Your Health   -   A to Z of Common Medical Conditions

Itching (Pruritis)

Description - Itching is extremely common. Anybody, in normal health, can "have an itch". Most constant itching is a very common symptom of skin disease and itching is often found in the elderly, simply as a result of ageing of the skin. Psychological causes for itching are very common particularly if people think they are in the presence of infestation or infection - tell a crowd of people that there are fleas in the room and they will soon all begin to scratch. This is, in itself, a problem. People with an itch, for whatever reason, scratch, the scratching irritates the skin, the itch gets worse, more scratching, and so on. Amongst illnesses that can cause itching are diabetes and thyroid problems, liver and kidney failure, gall bladder problems, blood complaints and malignant disease. Infestation by filaria and hookworm cause itching. Itching of the external female genitalia (pruritis vulvae) and around the anus (pruritis ani) is common. They are often the result of other conditions such as vaginal discharge (see Vaginal discharge) and, mostly in children, thread worm infection. Of the dermatological conditions, eczema/dermatitis and lichen planus are, probably, the commonest causes. Prickly heat (see Prickly heat) can cause acute itching as can insect infestation - scabies, fleas, mites, mosquitoes. Allergic rashes can be very itchy, so can fungal infection. The itching of the elderly is usually the result of drying up of the skin. Healing wounds etc. itch - "it's itchy, it must be getting better".

Management - The cause for a chronic itch has to be established. Itching in the elderly often shows no external signs except for localised scratch marks. Advising the elderly not to have baths or showers that are too hot often helps, as does the generous use of emollients that soften and moisten the skin. Emollients will help in all skin conditions where the irritation is associated with dryness. As with all itching, sedative antihistamines can help, particularly if given at night. Milder corticosteroid creams, such as hydrocortisone 1%, are often useful. If an itch is chronic and worrying, medical advice should be sought and the doctor may need to carry out some investigations such as blood tests, urine tests and skin scrapings. If there is a known dermatological condition efforts will be made to reduce itching as it can reach a very distressing level leading to sleep loss and exhaustion.

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