If itching keeps you up at night, you’re not alone.
Pruritus (aka itching) is a sensation we all experience daily, some of us more than others.
To ditch the itch, most of us resort to scratching to get relief. While this may feel oh so good, the moment you swipe at your skin, you trigger something known as the itch-scratch cycle.
“An itch can feel like a burning sensation, a slightly electrical or periodic nonpainful sensation, or like something is crawling along the skin,” says Dr. Melanie Palm, a board certified dermatologist and cosmetic surgeon.
Other than being extremely annoying at 2 a.m., an itch is a sensation caused by stimulation of nerve cells in the skin, which Dr. Adarsh Vijay Mudgil, founder of Mudgil Dermatology, says causes us to scratch.
If you think about it, scratching is a type of pain, yet we rely on it to get rid of an itch. When we scratch, Mudgil says we send low-level pain signals to the brain. These pain signals temporarily distract the brain from itch.
These pain signals also release serotonin in the brain, which he says feels really, really good.
But serotonin also resets the itch signal. In some cases, this can create a never-ending itch-scratch cycle.
To stop the constant need to scratch your scalp, back, or any other area of your body, you need to know why you get itchy in the first place.
“Itching is caused by a complex interaction between cells of the skin and our nervous system,” Mudgil says. Various cell types, proteins, and inflammatory mediators are involved.
“Chemicals released in the skin send a message to the spine through nerves in the skin, then the spine communicates with the brain, and we become itchy,” he adds.
“One of the most common causes of itch on the skin is dry skin, which causes microfractures within the skin barrier,” Palm says. When this happens, local inflammation from cell signaling occurs, and chemicals like histamine and kinins are released.
“This causes tissue redness, swelling, and nerve irritation that are then interpreted by our body as itch,” she explains.
Hives, irritants, or contact exposures on the skin can lead to a somewhat similar phenomenon as dry skin.
“All of these conditions can cause skin irritation and swelling, and local release of irritating chemicals from cells, such as eosinophils and basophils, that irritate skin nerves and create an itching sensation,” Palm says.
When to look for a cause
If you’re not getting relief, or your itching is getting worse, it might be time to see your doctor.
During your appointment, it’s important to provide your doctor with a detailed history so they can get to the root cause of the itch. Palm says this includes information about any:
- medical conditions
- surgeries
- medications
- supplements
- topical skin care products
- occupational or recreational habits
- travel history
- food allergies
“All of these are possible causes of an itch and should be systematically eliminated to identify the root cause of itch,” Palm adds.
Itching is an inherently harassing and annoying sensation.
“Our natural instinct is to eliminate it, and tactile stimulation (scratching) is a knee-jerk response for immediate, albeit temporary relief,” Palm says.
But since this is temporary, we’re left with the irritating itch, and the itch-scratch cycle repeats itself yet again.
Sounds frustrating, right? Well, the good news is there are plenty of ways to stop scratching an itch.
If you know the source of the itch, choosing the right remedy can help speed up the healing process.
But if you’re not sure what’s causing it, a trip to your doctor or dermatologist is in order. That’s because there’s no one-size-fits-all answer to stopping an itch or preventing scratching.
However, there are some general guidelines to follow when experiencing an itch.
Don’t scratch, really
The best way to eliminate scratching, says Palm, is not to start.
“As hard as that sounds, it can often amplify the intensity of the itch, and that’s why it’s important to identify the underlying cause of the itch so that it can be treated,” she explains.
Moisturize
If skin is dry, Palm says restoring the skin barrier with therapeutic moisturizers is extremely important and can provide fairly quick relief.
Find good anti-itch ingredients
To help soothe skin, look for anti-itch creams that contain:
- pramoxine
- capsaicin
- menthol
Try a topical corticosteroid
And if skin is inflamed, Palm says a topical corticosteroid or calcineurin inhibitor may be in order.
Use an antihistamine
Antihistamines are another popular option to relieve itching related to allergies and other skin conditions, such as hives.
Over-the-counter (OTC) oral antihistamines include nondrowsy products like Allegra and Claritin. You can also use Benadryl or Chlor-Trimeton, but proceed with caution. These products can cause drowsiness.
Apply a cold pack
Additionally, the American Academy of Dermatology (AAD) says applying a cold cloth or ice pack to the itchy area for 10 minutes or taking an oatmeal bath can help calm itchy skin.
Keep your hands busy
To avoid continuous itching, Palm says it’s important to occupy your hands, so you’re not unconsciously scratching.
“A stress ball, or activities that occupy the hands so that they cannot be tempted to scratch an itch, may be helpful for some,” she adds.
AAD anti-itch tips
Lastly, to help prevent itching, the AAD recommends:
- using fragrance-free products
- bathing with lukewarm water
- avoiding extreme temperature changes
- reducing stress
Itchy skin and persistent scratching might be annoying, but it’s not always cause for concern.
That said, if home remedies and OTC products aren’t providing relief, or the need to scratch is increasing, you may want to talk to your doctor or a board certified dermatologist to find out what’s causing you to itch.
With the proper diagnosis, you’ll be able to find an effective treatment.