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Pruritus

Over the course of our lives, almost everyone will experience pruritus – the itchy, irritating sensation that makes us want to scratch.
Pruritus tends to get worse when the skin is dry, so many people find that environmental factors may play a role – for example, during the winter months, when the heating is on. As the skin naturally becomes drier with age, people who are older may find that their skin is itchier than usual, even if they previously did not notice any dryness.

Many people can soothe their itching skin, either by using widely available products that help to moisturise the skin; switching their cleansing routines to include more gentle cleansers; and bathing with lukewarm, not hot, water. If pruritus is chronic, it may require the expert help of a doctor or pharmacist.

Pruritus

Even if there isn’t an underlying condition causing the pruritus, in many cases it can be treated with medicated lotions, moist dressings and oral anti-itch medicines.

Some options may be available over-the-counter, but if pruritus persists or worsens, it should be assessed by a doctor.

Symptoms of Pruritus

Pruritus can appear anywhere on the body, whether it is a small, localised site; a wider area (such as an arm or leg); or widespread, occurring all over the body.

The skin can be itchy without any other visible change, or it may be itchy and present with one or more of the following:

  • Redness
  • Bumps, spots or blisters
  • Dry, cracked or scaly skin
  • Leathery or ‘thick’ skin

Pruritus can vary in intensity and may get better or worse depending on environmental, or other, factors.

Causes of Pruritus

There are many possible causes for pruritus, but additional symptoms – like a rash, or visible swelling – may be helpful in determining the cause.

While some pruritus may be the skin’s reaction to an allergen or to heat, such as urticaria other itchiness may be due to chronic skin conditions, like eczema or psoriasis. Certain fungal skin infections can cause itching, such as ringworm or athlete’s foot. Pruritus may occur as a result of parasites or microscopic insects living on the skin, like scabies, head lice or pubic lice. Chronic skin conditions, fungal infections and parasites all require treatment, and the latter two can be communicable – meaning if they are not treated effectively, they can spread to other people.

Some women may experience pruritus as part of the hormonal changes during pregnancy or after the menopause. In most cases, this will resolve on its own.

Itchiness may also develop as part of psychological or emotional factors, like stress; or it can present as a manifestation of a chronic or acute mental health issue, like a panic attack, anxiety disorders or OCD.

It can also be difficult to stop scratching an itch, since scratching may offer temporary relief – but pruritus can actually become more aggravated when it is scratched.

In some rare cases, pruritus can indicate a more serious underlying condition that affects the nervous system, such as multiple sclerosis, diabetes, and shingles; or disease, such as thyroid, liver or kidney problems.

Some other factors that may contribute to pruritus include:

Fragrance
Whether a perfume, cologne, or an additive in washing powder, synthetic fragrance is known to irritate the skin, and may contain chemicals that can be allergens.
Hair Products and Cosmetics
As with fragrances, chemicals in cosmetic products for the face, body and hair can irritate skin. Additionally, certain products contain sulfates and synthetic colours which are not suitable for everyone.
Tight Clothing
Any material that rubs against skin, or traps sweat and other bacteria increases the risk of developing, or worsening pruritus. Additionally, many synthetic materials can cause itching.
Spicy Food
Some people find that eating spice can cause them to feel itchy, and it can bring on other conditions.
Hot Baths
Hot water dries out the skin, making it more prone to pruritus; but the heat may also trigger other skin conditions, so it is wise to avoid bathing in water that is too hot, or spending too much time in the bath.

Treatment for Pruritus at Derma

While your GP can be very helpful in diagnosing and treating many cases of pruritus, we are more than happy to see patients who prefer to consult a private dermatology specialist.

Your appointment will begin with a skin check and medical history, which will allow the dermatologist to diagnose any skin conditions that may be co-occurring.

Together with the dermatologist, you will discuss the latest and most effective treatments and explain all potential side-effects, enabling you to select the best option for you.

It’s possible that pruritus may be controlled using topical treatments available from chemists, but depending on your condition, prescription creams may be necessary. The dermatologist will let you know whether it is beneficial to continue with any over-the-counter treatments, or if it is advisable to stop.

In some patients where there is a suspected allergen, it may be necessary to confirm a trigger by testing. This may be referred to as a ‘patch test’ and is carried out by the application of patches to the skin which contain extracts of the substance that may be causing the allergy.

Whatever your needs, you can rest assured that Derma will provide the very best care for your skin, with access to the latest research and treatments.

Further reading: Patient leaflet from the British Association of Dermatologists

Related Specialists at Derma

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