Itching

Definition

Itching is a tingling or irritation of the skin that makes you want to scratch the affected area.

Alternative Names

Pruritus

Considerations

Itching may occur all over the whole body (generalized) or only in one location (localized).

Common Causes

There are many causes of itching, including:

• Aging skin
• Atopic dermatitis
• Contact dermatitis (poison ivy or poison oak)
• Contact irritants (such as soaps, chemicals, or wool)
• Dry skin
• Hives
• Insect bites and stings
• Parasites such as pinworm, body lice, head lice, and pubic lice
• Pityriasis rosea
• Psoriasis
• Rashes (may or may not itch)
• Seborrheic dermatitis
• Sunburn
• Superficial skin infections such as folliculitis and impetigo

Generalized itching may be caused by:

• Allergic reactions
• Childhood infections (such as chickenpox or measles)
• Hepatitis
• Iron deficiency anemia
• Kidney disease
• Liver disease with jaundice
• Pregnancy
• Reactions to medications and substances such as antibiotics (penicillin, sulfonamides), gold, griseofulvin, isoniazid, opiates, phenothiazines, or vitamin A

Home Care

For persistent or severe itching, see your health care provider for a diagnosis and treatment instructions.

In the meantime, you can take some steps to help deal with the itch:

• Avoid scratching or rubbing the itchy areas. Keep fingernails short to avoid damaging the skin from scratching. Family members or friends may be able to help by calling attention to your scratching.
• Wear cool, light, loose bedclothes. Avoid wearing rough clothing, particularly wool, over an itchy area.
• Take lukewarm baths using little soap and rinsing thoroughly. Try a skin-soothing oatmeal or cornstarch bath.
• Apply a soothing lotion after bathing to soften and cool the skin.
• Use moisturizer on the skin, particularly in the dry winter months. Dry skin is a common cause of itching.
• Apply cold compresses to an itchy area.
• Avoid prolonged exposure to excessive heat and humidity.
• Take part in activities that distract from the itching during the day and make you tired enough to sleep at night.
• Try over-the-counter oral antihistamines such as diphenhydramine (Benadryl), but be aware of possible side effects such as drowsiness.
• Try over-the-counter hydrocortisone cream on itchy areas.

Call your health care provider if

Call your provider if itching:

• Occurs with other, unexplained symptoms
• Is severe
• Does not go away
• Cannot be easily explained

Most itching does not require medical evaluation. Look for an obvious cause of itching at home.

It is sometimes easy for a parent to find the cause of a child's itching. Looking closely at the skin will help you identify any bites, stings, rashes, dry skin, or irritation. Often the cause of itching is fairly obvious, such as a mosquito bite.

Have the itching checked out as soon as possible if it keeps returning and does not have an obvious cause, you have total body itching, or you have hives that keep returning. Unexplained itching may be a symptom of a disease that could be serious.

What to expect at your health care provider's office

Your health care provider will take your medical history and do a physical examination.

You may be asked the following questions:

• How long have you had this itch?
• Does it itch all the time?
• Does it seem to get worse, and has it spread?
• What do you think caused this itch?
• Have you ever had this kind of itch before? What caused it then?
• Did you recently come in contact with any irritating substance?
• Do you have any allergies or sensitivities?
• What medications are you taking?
• Have you started using any new product recently? What was it?
• Have you used any new soaps, fabric softeners, perfumes, deodorants, fabrics such as wool, or chemicals?
• Have you been around animals?
• Have you eaten shellfish or nuts recently?
• Have you had insect bites recently?
• Do you use lotions on your skin?
• Have you been in the sun recently?
• What part of your body itches?
• Is it all over your body (generalized itch)?
• Is the itch limited to a specific area? What area?
• What does the skin that itches look like?
• Is there a rash? If so, are there blisters or scales?
• Are you being treated for other medical conditions?
• What other symptoms do you have?

If there is no infection or skin lesion, tests to find the cause may include:

• Blood tests
• Skin biopsies
• X-rays

Your health care provider may prescribe medications such as topical corticosteroids, antihistamines, or tranquilizers.

References

Moses S. Pruritus. In: Rakel P, Bope ET, eds. Conn's Current Therapy 2008. 60th ed. Philadelphia, Pa: WB Saunders; 2008:chap 10.

Morelli JG. Eczematous disorders. In: Kliegman RM, Jenson HP, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 654.