Itching is an unusual and unpredictable sensation that can occur
at any time and urgently solicits your attention. How many times
have you picked up a package with both hands and have noticed an
itchy sensation on your face or the tip of your nose? Well, perhaps
that was a coincidence.
Itching is an unusual and unpredictable sensation that can occur at any time and urgently solicits your attention. How many times have you picked up a package with both hands and have noticed an itchy sensation on your face or the tip of your nose? Well, perhaps that was a coincidence.
Allergy is one of the main causes of itching but there are many others.
Why do we itch?
Itching disrupts and disturbs the harmony of our normal skin sensation. Whether an itch is result of a mechanical cause, such as an exposure of a foreign body to the skin, or a chemical cause, such as the entry of a bee sting’s allergen into our blood stream, the natural physiology of our body changes. Release of a chemical called histamine starts the cycle of itching. When you scratch your skin, you may feel a temporary relief but the itching may get worse. You may scratch the itchy area again for a relief but unknowingly you would get into a vicious itching-scratching cycle. The fact is that when you scratch the itchy area, the adjacent area also starts to itch, a phenomenon known as a domino effect.
External causes of itching
Environment: The sensation of a cold air on your skin may elicit itching. The sensitive skin of an infant is perhaps a good example of air-induced itching. Some elderly have itching problems in winter; this is also known as “winter itch” and perhaps the reason is the dry skin. The elderly have tendency to develop drier skin than younger people.
Foreign body exposure: A piece of hair on your skin, especially on sensitive skin such as that on the face, can elicit an itching sensation. It’s like those old movies, where feather was used to wake someone up by rubbing it on the nose?
Another example of an external cause of itching is a bee sting allergy. The person allergic to the bee sting reacts to it and develops various symptoms including local or generalized itching.
Inhalants: Inhalation of pollens, mold spores, dust mites and animal danders can cause itching in allergic individuals; such people experience itching in the nose, throat, palate (roof of the mouth) and eyes.
Contactants: Touching a poison ivy or a poison oak plant (contact) is an example of such exposure. The delayed reaction due to exposure to such plants consists of severe itching and sore skin.
Ingestants: Certain food can cause allergic reactions in susceptible individuals. The allergic reaction can manifest itself as hives in various areas of the body. Certain individuals who are allergic to pollen, may develop oral allergy symptoms such as itching of the mouth after ingesting fresh fruit or vegetables; this is because of a similarity in structure of certain pollens and the fruits or vegetables. For example, people with allergy to birch tree pollen may develop an itchy mouth when they eat an apple.
Medications: certain medications especially topical creams, ointments or lotions may cause itching of the skin.
Infections: certain infections such as scabies, caused by mites, can cause severe itching. The intense itching is due to mite’s secretion.
Internal Causes of Itching
Internal causes of itching are usually chronic diseases. Some examples are as follows:
Diabetes: Diabetic patients may develop generalized itching.
Renal disease: Patients with end-stage renal disease may develop generalized itching. Patients may have diabetes and renal disease; in fact renal disease is one of the complications of diabetes.
Liver disease: Liver disease is another example of a cause of generalized itching.
Cancer: Certain cancers such as lymphoma or leukemia may cause generalized itching.
Eczema: This is a chronic condition of the skin, and it usually occurs in patients who have allergies or have a family history of allergies. It can also occur in unallergic patients due to contact with certain chemicals.
One of the other causes of itching is dry skin. This problem is especially common in elderly – as the skin ages, it becomes dehydrated and dry, leading to itch.
How to prevent and mange itching
n Treat the underlying cause of the itch. If the cause is a chronic disease, you need to control and manage the symptoms and prevent the complications.
n Break the itch-scratch cycle – there are various ways to achieve this goal; one is to use cold compresses on the itchy area. I advise my patients to apply an ice pack, a frozen vegetable bag or a cold soda can on the affected area when itching.
n Use moisturizer – Liberal use of moisturizer on dry skin can prevent or reduce the itching.
n Keep your fingernails short. Scratching with long fingernails may cause more irritation and soreness of the skin. I also advise my patients to wear cotton gloves at night to prevent accidental skin injury during sleep.
n Avoid wearing irritating or tight clothing.
n Limit your shower and use lukewarm water.
n Use an anti-itch medication. Antihistamines, especially the older generation, such as diphenhydramine (Benadryl), may help to reduce your itch. Corticosteroid cream or ointment may also reduce your itching. Your physician can advise you to use the right corticosteroid, if necessary.
