weeks despite self-care efforts, severe itching that disrupts your daily life or sleep, sudden unexplained itching, itching all over your body, or if itching is accompanied by other concerning symptoms such as weight loss, fever, or night sweats, it’s important to seek medical attention from a healthcare provider or dermatologist.
If the problem persists after three months of treatment, it’s advisable to see a dermatologist to get checked for skin disease.
Causes
There are situations where the cause of the itching is unknown. The following causes of pruritus includes:
- Skin conditions: Pruritus could result to inflammation or swelling within the body. Examples include dermatitis (dry skin), psoriasis, scabies, burns, scars, insect bites, and hives.
- Internal diseases: A condition such as liver disease, renal disease, anemia, diabetes, thyroid issues, and some tumors may be the cause of pruritus throughout the entire body. Among other things, this could involve hormone shifts or age–related natural changes to your body.
- Nerve disorders: Itching is a result of nerve injury or disorders of the nervous system. Herpes zoster, pinched nerves, and multiple sclerosis are a few examples.
- Psychiatric conditions: Itching is an indication of mental health issues or disorders of the nervous system. Depressive disorders, anxiety disorders, and OCD are a few examples.
- Irritation and allergic reactions: Among other things, wool, chemicals, and soaps can irritate the skin and result in rashes and itching. A material, like cosmetics or poison ivy, might occasionally trigger an allergic reaction. Itchy skin can also result from drug reactions to certain medications, such as opioid drugs used to alleviate pain.
- Environmental: Itching is caused by an irritation in the surrounding area. Clothing materials, insect bites, medicine reactions, temperature changes, or painful objects could all be examples of this.
Risk factors
Everyone will experience pruritus at some point in their lives. Everybody experiences the severity and frequency differently. Pruritus may be more likely to strike if you:
- People who are at the age of 65 years older.
- Experience itching due to an underlying medical problem, such as dermatitis, thyroid illness, anemia
- Those who are undergoing dialysis.
- Pregnant women.
Diagnosis
The following will assist the healthcare provider to properly diagnose pruritus.
- Physical examination: A thorough physical examination and discussion of your medical history are the initial steps in determining the cause of pruritus. If your healthcare provider suspects a medical issue as the cause of your itchy skin, confirmatory tests may be recommended.
- Blood test: A complete blood count may reveal signs of an underlying condition, such as anemia, which could be contributing to your itching.
- Liver and kidney function tests: Itching can be a symptom of thyroid issues such as hyperthyroidism, as well as liver or kidney problems.
- Imaging tests: If you have itchy skin and enlarged lymph nodes, a chest X-ray can help identify any underlying conditions.
- Skin biopsy: A skin biopsy may be performed to determine the specific skin problems causing the itchiness. During this procedure, a small sample of skin is taken and examined under a microscope.
Treatment
Each person’s experience with itching (pruritus) is unique, and treatment approaches differ based on the underlying cause of your symptoms. The primary aim of treatment is to address the cause of the itching. Your healthcare provider may recommend prescription medications or alternative therapies if home remedies fail to provide relief. Managing itchy skin symptoms can be challenging and may require ongoing treatment.
- Corticosteroid creams and ointments: Your healthcare provider might recommend applying a medicated cream or ointment to areas of your skin that are itchy and swollen. Following that, you could cover the treated area with a damp cotton cloth. Moisture helps to cool the skin and enhances the absorption of the cream.
Your healthcare provider may recommend the following nighttime regimen if you experience severe or persistent itching. After 20 minutes of simple, lukewarm bathing, apply triamcinolone. over damp skin. This helps the medication absorb by retaining moisture. So put on your pajamas. For several evenings, repeat this process before going to bed.
- Other creams and ointments: Additional skin treatments include calcineurin inhibitors like pimecrolimus (Elidel) and tacrolimus (Protopic). Alternatively, topical anesthetics, capsaicin cream, or doxepin cream might provide some comfort.
- Oral medicines: Your healthcare provider may recommend various medications to alleviate pruritus, which could include antihistamines, oral steroids, and immunosuppressant drugs like cyclosporine A.
Selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants, may be useful in treating some chronic itching conditions. Sertraline (Zoloft) and fluoxetine (Prozac) are two SSRI examples. Tricyclic antidepressants, such doxepin, are an additional choice. Some of these medications may not start to take effect for 8 to 12 weeks after treatment begins.
- Light therapy (phototherapy): Phototherapy is the application of a particular kind of light to the skin. For some who are unable to take oral medications, this may be a useful alternative. It is probable that several phototherapy sessions will be required until the irritation subsides.
