Pruritus Symptoms, Causes & More
Article Sources
- 1. 'Pruritus,' www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/dermatology/pruritus-itch/
- 2. 'Pruritus (PDQ)–Patient Version.' National Cancer Institute, www.cancer.gov/about-cancer/treatment/side-effects/skin-nail-changes/pruritus-pdq
- 3. 'Itchy Skin (Pruritus).' Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Jan. 2021, www.mayoclinic.org/diseases-conditions/itchy-skin/symptoms-causes/syc-20355006
- 4. Staff, Familydoctor.org Editorial. 'Pruritus: Symptoms, Causes & Treatment.' Familydoctor.org, 21 Sept. 2020, familydoctor.org/condition/pruritus/
- 5. Itching (Pruritus) By Julia Benedetti, et al. 'Itching - Dermatologic Disorders.' Merck Manuals Professional Edition, Merck Manuals, www.merckmanuals.com/professional/dermatologic-disorders/approach-to-the-dermatologic-patient/itching
- 6. 'Pruritus (Itchy Skin).' Cleveland Clinic, my.clevelandclinic.org/health/diseases/11879-pruritus
- 7. 'Itchy Skin (Pruritus).' Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Jan. 2021, www.mayoclinic.org/diseases-conditions/itchy-skin/diagnosis-treatment/drc-20355010
Pruritus or itching is an unpleasant feeling on the skin that makes a person want to scratch. Sometimes itching may feel painful. Pruritus may be localized to certain areas, or widespread itching may occur all over the body. In some cases, lesions may appear on the itchy areas of the skin, but sometimes no visible signs are evident.
Pruritus can last for varying amounts of time. Sometimes the itching is short-lived, but it may last for weeks. Pruritus that persists for six weeks or more is considered to be chronic. Itching can be debilitating, and it's sometimes a challenge to diagnose.1‘Pruritus,’ www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/dermatology/pruritus-itch/,2‘Pruritus (PDQ)–Patient Version.’ National Cancer Institute, www.cancer.gov/about-cancer/treatment/side-effects/skin-nail-changes/pruritus-pdq
Pruritus Symptoms
Skin that itches may appear perfectly normal aside from the fact that the person feels a persistent need to scratch it. But sometimes changes on the skin are evident, and these may provide clues as to the cause of the itching.
In some cases, the skin may appear dry and cracked or leathery and scaly. A rash, lesions, hives or blisters may be present. The itchy skin may be red, swollen and warm with possible oozing of fluid, indicating a possible infection. If the person has been scratching the area, scratch marks may be noticeable.3‘Itchy Skin (Pruritus).’ Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Jan. 2021, www.mayoclinic.org/diseases-conditions/itchy-skin/symptoms-causes/syc-20355006,4Staff, Familydoctor.org Editorial. ‘Pruritus: Symptoms, Causes & Treatment.’ Familydoctor.org, 21 Sept. 2020, familydoctor.org/condition/pruritus/
Who Gets Pruritus?
Anyone can develop pruritus, but it commonly occurs in the elderly since they're more likely to have undergone immune system and nerve fiber changes. Pregnant women may also be more likely to experience pruritus.
People with seasonal allergies, such as hay fever, and skin conditions, such as eczema, may be prone to developing itching. Those with certain diseases or conditions, such as diabetes and HIV, may also experience frequent itching.5Itching (Pruritus) By Julia Benedetti, et al. ‘Itching - Dermatologic Disorders.’ Merck Manuals Professional Edition, Merck Manuals, www.merckmanuals.com/professional/dermatologic-disorders/approach-to-the-dermatologic-patient/itching,6‘Pruritus (Itchy Skin).’ Cleveland Clinic, my.clevelandclinic.org/health/diseases/11879-pruritus
Things That Trigger Pruritus
Certain irritants may trigger pruritus in some people. Common culprits range from long, hot baths and scents, fragrances and perfumes to laundry detergents, fabric softener sheets and skincare and beauty products. Tight clothes and apparel made of fabrics such as wool may also cause itching.
Itching may be triggered by dry indoor air or dehydration. Some people are sensitive to particular over-the-counter and prescription medications, and taking these may lead to pruritus.2‘Pruritus (PDQ)–Patient Version.’ National Cancer Institute, www.cancer.gov/about-cancer/treatment/side-effects/skin-nail-changes/pruritus-pdq,5Itching (Pruritus) By Julia Benedetti, et al. ‘Itching - Dermatologic Disorders.’ Merck Manuals Professional Edition, Merck Manuals, www.merckmanuals.com/professional/dermatologic-disorders/approach-to-the-dermatologic-patient/itching
Other Causes of Pruritus
Other possible causes of pruritus include insect bites, parasites and burns. Underlying illnesses, including liver, kidney or thyroid disease as well as diabetes and anemia, may be responsible for itching. Food allergies are another possible cause of pruritus.
Nerve disorders, such as shingles, multiple sclerosis and pinched nerves, may lead to pruritus. Psychological conditions may also play a role in itching, with anxiety, depression and obsessive-compulsive disorder possibly causing pruritus.3‘Itchy Skin (Pruritus).’ Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Jan. 2021, www.mayoclinic.org/diseases-conditions/itchy-skin/symptoms-causes/syc-20355006,5Itching (Pruritus) By Julia Benedetti, et al. ‘Itching - Dermatologic Disorders.’ Merck Manuals Professional Edition, Merck Manuals, www.merckmanuals.com/professional/dermatologic-disorders/approach-to-the-dermatologic-patient/itching
Diagnosing Pruritus
To diagnose pruritus, a health care provider conducts a physical examination and asks a number of questions, including how long the itching has been present; if the person has used any new medications, personal care or laundry products recently; and if any other unusual symptoms have developed.
A skin biopsy, as well as allergy, blood and imaging tests, may also provide information to help the doctor understand why the itching is occurring.6‘Pruritus (Itchy Skin).’ Cleveland Clinic, my.clevelandclinic.org/health/diseases/11879-pruritus
Complications of Pruritus
Itching and scratching may become a vicious circle. Sometimes the more a person scratches an itch, the itchier it becomes. Continual scratching of itchy skin may lead to breaks in the skin that bleed, become infected and leave scarring.
Itchiness may have a negative impact on the quality of a person's life, especially if the pruritus becomes chronic. Falling asleep and sleeping through the night may be difficult, and people with pruritus may develop anxiety or depression.3‘Itchy Skin (Pruritus).’ Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Jan. 2021, www.mayoclinic.org/diseases-conditions/itchy-skin/symptoms-causes/syc-20355006
When To See a Doctor
It's best to seek medical assistance if itching lasts for several weeks without noticeable relief. Medical evaluation is also necessary if signs of infection develop, such as fever and skin that's red or swollen with a pus discharge.
Anyone noticing unusual symptoms accompanying the itching should discuss the situation with a doctor. Significant weight gain or loss, fatigue, altered moods and changes in urinary or bowel habits may indicate underlying conditions that require diagnosis and management.6‘Pruritus (Itchy Skin).’ Cleveland Clinic, my.clevelandclinic.org/health/diseases/11879-pruritus
Home Care for Pruritus
Self-care measures may be sufficient to address pruritus. Taking short, lukewarm baths or showers, using a humidifier and applying hypoallergenic moisturizers can help keep skin moisturized. Avoiding scratchy fabrics, wearing loose clothing and using mild, unscented laundry products may help prevent irritation that leads to itching.
Placing cool compresses on affected skin may help calm the itch. Taking over-the-counter allergy medications and applying topical preparations, such as calamine lotion, may also be helpful.6‘Pruritus (Itchy Skin).’ Cleveland Clinic, my.clevelandclinic.org/health/diseases/11879-pruritus,7‘Itchy Skin (Pruritus).’ Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Jan. 2021, www.mayoclinic.org/diseases-conditions/itchy-skin/diagnosis-treatment/drc-20355010
Medical Treatment of Pruritus
If home care solutions aren't effective, a health care provider may prescribe antihistamines and topical or oral corticosteroids to ease the itching and antibiotics to treat infections. Antidepressant and immunosuppressant medications may be helpful. Taking higher doses of antihistamines at night may help promote restful sleep.
Sometimes, light therapy or acupuncture may be effective in managing pruritus. Some people find relief using transcutaneous electrical stimulation therapy, or TENS.2‘Pruritus (PDQ)–Patient Version.’ National Cancer Institute, www.cancer.gov/about-cancer/treatment/side-effects/skin-nail-changes/pruritus-pdq,5Itching (Pruritus) By Julia Benedetti, et al. ‘Itching - Dermatologic Disorders.’ Merck Manuals Professional Edition, Merck Manuals, www.merckmanuals.com/professional/dermatologic-disorders/approach-to-the-dermatologic-patient/itching,7‘Itchy Skin (Pruritus).’ Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Jan. 2021, www.mayoclinic.org/diseases-conditions/itchy-skin/diagnosis-treatment/drc-20355010
Preventing Pruritus
Taking steps to prevent dry skin may help keep pruritus at bay. This may include drinking plenty of fluids, installing a humidifier in the home, using lukewarm water for bathing and using moisturizers and sunscreen regularly.6‘Pruritus (Itchy Skin).’ Cleveland Clinic, my.clevelandclinic.org/health/diseases/11879-pruritus
People with known allergies that may lead to pruritus should try to avoid triggering products and situations and take necessary medications as directed. If an underlying condition is causing dry skin, taking steps to control or eliminate it may help prevent pruritus.4Staff, Familydoctor.org Editorial. ‘Pruritus: Symptoms, Causes & Treatment.’ Familydoctor.org, 21 Sept. 2020, familydoctor.org/condition/pruritus/
