Prurito

What causes itching?

Itching (the medical term is pruritus) is a symptom that can be caused by a large number of conditions.

• Skin condition. Sometimes itching is caused by a skin condition, such as eczema o orticaria. You would usually have a rash to see if this is the case. Scabies is a fairly common cause of itching. It is caused by mites and you will see a rash.

• General illness. Other times, itching is caused by a more general illness, such as jaundice o malattia renale cronica.

• Gravidanza. Itching is also common in pregnancy.

• Itchy bottom and itchy vulva. Sometimes you itch in a specific place. Itch of the back passage (anus) and itch of the external sex organs of a woman (her vulva) are common, for example, and have various causes. These conditions are also known as pruritus ani and pruritus vulvae. See separate leaflets called Itchy bottom (Pruritus ani) e Itchy vulva (Pruritus vulvae) per maggiori dettagli.

• Unknown cause. However, in many cases no cause is found for a skin itch. This article deals only with itch that is fare affidamento due to any underlying skin or medical condition. This is called itch of unknown cause.

• Pelle secca. One possible factor is that in some people with itch of unknown cause, their skin may be drier than average, which may contribute to the itch. Itch of unknown cause is most common in older people whose skin tends to be drier than that of younger people. Itch tends to be worse at night and may be made worse by bathing. Any part of the skin may be affected.

Itching can occur over your entire body or just in one area. It can be very unpleasant and uncomfortable.

If you are not sure why you are itching, you should see your doctor. If no cause for an itch is obvious, then your doctor may suggest some blood tests to see if there is an underlying cause for the itch. However, in many cases, the tests are normal and the cause remains a mystery.

The following may help to improve your itching:

• Keep your nails short to limit any damage done to your skin by scratching. As much as possible try not to scratch. It is thought that scratching can make itch worse and you may get into an 'itch-scratch' vicious cycle. (That is, you itch more because you scratch, so you scratch more because you itch more ... and so on.)

• Keep cool as much as possible. You might find having cool (or lukewarm) baths or showers soothing.

• Avoid irritants such as soaps, bubble bath and detergents. Cotton clothes are usually preferable to woollen clothes.

• Idratanti (emollienti). Dry skin may be making the itch worse. Moisturisers are useful to keep your skin supple and moist.

  • They can be applied once a day or several times a day if your skin becomes very dry. Water and soap dry out the skin as they wash away the natural skin oils.

  • Therefore, the most important time to use moisturisers is after a bath or shower. Moisturisers work by providing a replacement for these body oils and keeping the skin moist.

  • Numerous moisturisers are available as creams, ointments and bath/shower additives, and also to use instead of soap. It may be worth trying out a few to see which is the most suitable. These can be bought from a pharmacy. Use them liberally, as often as needed.

• Antihistamine medication is sometimes tried. Antistaminici are useful for some skin conditions that cause itch such as orticaria. However, they do not help with all types of itch. For itch of unknown cause they may have little effect. Some antihistamines also tend to make you drowsy. However, these types of antihistamines may be worth trying at bedtime if itch is troublesome at night. An example is chlorphenamine. Your doctor or pharmacist can advise you further and these can be bought from a pharmacy.

• Relaxation techniques can be beneficial for some people. A brain-training treatment called terapia cognitivo-comportamentale (TCC) may also be helpful. This helps you to break the itch-scratch cycle.

• Certain antidepressants. These may occasionally be prescribed when itching is very distressing. They work by helping to tone down the chemicals in the brain which make you feel an itch and want to scratch.

The amount of discomfort from itch can vary from person to person, and in its frequency in the same person. A referral to a skin specialist may be advised if your itching persists or is severe. There are different treatments which are being investigated in clinical trials which may be available in the future.