Management of Itchy skin (aka Pruritis)

Itch is defined as the unpleasant sensation which provokes a person to scratch.  Chemical mediators such as histamine, serotonin, bradykinin and interleukin-3 causes the body’s sensation of itch.  These mediators are released by the body in response to the external and internal causative factors mentioned below.  Scratching provides some relief to the itch. However, when you start to scratch, it will start the Itch-Scratch Cycle which makes the itching worse.

Causes of Itch

Itch can be caused by either external or internal factors;

1. External Factors

• Skin conditions such as eczema or psoriasis
• Allergic reaction such as hives or urticaria
• Contact dermatitis where contact with substances (such as rubber, colour chemicals, certain metals like nickel, detergents, plant saps etc) can cause an allergic itch. Your doctor can perform an Allergy Skin Test to identify which substances you are sensitive to
• Insect bites (such as mosquitos or ants etc)
• Healing skin wounds (from surgery or after trauma)
• Skin infections such as fungal infection or scabies

2. Internal Factors

• Allergy to foods or medications
• Stress or anxiety
• Thyroid disorder
• Kidney disorder or liver disease with jaundice

Classification of Itch

Treatment Guide for Itchy Skin by Breaking the Itch-Scratch Cycle

The management of itch is to treat the skin in 3 components;

1. Moisturise the Skin

A health skin is important to prevent infection and reduce the sensation of itch by maintaining the skin barrier against bacteria and chemicals.  The role of the moisturiser is to;

• Reduce skin dryness, increase hydration and maintain the skin barrier function
• Reduce friction and fill any fissure gaps between the skin cells

2. Soothe the Skin

A soothing cleanser can be used to clean the skin from irritants or inflammation and help keep the skin soft and smooth.

3. Treat the Itch

Menthol has a cooling effect which can relieve itchy by producing a tingling sensation to the nerves so that it can mask the itchy sensation.   It can start to work within 1-2 minutes and has the added advantage that it does NOT contact steroids.  However, in severe cases, mild steroid cream or ointment may be required to treat the itch.

Long Term Maintenance Therapy

In most cases of mild allergy or sensitive skin, self care using a combination of cleanser and moisturisers for the skin is sufficient.  Your pharmacist can recommend whether your condition is better suited for a more aqueous-based moisturiser lotion or a more oil-based ointment (see chart below).  Remember the basic principles of good skin-care are;

• Avoid allergens
• Wear loose fitting and comfortable clothing
• Shower regularly
• Cleanse using a suitable skin cleanser
• Moisturise your skin regularly

You should discuss the long term treatment of your skin condition with your doctor or skin specialists if your skin condition requires medication such as steroids or immuno-suppression therapy such as Tacrolimus as they can have serious side effects. 

See your Doctor or a Skin Specialist to get treatment if the condition keeps recurring

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Disclaimer. TELEME blog posts contains general information about health conditions and treatments. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. The information is not advice and should not be treated as such. 

If you think you may be suffering from any medical condition, you should seek immediate medical attention from your doctor or other professional healthcare providers. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.