Pruritus, or itching, is a tingling, irritating sensation on the surface of the skin that provokes scratching. While incidental itching may be resolved by scratching, persistent itching is often only worsened by this response. Itching may be confined to one area on the body or may be an encompassing condition. When confined to a specific area, itching is usually the result of a localized contact with an irritant. When it involves the whole body, it is more likely the result of a systemic disorder and may require a medical diagnosis through blood tests or skin biopsy. Severe itching is experienced as akin to pain.
Causes of Pruritus
Pruritus may be caused by an allergic reaction to food or medication or may simply be the result of very dry and irritated skin. There are many other possible causes of itching which include:
- Skin disorders, such as eczema or psoriasis
- Contact dermatitis
- Insect bites or stings
- Irritating chemicals
- Parasites, such as lice
- Rashes from diseases like measles or chicken pox
Certain systemic disorders like diabetes, leukemia or kidney failure may also cause itching of the skin.
Treatment of Pruritus
Patients experiencing itching are advised to avoid scratching, since this simply exacerbates the problem, and to wear loose, non-irritating fabrics against the skin. Simple itching may be helped by moisturizing creams, oral antihistamines and topical corticosteroids. Cold compresses and lukewarm baths, particularly with a colloidal oatmeal solution, may also be helpful. Where itching is severe or persistent, it is important to seek medical assistance to determine the underlying cause of the problem and to develop an appropriate treatment.
Complications of Pruritus
When itching is followed by scratching that breaks the skin, there is danger of infection. When such skin breaks become hot, red or swollen, or when they are accompanied by fever or swollen glands, a physician should be consulted since antibiotic treatment is usually required. Similarly, when red lines emanating from the site appear, this indicates an involvement of the lymphatic system and should not be ignored. Severe or persistent itching requires medical consultation since it may be a symptom of a more serious underlying medical disorder. When allergic itching is combined with any breathing or swallowing difficulty, it constitutes a medical emergency.