What Is Pruritus?
Pruritus (pruritus meaning itchy skin) is a skin condition resulting in an itch that needs to be scratched. This symptom can occur on its own or may result from another condition. In many cases, dry skin is the primary cause of pruritus, though skin diseases, other systemic conditions, pregnancy, medications, or contact irritation can likewise cause pruritus. In rare cases, pruritus can result from cancer. Pruritus is considered a chronic condition if the itching sensation endures for more than six weeks. Itchy skin can cause discomfort and frustration, resulting in disturbed sleep, anxiety, and other psychological conditions in severe cases. Scratching the skin can cause a significant amount of damage to the skin and reduce its ability to effectively protect the body from foreign invaders, such as bacteria and other contaminants.
What Causes Itchy Skin?
There are four main types of pruritus causes, including pruritic skin conditions, systemic diseases, nerve disorders, and psychological conditions. Another cause of pruritus is skin irritation caused by exposure of the skin to an irritating substance or environmental conditions.
Pruritic Skin Diseases
There are several different skin conditions that commonly cause pruritus, including the following skin conditions. Additionally, skin disorders causing itchy skin may include allergies, advanced age, excessive exposure to sunlight, pregnancy, insect bites, insect infestations, and taking certain medications.
- Lichen planus
- Bullous pemphigoid
- Lice
- Scabies
- Miliaria
- Sunburn
- Pityriasis rosea
- Mycosis fungoides
Systemic Diseases
Pruritus in systemic conditions is generalized, meaning it can occur all over the body and is commonly seen in people with conditions such as chronic renal failure and kidney disease. In diseases in the liver, gallbladder, or biliary tract, cholestatic pruritus can occur. Systemic infections, like HIV and chickenpox, can likewise result in widespread pruritus. Additionally, thyroid gland disorders, such as hypothyroidism and hyperthyroidism, and certain blood-related disorders, such as anemia, can lead to pruritus. Certain types of cancer, such as Hodgkin lymphoma and polycythemia vera, can also develop itchy skin.
Nerve Disorders
Specific nerve disorders can lead to tingling and sensations of itchiness, which may also cause of pruritus. Another cause of nerve-related pruritus is herpes zoster (shingles), which results from the reactivation of the dormant varicella-zoster virus, which causes chickenpox. Pruritus is also commonly seen in people with multiple sclerosis, or MS, an immune condition that causes the protective covering of the nerves to break down. Additionally, it can likewise occur in people with diabetes mellitus as a result of diabetic neuropathy, which is a disorder of the peripheral nerves.
Psychological Conditions
Psychogenic pruritus or somatoform pruritus is pruritus that occurs as a result of psychological conditions. Psychological conditions which may trigger pruritus include substance use disorders and obsessive-compulsive disorder (OCD). Some individuals may experience delusional parasitosis, in which the person believes their skin is infested with parasites, worms, bugs, or insects, despite the fact that there is no actual infestation on their skin.
Symptoms Of Pruritus
In addition to an itching sensation on the skin, pruritus symptoms may include redness, bumps, lesions, blisters, dry skin, cracked skin, leathery skin, scratch marks, and scaly skin patches. Dry and irritated skin is more likely to become infected. Should the skin become infected, it will become red, warm, and swollen and may ooze fluid or pus.
This type of infection may require you to take antibiotics to get rid of it. Severe itching or pain, specifically in older adults, may be caused by a severe medical issue. Call your dermatologist or general provider if you are an older adult with severe itching or pain that does not have an obvious source and does not improve within two weeks. Contact Advanced Dermatology and Skin Cancer Center today.
Who Gets Pruritus?
Anyone can get pruritus. Certain groups of people, however, are more susceptible to pruritus, including the following groups.
- Elderly adults
- People with seasonal allergies or hay fever
- People with asthma and eczema
- People with diabetes, HIV, and AIDS
- People with various types of cancer
- Pregnant individuals
- Patients with kidney failure or dialysis
How Is Pruritus Diagnosed?
During your appointment with our dermatologist, your doctor will likely examine your skin, including the affected area of the body. If your itching has been severe, you might have visible scratch marks or red skin. Your doctor may ask you questions regarding when the itching began, any changes to your hygiene productions, any other symptoms experienced with the itching, any new medications, and whether or not you touched something specific, such as a plant or a new pet, which is a likely cause if the itchiness is confined to one area of the body. Tests may be performed to determine the cause of the itching. The itching may be the primary issue, or it might be a symptom of another condition. Your dermatologist may suggest allergy tests, blood tests, imaging tests, and skin biopsy. For more information, please contact Advanced Dermatology and Skin Cancer Center to book an appointment.
Pruritus Treatment
In most cases, the cause and severity of the itching determine the course of pruritus treatment. Pruritus skin treatments typically focus on removing the cause of the itch. If home remedies do not ease the itchy skin, your dermatologist may recommend prescription medications or other treatments. Controlling your pruritus symptoms can be challenging and may require additional or long-term therapy. Treatment options may include the following.
Corticosteroids
If your skin is itchy, red, and irritated, your dermatologist may recommend applying a medicated topical medication, such as a cream or an ointment, to the affected area. Then use a damp cotton material to cover the treated skin. Moistening the cotton material before applying it to the skin can help the skin absorb the medication.
Creams & Ointments
Other topical treatments that may be prescribed include calcineurin inhibitors, such as tacrolimus and pimecrolimus. Alternatively, you might relieve your symptoms by using topical anesthetic medications, as provided and directed by your practitioner.
Oral Medications
Certain antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants, may be useful in easing some chronic itch from pruritus. These drugs may require some time to take effect and relieve your symptoms.
Phototherapy
Light therapy, or phototherapy, involves exposing the skin to a specific type of light, which may benefit for individuals unable to take oral medications. You will likely need multiple phototherapy sessions until your symptoms are under control.
When To Contact Your Dermatologist
You should contact your healthcare provider if you have itchiness that lasts longer than two weeks; the itchiness causes sleep difficulties; the recommended suggestions prove ineffective; you scratch your skin significantly; and if the scratches become infected. Signs of infection include red or swollen skin, pus in the area, or a fever. Additionally, you should contact your dermatologist or provider if you develop new symptoms, such as weight loss, weight gain, changes in normal bodily functions, fatigue, or mood changes.
Complications Of Pruritus
Severe itchy skin or itching lasting for more than six weeks, also referred to as chronic pruritus, can affect your quality of life. The itching can interrupt your sleep or cause you to experience anxiety or depression, among other issues. Prolonged itching and scratching can increase the intensity of the itching sensation, possibly resulting in skin injuries, skin infections, and scarring. Contact us for more information about possible complications of pruritus.
How Can I Prevent Pruritus?
While not every case of pruritus can be prevented, practicing healthy skincare habits can help you avoid developing pruritus. Eating a healthy diet and protecting your skin from harm and excessive damage can help you avoid skin itchiness. Drinking plenty of water, moisturizing regularly to help prevent dry skin, using cool-to-warm water for washing your skin, and applying adequate sunscreen every day are also good habits for your skin. If you know what causes your skin to itch, you may be able to avoid pruritus by, for example, taking allergy medication regularly if allergies cause it.
You might have to avoid spending extended periods outdoors or other activities that trigger pruritus. If you have diabetes and experience pruritus, it may indicate that you are not effectively controlling your blood sugar levels. As such, you should follow your practitioner's directions for taking medications, exercising, eating a healthy diet, and caring for your skin. For individuals who develop pruritus while pregnant, the condition will likely dissipate once the baby is born.