Itching symptoms are very common in daily life, especially in autumn and winter, when the weather is dry, it is even more itchy.
Pruritus can be present both independently and as a concomitant symptom and is seen in a variety of diseases and physiological states.
01 Most of the itching is caused by skin diseases
Skin diseases that can cause itching can be broadly divided into two broad categories:
Skin disease with primary rash
For example, allergic skin diseases such as eczema and urticaria, infectious skin diseases such as tinea psoriasis, athlete's foot, and body ringworm, psoriasis (psoriasis), pityriasis rosea and other unexplained erythematous skin diseases, as well as a small number of skin diseases caused by parasites such as pinworms, lice, and scabies.
These skin diseases are problems with the skin itself, often manifested as a rash first, followed by itching, or can manifest as a rash and itching at the same time.
Pruritus is more persistent and can be paroxysmally aggravated by environmental changes, clothing irritation, dietary factors, and psychiatric factors.
Skin diseases without primary rash
For example, neurodermatitis, simple pruritus (granular rash or small papules with severe itching), pruritus and other neurodegraded skin diseases. In general, the skin itself has no practical problems, but the nerve function is impaired, too excited and sensitive, which makes people have the illusion of itching.
Itching occurs first, and then a rash occurs due to scratching, and long-term friction and scratching may also cause the skin to become thicker and darker, or secondary to some skin damage, showing a manifestation similar to a skin disease.
Pruritus caused by neurotic dermatosis is often paroxysmal and can be weakened with the shift of attention.
02 Itching may also be a "signal light" for some diseases
Persistent, stubborn, unexplained, severe itching and an invisible rash may indicate some systemic disorder.
For example, patients with hepatobiliary diseases such as renal failure and jaundice may be excreted poorly due to urea and bile, resulting in urea and bile being excreted through the skin, irritating the skin and causing itching, which is more common in middle-aged and elderly people.
Endocrine diseases, such as thyroid diseases, can also cause skin itching, and can also appear sleep disorders, emotional instability and other symptoms, more common in young people; diabetes can lead to a decrease in skin resistance, easy to cause itching due to external stimuli or infections.
Some patients with malignant tumors may also have stubborn, incurable itching, and most of them will be accompanied by short-term weight loss.
In addition, itching may also occur if there is an endocrine disorder with a series of physiological or pathological changes in hormone levels.
03 Itching may also occur in some specific periods and special groups
Menstrual pruritus and pregnancy pruritus are common in women and may be related to factors such as changes in hormone levels.
Pregnancy pruritus generally appears after 3 months of pregnancy, peaking 2 months before childbirth, the itching is severe, and may also affect the life and sleep of pregnant women. In addition, itching in the elderly is also very common.
Due to poor skin elasticity, thinning of the skin, atrophy of the sebaceous glands and other skin aging reasons, resulting in weakened skin barrier function, no oil protection, easy to dry, it is easy to itch.
Since so many diseases can cause itching, is there any medication that can help stop itching?
04 There is no special drug for antipruritics, but it can be alleviated for the cause
We all know that you can eat "painkiller tablets" when you are in pain, and you can take "anti-fever drugs" when you have a fever, but unfortunately, so far, there are no "anti-itch tablets" that cannot solve the problem from the root cause, and can only relieve the itching through some drugs.
/ Oral antihistamines /
Studies have found that inflammatory mediators such as histamine and serotonin can cause itching.
Therefore, patients with itching caused by allergies and inflammation can appropriately take some antihistamine drugs such as loratadine and cetirizine, which is often referred to as anti-allergic drugs to relieve itching.
However, if it is itching caused by neurological dysfunction and the antihistamine antipruritic effect is minimal, it can be relieved by drugs that regulate and nourish the nerves such as oryzanol, and sedative drugs such as diazepam.
For pregnancy itching, if the situation is mild, some ointments to relieve itching can be applied, and slightly more severe ones can be used for a short period of time, or alternately. In the third trimester of pregnancy, some antihistamines can be used appropriately, but their use is not recommended in the first trimester (within 3 months).
/ Topical antipruritics /
Irritating antipruritics that can suppress the sensation of itching through stimulation. For example, applying alcohol, or anti-itching potions that feel cold such as ice chips and mint, or mashed garlic, chili soaking water, pepper salt water, etc. also have a certain effect.
However, this method can only be applied to normal and undamaged skin, and the skin is red, swollen, pus, and ulcerated, which cannot be used, otherwise it is easy to aggravate inflammation or cause allergies.
Soothing antipruritics, such as calamine lotions, silicone creams, oils, etc., isolate the itchy skin from external stimuli, or use boric acid cold compresses to relieve inflammatory redness, swelling and itching.
Anti-inflammatory, anti-allergic ointments, such as antibiotic ointments that kill bacteria such as mopirocin ointment, antifungal ointments such as natefenoneconazole ointment, or hormonal ointments such as codiesone. However, beware of the itching caused by fungal infections, and applying hormonal ointments will aggravate the condition.
Moreover, the use of hormone ointment for a long time will have side effects such as pigmentation and skin atrophy, and it is recommended not to use it continuously for more than two weeks in the same area.
/ Pat, cold compress, emollient /
Most people can't help scratching when itching, but scratching is easy to scratch the skin, damage the skin barrier, increase the probability of infection, so it is recommended to use a gentle patting method instead of scratching to stop itching.
There are also some people will choose hot compresses to relieve itching, although a short period of time does have a certain effect, but hot compresses are easy to destroy the sebaceous film on the surface of the skin, affect the skin to lock water, dryness, but it is easier to itch, long-term repeated heat stimulation will also promote skin aging, forming a vicious circle.
Therefore, it is recommended to replace it with a cold compress, the blood vessels constrict in the cold, which can reduce inflammation and swelling.
For the elderly who have aging skin and are prone to dryness, they should try to dress loosely and breathable as much as possible to reduce skin nudity.
Do not take frequent baths, the bath water temperature is not too high, pay attention to applying emollient products after washing, drink more water appropriately, etc., can have a certain preventive and slowing down itching effect.
References: Medical Microvision Official Website - Chen Yong Chief Physician "Itching"