Itching

There can be different types of itches, depending on their appearance and cause. Since itching is mostly a symptom, it can range from mild to severe. The most common types of itchy skin include:

• Rash
  A rash appears like a red patch that may be accompanied by swelling and blisters. A rash may also make the skin appear scaly or crusty. The swelling on the skin can cause slight bleeding as well. Most of the times, the rash occurs due to seasonal allergies or friction caused by the rubbing of the skin against a tight cloth. Rashes can take up to 3-4 days to heal completely, and the itching subsides with time. Depending on the severity, the doctor may provide ointments or lotions to soothe the affected area.
   
• Xerosis
  Xerosis is the medical term for skin that is abnormally dry. Causes include dehydration, extremely dry weather, prolonged exposure to an air-conditioned environment or use of harsh cleansing agents. Itching caused by dry skin is usually treatable by making a few daily lifestyle changes that aim at reviving the moisture content to the skin.
   
• Hives
  Hives, also known as welts, appear as pink and red-colored bumps that itch. They may erupt suddenly and then fade within a few hours. Most doctors believe that hives are a result of a reaction by the immune system, which may be triggered by allergies, medications, or stress. Occasionally, hives may appear suddenly and take weeks to heal on their own.
   
• Fungal Itches
  Fungal infections, such as Athlete’s foot, ringworm, and jock itch, can form patchy and scaly layers on the skin, which tend to itch severely. Such infections are highly contagious and make the skin flaky as well as sore. However, these can be treated with the help of antifungal ointments.

Based on the cause, the types of itch include:

• Pruriceptive Itch
  A pruriceptive itch is triggered by an allergic reaction, skin damage, or dryness. There is swelling in the areas of skin affected. Various skin conditions are associated with this type of itch, including eczema and hives. 
   
• Neurogenic Itch 
  Neurogenic itches are mostly caused due to liver or kidney diseases.
   
• Neuropathic Itch
  A neuropathic itch is accompanied by a sensation of numbness and tingling. The main cause of this itch is damage to the nervous system. It may occur after a stroke or a burn injury.
   
• Psychogenic Itch
  A psychogenic itch is caused due to a reaction of certain hormones in the body. These hormones include serotonin and adrenaline. The hormonal interactions may result in false sensations of itching, which seem real to the person but occur without any real cause.

The sensation of itching is quite common and easily identifiable. It may last for a long time or may subside after some scratching. However, if the cause of itching is related to a health condition, simply scratching the area may not be enough. Itching can be accompanied by:

• Redness
• Inflammation
• Tingling or Burning Sensation
• Appearance of Bumps
• Dry Skin
• Flakes
• Scaly Texture on the Skin
• Skin Peeling
• Blisters

Itching can occur in different areas of the body, such as the arms, scalp, and back, or the genital area.

Causes

There can be several causes of itching. The most common ones include:

• Dry Skin
  Dry skin may lead to itching due to stretching of the skin. This is common in people who do not have an optimum intake of water or tend to use harsh cleansing agents. Dry skin could also be caused due to the harsh weather conditions. An itch caused due to dry skin (xerosis) will be accompanied by slight redness and stretched skin. There are generally no blisters or red areas of skin. 
   
• Nerve Disorders
  Health conditions that affect the nervous symptoms, such as multiple sclerosis, diabetes, and shingles can cause itching.
   
• Allergies
  Allergies to certain chemicals, substances, and environmental agents can lead to itching. Food allergies can also trigger an itch, while contact with skin irritants, which may be present in soaps or air sprays, can lead to itching. Fungal infections can also lead to intense itching.
   
• Drugs and Medications
  Adverse drug interaction in the body caused due to certain antibiotics, antifungal medicines, and painkillers could cause temporary rashes and itching.
   
• Pregnancy
  Pregnant women may sometimes experience itching due to hormonal changes and may specifically experience itching in the abdominal area due to the stretching of the skin. If a woman already suffers from skin conditions, such as eczema or psoriasis, then the itching may worsen during pregnancy.
   
• Skin Conditions
  Dermatitis, psoriasis, scabies, and lice can cause itching in specific areas of the skin. The itching caused due to such skin conditions may result in blisters and redness.
   
• Health Conditions
  Underlying health conditions, such as anemia, kidney failure, thyroid problems, certain cancers, and liver diseases, are associated with itching. Itching caused by these diseases tends to involve the entire body.

Risk Factors

People who already have underlying health conditions, such as diabetes mellitus or kidney issues, are more prone to developing itchy skin as a symptom. Skin conditions, such as psoriasis and dermatitis, are also accompanied by itching.

A crucial aspect in the prevention and management of itching is determining the cause of itching.

Itching caused due to allergic reactions can usually be avoided if one is able to identify the allergen and stay away from it. For example, when there can be pollen in the surroundings during the spring season, someone allergic to pollen must try to stay indoors or avoid going to places where an allergic reaction might get triggered. Some other common allergens or irritants include perfumes, soaps, disinfectants, dust, chlorinated water, and sometimes metals present in jewelry. Allergic reactions caused due to respiratory inflammation can be prevented by wearing a protective mask to avoid getting dirt or dust into the nostrils. Allergic reactions caused due to environmental dust and dirt may lead to itching in the eyes.

Since hands are the first area of contact, it is important to make sure you do not touch something that may lead to itchy arms. Some preventive measures are as follows:

• It is recommended to avoid water that is too hot or too cold. Use water that is lukewarm. Cold water may lead to dryness, and hot water triggers or worsen itching. 
   
• Avoid using strongly fragrant products for cleansing the body or the hands. These products contain artificial perfumes and harsh chemicals, which can irritate the skin.
   
• Moisturize your skin regularly. Make it a habit to apply a mild moisturizer generously all over your skin after stepping out of the shower. If your skin tends to become stretchy and itch, then apply a lightweight moisturizer immediately to soothe the area. You can also try using medicated lotions, which will sooth your irritated skin.
   
• When handling harsh chemicals, such as cleaning detergents, disinfectants, or dyes, make sure you wear protective gloves to avoid coming in direct contact with the chemical.
   
• If you already suffers from dry skin, avoid taking very long baths.
   
• It is recommended to use petroleum jelly or other emollients to lock the moisture into the skin. Applying petroleum jelly will also form a protective barrier on top of the skin and prevent direct contact with other skin irritating substances.
   
• If you suffer from skin conditions, such as eczema or psoriasis, then after taking a shower, it is recommended that they use patting motions to dry your skin. Vigorous rubbing of the skin must be avoided at all costs as the friction can lead to irritation and skin peeling.
   
• Avoid exposure to an air-conditioned environment for prolonged periods. This is because it can dry out the skin and lead to itching.
   
• For allergic reactions and itching triggered by an immune response, the doctor may recommend some oral medications since they can be very effective. Out of all the types of skin itching, the one caused by dry skin is the most preventable. 
   
• To prevent fungal itching, it is important to ensure that the skin remains clean at all times. Avoid wearing clothes that are still damp and not properly dry. Avoid close contact with people having fungal infections. Refrain from sharing their belongings such as combs, towels, bed sheets, hair ties. 

In most cases, the itching disappears by itself within a period of two weeks. However, if the itching it getting more intense or is accompanied by other symptoms, such as bleeding, skin peeling, or excessive inflammation, a visit to the doctor is mandatory. A change in the color of the skin is also a sign that a doctor must be consulted immediately. 

Patch Test
In case the doctor suspects an allergic reaction, which could have caused the itching, you may have to undergo a patch test. The test is performed to simply identify or determine the source of the allergic reaction.

Blood Test
If the doctor suspects the skin itching is being caused by an underlying skin condition then other tests may follow. A blood test can help in determining any internal causes of the itch, such as anemia or cancer.

Ultrasound
An Ultrasound may be carried out by the doctor to verify if the liver, kidney, or thyroid disorders are associated with itching. In some cases, X-rays may also be performed.

After determining the cause of itching, the treatments can be as follows:

• Corticosteroid Creams
  These medicated creams have a soothing and healing effect on the skin. They also prevent dryness and hence help in treating itching skin as well. They usually contain 1% hydrocortisone. A steroid cream must not be used without prescription and consultation with the doctor.
   
• Calcineurin Inhibitors
  These drugs can be used to treat itching in specific areas.
   
• Antidepressants
  Antidepressants have an impact on the hormones in the body and hence help in getting rid of itching. 
   
• Gels
  A simple Aloe vera gel can be recommended as a moisturizer to soothe the irritated skin and heal dry skin as well.
   
• Antihistamines
  Antihistamine medications (usually meant to be taken orally) are very helpful in curbing allergic reactions. They prevent inflammation and hence prevent itching as well.
   
• Light Therapy
  Light therapy makes use of UV rays of a well-determined wavelength to get the skin itching under control. It is also known as phototherapy and requires multiple sessions to provide long-term benefits. 
   
• Treatment of Underlying Health Conditions
  Treatment of health conditions related to the kidneys and liver or the blood sugar level can help in bringing the itching under control. The treatment of the diseases eliminates its symptoms as well.

Lifestyle modification

Some lifestyle changes can prove to be very helpful in managing itchy skin:

• Avoid agents or substances which lead to itching of the skin.
• Apply medicated lotions on the irritated area. They are easily available in the pharmacies and these lotions quite helpful in soothing dry and irritated skin.
• Avoid scratching the affected area. If it is a fungal infection, then itching can damage the skin and may also lead to spread of the infection to the other areas of the skin. Scratching can also transfer germs from the nails to the irritated skin and lead to further inflammation.
• Reduce stress levels. An increased stress level can trigger the immune system and lead to itching or other allergic responses.

Prognosis

Itching is a very common health problem and usually subsides on its own. Most of the times it does not indicate any serious underlying cause. The first step that can be taken after experiencing the symptoms is to make sure that the surroundings are clean and that the affected skin is clean. This will ensure that environmental pollution or dust is not irritating the skin anymore.

Hygiene is an extremely important factor when it comes to keeping the itching under control. It can not only prevent fungal infections but help in better treatment as well. Hence, it is extremely important to keep clothes and bed sheets free from fungal spores. 

Sometimes, itching can be caused by mosquito bites and bite from other tiny insects. This can be avoided by the generous use of protective ointments that help in keeping mosquitoes away. 

Complications

There are no serious complications of itching. However, if itching is related to an underlying health condition, it is important to treat the underlying cause. Hence, it is important to get yourself tested if the symptoms do not go away within two weeks. Excessive itching and scratching may lead to broken skin and bleeding making it prone to infections. 

Itching, also medically known as pruritus, refers to the uncomfortable sensation, leading to the urge to scratch and rub the affected area of the skin. There can be several causes of itching. However, the most common cause is dry skin. A dry and flaky skin may itch and cause a burning sensation due to the friction caused while itching. Depending upon the cause of the itch, one may experience other effects, such as redness, blisters, rash, and sometimes bleeding (mostly due to excessive and abrasive scratching). In some people, persistent itching may be associated with an underlying health condition, such as skin disease, psoriasis, pregnancy, and very rarely, cancer. It has been noted that people with various health problems such as diabetes, allergies, and asthma, tend to experience more itching. Elderly people are also more prone to developing an itchy skin since the skin tends to lose its natural moisture with progressing age. 

Some home remedies have also been proven helpful in treating itchy skin.

The safest home remedy is the application of a cold Aloe vera gel. The gel not only soothes the skin but hydrates it as well. Aloe vera gel prevents the skin from getting dry.

Neem oil and tea tree oil can be helpful in getting rid of the itching caused due to fungal infections. These oils have antibacterial and antifungal properties and can hence eliminate the fungal infection. Simply dilute half a teaspoon of these oils with one-fourth cup of water and wash the affected area with it.

It is important to remember that home remedies are not a permanent solution. In case the itching does not subside or worsens over the next couple of days, it is best to consult a doctor.