Itchy skin which affects people of all ages can be a mild annoyance or a persistent problem that significantly impacts one's quality of life.

Causes of Pruritus

Pruritus, or itching skin, may arise from a variety of sources, including skin rashes and other dermatological conditions. However, it can also serve as an indication of a more severe ailment, such as liver disease or kidney failure. Pruritus can stem from various factors, such as:

Dry Skin: One of the most common causes of pruritus is dry skin, which often worsens during winter months when humidity levels drop. Dry skin can lead to itching, flaking, and roughness. It is important to maintain proper hydration, use gentle moisturisers, and avoid harsh soaps to alleviate the symptoms of dry skin.

Allergies: Pruritus can be triggered by allergic reactions to substances like pollen, pet dander, certain foods, or medications. Contact dermatitis, an allergic skin reaction caused by direct contact with irritants or allergens, can also result in intense itching.

Skin Conditions: Pruritus can be a symptom of various existing skin conditions, such as eczema, psoriasis, hives, and fungal infections like athlete's foot or ringworm. These skin conditions cause inflammation, redness, and itching, often requiring specific treatments to address the underlying cause.

Underlying Medical Conditions: Pruritus can develop in individuals who are suffering from certain underlying medical conditions, such as liver or kidney disease, thyroid problems, diabetes, and certain cancers. These conditions disrupt the body's normal functioning, leading to systemic symptoms, including itchy skin.

Medications: As a side effect certain medications, such as opioids, antifungal drugs, antibiotics, and chemotherapy drugs, can also cause pruritus. If itching persists after starting a new medication, it is essential to consult a healthcare professional for further evaluation.

Treatment Options

The treatment for pruritus will vary depending on the underlying cause. However, some general treatments for itching include:

Topical treatments: For mild cases of pruritus, regular use of moisturisers and emollients can help restore the skin's moisture barrier and alleviate itching. Topical treatments containing hydrocortisone or calamine lotion can provide temporary relief from itching and reduce inflammation.

Antihistamines: Over-the-counter or prescription antihistamines can effectively relieve itching caused by allergies or allergic reactions. These medications block histamine receptors, reducing the body's allergic response and alleviating itching.

Medications: In cases where pruritus is severe or associated with an underlying medical condition, prescription medications may be necessary. These may include corticosteroids, immunosuppressants, or antifungal medications, depending on the specific cause.

Avoiding Triggers: It is important to identify and avoid triggers that worsen pruritus symptoms. This may involve avoiding specific foods, minimising exposure to allergens or irritants, and adopting a gentle skincare routine.

Phototherapy: Phototherapy, also known as light therapy, involves exposing the affected skin to controlled doses of ultraviolet (UV) light. This treatment option is commonly used for chronic pruritus associated with certain skin conditions like psoriasis.

Treating Underlying Medical Conditions: If pruritus is a symptom of an underlying medical condition, it is crucial to address and manage the primary condition. This may involve lifestyle modifications, medication adjustments, or other specific treatments as recommended by a healthcare professional.

Symptoms of Pruritus:

Itchy skin can manifest in localised areas like the scalp, arm, or leg, or it can encompass the entire body. Itching may occur without any visible changes on the skin, but it can also be accompanied by the following:

• Skin inflammation

• Scratch marks

• Bumps, spots, or blisters

• Dry, cracked skin

• Leathery or scaly patches

At times, the itchiness can be prolonged and intense. The act of rubbing or scratching the affected area can further intensify the itch, leading to a cycle that is challenging to break.

When to seek medical attention?

It is advisable to consult a healthcare provider or a dermatologist (specialist in skin diseases) if you experience the following:

• Itching lasts for more than two weeks and does not improve with self-care measures

• Severe itching that interferes with daily routines or disrupts sleep

• Sudden onset of unexplained itching

• Itching affects the entire body

Itching is accompanied by additional symptoms such as weight loss, fever, or night sweats.

If the condition persists for three months despite treatment, it is recommended to consult a dermatologist for an evaluation of potential skin diseases. It may also be necessary to see an internist (doctor specialising in internal medicine) to rule out other underlying conditions.

Conclusion

Pruritus, or itchy skin, can be a distressing condition that significantly impacts an individual's well-being. Pruritus can be caused by various factors and requires a comprehensive approach to management. Remember, if you experience persistent or severe itching, it is important to consult a healthcare professional for proper diagnosis and treatment.