Itching (Pruritus)

From time to time, everyone develops an itching sensation, which prompts an instinctive desire to scratch. Most itches are caused by localized skin conditions, that range from insect bites or dry skin, to allergic reactions or rashes resulting from chickenpox, athlete's foot, and other infectious diseases. A maddening and persistent itch characterizes some skin disorders, especially eczema, and stress can either produce or aggravate it.

Diagnostic Studies and Procedures

The presence of an itch is readily apparent, but tracking down the cause often requires some medical detective work, such as a review of recent activities. If there is no evidence of dry skin, a rash, or another type of skin lesion, a doctor may order blood and urine studies to identify an underlying cause.

Medical Treatments

Simply eliminating an underlying disorder usually solves the problem. In the meantime, a cortisone cream or topical antihistamiae / antipruretic (anti-itching) product may be advised, depending upon the reason for the itching. For example, cortisone eases itching from insect bites and allergies but should not be used for fungal infections.

If itching is interfering with sleep, an oral antihistamine, such as astemizole (Hismanal), may be prescribed. For severe, chronic itching, a tranquilizer, such as hydroxyzine (Atarax), may provide relief.

Alternative Therapies

Numerous alternative remedies can alleviate itching; they include:

Biofeedback Training. This approach may be advised for chronic itching that does not appear to be caused by an underlying disease.

Herbal Medicine. Creams or lotions containing aloe vera can stop itching brought on by dry skin. For itching eczema, try duckweed applied as an ointment or cream or in oil form added to bathwater. Herbalists also recommend urtica dioica (stinging nettle) capsules for localized itching. Chinese herbalists advocate pueraria (arrow root vine) for generalized itching.

Hydrotherapy. Topical poultices or bath additives can often ease itching. Try adding cornstarch, baking soda, or colloidal oatmeal to bathwater. Alternating cold and hot water sprays may also bring relief. Be aware, however, that too much bathing can aggravate dry skin, especially in winter.

Meditation and Visualization. These and other relaxation techniques, including self-hypnosis, may help prevent itching related to stress.

Nutrition Therapy. Food allergies and sensitivities provoke hives and itching in many people. If itching appears to be related to your diet, keep a food diary to help identify likely culprits. Then eliminate these foods for two or three weeks to see if the itching abates. Return the foods, one at a time, should itching recur, avoid that food.

Self-Treatment

Scratching results in an "itch-scratching" cycle that intensifies the itching and can lead to an infection. Try a counter-irritant ointment instead.

When bathing, wash with warm, rather than hot, water. Choose a soap formulated for dry skin, avoiding deodorant soaps and others that may contain harsh chemicals. After bathing, pat your skin dry, don't rub it. Before you are totally dry, apply a moisturizing lotion containing lactic acid or 10 percent urea to your whole body.

Should you develop itchy skin when you are wearing a new garment or one that has just been washed, you may be reacting to the fabric or to chemicals in the detergent. Try washing the garment in a mild soap. If it still provokes itching, suspect the material itself.

Other Causes of Itching

Generalized itching can stem from an obstruction of the bile ducts, jaundice, thyroid disease, uremia, lymphoma, leukemia, or polycythemia, a blood disorder in which the body produces too many red blood cells. Pregnancy is occasionally associated with itching. Some drugs also cause itching.