You’ve just had a wound closed with stitches, and all you can think about is how much it itches. You know scratching your stitches would be a bad move, but what causes this itching, and what can you do to safely relieve it?

Itching, or pruritis, is a part of recovery when you have a healing wound. Whether you had a traumatic wound or surgical wound closed — either by stitches, staples, or glue — pruritis is a normal, albeit frustrating, part of cell reconstruction.

As cells rebuild, there are chemical and mechanical reactions that cause itching. The important thing is to not disrupt this process. You’ll delay your healing, and go back to square one.

Itchiness is a normal part of wound healing. To understand the cause of itching, you have to understand how a wound — even one closed with stitches — is rebuilt.

Hemostasis and clotting

In this first stage of wound healing, your body will shut off the blood supply to the wound through a process called vasoconstriction. This seals off the vessels that supply blood to the affected area.

It works the same for an injury or a surgical incision. As blood clots on the edge of the wound, bits of fibrinogen proteins found in plasma form a natural wound closure commonly known as a scab. The scab forms as fibrin and other substances dehydrate and form a protective covering over the healing wound.

Inflammation

The next stage of wound healing is where the real pain and itching begin. In this phase, inflammatory cells rush to the wound site to help clean the base of the wound and prepare for new cells. Some of these cells, called histamines, help open the vessels around the wound for immune cells to begin cleanup.

Unfortunately, histamines are also a primary chemical cause of itching. An infected wound will create additional itching, as inflammatory and immune cells work overtime to fight bacteria. In some unfortunate cases, wounds stop healing properly and become stuck in this phase.

When wounds don’t move past the inflammation stage, they are considered chronic wounds. Itching is a major problem with complications that result in chronic wounds.

Proliferation and repair

As cells flock to the wound site to build new tissue in the proliferation phase of healing, they layer cells to create a matrix that’s filled in with various types of cells, creating a sensitive area of new growth. As these new layers are pulled together in the final phase, fluid builds below the wound surface. That’s when new nerve connections are joined to the old, creating a mechanical reaction that results in an itching sensation.

Other causes requiring medical attention

There are a few abnormal aspects of healing that could cause extra itching over your stitches. Contact your doctor if you experience inflammation, redness, or oozing, which can be signs of:

  • necrotic or dead tissue at the base of the wound
  • excess fluid buildup or draining at the incision site
  • induration, or a hardening of the suture site

Wound care can be complicated and may include cleaning and dressing the area. Scratching an itchy wound could cause it to break open and delay healing. Some ways to relieve stitch itch include:

  • applying an ice pack or cold compress
  • antihistamines like Benadryl
  • proper dressing and bandaging (speak with your healthcare team about how to care for your wound)
  • keeping skin moisturized
  • protecting the wound from irritation with a covering or clothing

For more severe wounds and itching, or wounds that take a long time to heal, your doctor may have to try:

You might think that scratching, or even a gentle rub, will help relieve your itch. But scratching stitches or any other healing wound can disrupt the healing process. Delicate new layers of tissue can easily be ripped apart, forcing you to return to earlier healing stages. This will make your wound take even longer to heal, further prolonging your itch, and possibly leading to complications like chronic wounds or infections.

If you’ve had stitches to repair a traumatic wound or after surgery, your doctor should give you specific instructions on caring for your stitches, and when and how they will be removed. Not all wound closures — like dissolving stitches or surgical glue — require removal.

Here are some tips on caring for your stitches:

  • Keep your stitches dry for the first 24 to 48 hours.
  • After the first few days, you may clean gently around your stitches with cool water and mild soap one to two times per day.
  • Dab your incision site dry. Do not rub it.
  • Do not scratch or scrub your incision.
  • Avoid strenuous activity that could cause the stitches to tear.
  • Do not remove adhesive strips (Steri-Strips) that may be covering your stitches. These will fall off on their own.
  • Change your dressing as directed by your doctor.
  • Do not apply any creams or ointments to your stitches unless advised by your doctor.
  • Call your doctor if you have a fever or increasing redness and pain, purulent drainage like yellow or green pus, or bleeding at the site. This could be a sign of infection.
  • Do not pull at your stitches or staples, or scabs covering the wound.
  • Keep your hands and supplies clean during dressing changes.

Sometimes, excessive itching can be a sign of a complication in your wound healing. Necrotic tissue, infection, excessive fluid buildup, and more can all lead to increased itching and problems with wound healing.

If you suspect your wound isn’t healing right, or you have any of the following problems, contact your doctor for further evaluation.

  • fever of 100 degrees Fahrenheit or higher
  • yellow, thick, cloudy, or foul-smelling draining from the site
  • excessive bleeding
  • stitches that fall out
  • opening in the incision before your stitches are removed
  • new numbness or tingling at the site
  • increasing pain or redness

Stitches are meant to help improve healing for deep wounds or incisions and speed up the natural tissue building process. Sometimes, however, stitches can complicate matters, especially if you scratch them open and complicate the wound.

Home remedies and over-the-counter or prescription medications can help as your incision or wound heals. Contact your doctor if you suspect your incision isn’t healing correctly or has become infected.