Pruritus: Causes, Symptoms, Diagnosis, Treatment and Complications

Pruritus is a skin condition in which you want to scratch your skin due to its intense itching. As people age, their skin tends to become drier, which greatly contributes to itchy skin.

Your skin may appear normal, strange, irritated, rough, or bumpy, depending on what is making you scratch. Scratching frequently could result in larger, elevated skin areas that could bleed or get infected.

Activities that promote self-care include moisturizing, using mild cleansers, and taking brief baths. You must find and address the source of your itchy skin for long-lasting relief. Treatments that are frequently used include medicated lotions, wet dressings, and oral anti-itch medications.

Causes Of Pruritus

The following list of factors can result in itchy skin:

• Skin problems. Examples include xerosis, dermatitis, psoriasis, scabies, parasites, burns, scars, insect bites, and hives.
• Internal diseases. Whole-body itching could be a sign of an underlying condition such as liver disease, renal disease, anemia, diabetes, thyroid issues, or even some malignancies.
• Psychiatric disorders. Anxiety, OCD, and sadness are a few examples.
• Allergies and irritation. Wool, chemicals, detergents, and other items can irritate the skin and result in rashes and irritation. An allergic reaction can occasionally be brought on by a chemical, such as cosmetics or poison ivy. Additionally, adverse reactions to several medications, including those used to alleviate pain (opioids), can result in itchy skin.

Symptoms Of Pruritus

Small patches of skin, such as the scalp, arm, or leg, can become itchy. The entire body could also be covered. Itchy skin might develop even in the absence of other obvious skin changes. It could also include:

• Skin inflammation
• Scratch patterns
• Bumps, blemishes, or blisters
• Cracked, parched skin
• Patches with leather or scales

Sometimes the itching is severe and lasts for a long time. The region becomes itchier as you rub or scratch it. And the more you scratch, the itchier it is. It can be difficult to control this itch cycle.

Diagnosis Of Pruritus

Beginning with a physical examination and inquiries about your medical history, the cause of your itching skin might be identified. You might undergo tests, such as the following ones if your doctor suspects a medical problem is responsible for your itchy skin:

• Blood test. A complete blood count can show whether anemia, for example, is the fundamental problem causing the itch.
• Tests for the kidneys and liver's function. Itching can be brought on by liver, renal, and thyroid diseases, including hyperthyroidism.
• A chest X-ray. If you have swollen lymph nodes, which can be associated with itchy skin, a chest X-ray can reveal this.

Treatment Of Pruritus

The goal of treating itchy skin is to eliminate its root cause. In the event that over-the-counter medications and other treatments don't help you manage your symptoms, consult with your doctor. It can be difficult to control itchy skin symptoms, and long-term therapy may be necessary. Options include

• Ointments and creams containing corticosteroids. Your medical professional can advise using a medicated lotion or ointment on the affected regions of your skin if it is irritated and a sensation of itching is present. Then you can use a wet cotton cloth to cover the affected skin. In addition to cooling the skin, moisture helps in the cream's absorption.
• Your doctor may advise following this bedtime regimen if you have chronic or severe itching: Apply triamcinolone after taking a 20-minute bath in lukewarm water only. Apply 025% to 0.1% of an ointment onto wet skin. As a result, the drug can absorb moisture more easily. . For several evenings, repeat this ritual before you go to sleep.
• Additional creams and ointments. You can also use calcineurin inhibitors on your skin, such as tacrolimus (Protopic) and pimecrolimus (Elidel). Alternately, topical anesthetics, capsaicin cream, or doxepin cream might provide some comfort.
• Oral medication. Selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants, may be useful in reducing some types of chronic itching. Examples of SSRIs include sertraline and fluoxetine.
• Tricyclic antidepressants, such as Doxepin, are an alternative. Some of these medications may not start to really benefit you for 8 to 12 weeks after starting treatment.
• (Phototherapy) Light therapy. Your skin will be exposed to a specific type of light during phototherapy. For some people who cannot take oral medications, this may be a useful alternative. A few phototherapy sessions will probably be required before the itching is under control.

Complications Of Pruritus

Your quality of life may be impacted by severe itching that persists for longer than six weeks and it is known as chronic pruritus. Sleep disruption, anxiety, or despair could result from it. Scratching and itching over an extended period of time can make the itch worse and raise the risk of skin damage, infection, and scarring.

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