Pruritus is a medical term meaning itching of the skin. It is widespread and can have many causes. What are the factors that cause itchiness? How can it be treated?
What is pruritus?
In medical terms, pruritus (from the Latin pruritus) includes all itching of the skin, regardless of its location on the patient’s body. This symptom does not involve pain but leads to scratching the skin and possible skin lesions. Its causes range from viral infection (herpes) to skin irritation, such as eczema, to a simple mosquito bite. However, these disorders split into two categories: related to a skin lesion or a disease.
In the case of pruritus, the more or less acute symptoms begin with the same picture in the patients: It is initially an unpleasant sensation of itching, associated or not with a feeling of tightness. The itching may be local or generalized (i.e. occurring over the entire body), sometimes in patches.
The sensation of needing to scratch arises from the stimulation of specific receptors. Transmitted by the nerve impulse, it sends information about the itching through certain neuromediators: histamine, serotonin, and prostaglandin. These activate the brain’s sensory, emotional, and motor areas, triggering the need to scratch in the patient. Hence the vicious circle of “itch-scratch”, causes scratching skin lesions, making pruritus and itching worse.
What causes itchiness?
The causes of pruritus can be diverse and of varying severity. A skin and medical examination may be necessary to determine the origin of pruritus in the patient.
This condition can be associated with different situations, for example, related to a local problem on the skin:
- An infection: viral (herpes, shingles, chickenpox…), mycotic, or bacterial (impetigo) that creates a skin reaction;
- Skin sensitivity or inflammation: eczema, psoriasis, urticaria, lichen planus, dry skin, atopic dermatitis… ;
- Irritation due to the environment: allergies to certain materials and products (cosmetic substances, metals, textiles, food, or medication), irritation due to heat or humidity can create dryness or mycosis;
- Allergic reactions to insects, parasites, or plants such as mosquitoes, fleas, bees, wasps, lice, or nettles.
In other cases, it will be a health problem’s symptom and help to point to internal diseases: liver disease (hepatic cholestasis), renal failure, diabetes, blood cancer, and thyroid disease can also induce skin dryness, lesions, or itching.
Finally, it can be a neurological disease: in this case, the skin receptors are stimulated by stress. We can evoke depression, anxiety, and obsessive-compulsive disorders (OCD).
What are the factors promoting pruritus?
- Stress. Whatever the cause, stress will increase receptors’ stimulation and lead to more scratching, and more important skin lesions. In case of stress is observed as aggravating the skin condition, the doctor can prescribe antidepressants in low doses.
- The dryness of the skin is also a factor favoring pruritus and its aggravation. Dry skin is also a factor that favors pruritus and its aggravation. We must be aware of what favors the stimulation of the receptors, and act accordingly.
In case of problematic itching, the dermatologist also proposes solutions to learn how to quickly attenuate the stimulation of these receptors:
- Prefer loose-fitting cotton clothes to tight-fitting synthetic ones, for example;
- Limit yourself to one shower a day, moisturizing your skin carefully afterward;
- Rinse the skin with cold water, especially the itching area in case of scratching;
Massaging the skin, with suitable vegetable oil or moisturizing cream, a substance tolerated by the skin. The objective is to divert attention from scratching, to allow time for the pH of the skin to regulate itself, and for the sensation of itching to gradually fade away.
Pruritus: what treatment to adopt?
Pruritus is a symptom, so the doctor will first consider a treatment targeting the symptom’s cause, then reduce the aggravating factors as much as possible until the itching is reduced. The medication prescribed will depend on the origin of the pruritus.
For example, for pruritus due to an allergy, treatment involves antihistamines. A virus-induced pruritus is treated with antiviral medication. Pruritus linked to a parasite is treated with antiparasitic. An antifungal cream is helpful against mycosis. When the cause of the dermatitis is treated, the inflammation will subside, and the scratching will gradually disappear.
Finally, in the case of pruritus and itchy skin, whether occasional or chronic, emollient care against the leading cause can be added to the treatment to moisturize the skin.
As mentioned above, and as far as possible, the treatment of skin disorders can also induce limited stress, which is one of the main aggravating factors of pruritus. Relaxation, yoga, and massage are options for diverting attention from skin sensations and achieving lasting relaxation. In short, learning to take care of yourself in many different ways is as good for your morale as it is for your skin.