Why is your skin itchy and how to treat it?

Do you feel an unrelenting urge to itch?

In most cases, skin itching is caused by the most trivial causes but sometimes it is a sign of a skin disease or even internal organ disease. In this article, we are going to discuss how can you find out the reason for skin itching and cope with it.

We advise to begin with the easiest solutions: try not wearing synthetic clothes, change bed clothing, change your hygiene products to hypoallergenic ones, do not spend much time outside in the sun, moisturize your skin, eat less salt and spices, and so on. If that doesn't work, talk to your physician or dermatologist who can appoint the tests to find out the underlying reason and chose optimal treatment.

In cases when skin itching doesn’t require any special therapy, for instance, with antibiotics or antivirals, you can use ointments and gels such as Diprogenta (Betamethasone Dipropionate with Gentamicin Sulfate). It is a universal medication used for a variety of skin conditions including dermatoses of various origin, infectious diseases of the skin, and many others. You can buy the medication without a prescription at our online drugstore but we still advise you to consult your doctor and find out the reason for the itching before you get the cream.

The simplest reason your skin can be itchy – dry skin

People who generally have dry skin are familiar with skin itching. It is usually present year-round but can flare-up during winter when the outdoors air is dry due to heating. Worth noting that skin becomes dryer even in people with generally normal and oily skin when they get older.

To cope with itching due to skin dryness, follow these simple tips:

- After a shower, bath, swimming poll, swimming in the sea, and so on – always use a hypoallergenic moisturizer on the still damp skin;
- Always stay hydrated – it is advised to drink 1.5-2 liters of clean water a day and if you workout, walk a lot, during winter and in summer make sure you drink even more water.
- Buy a humidifier. It helps to avoid excessive air dryness even in the heating season.
- Do not spend much time in the shower and avoid using hot water as water on its own promotes dryness and hot water makes it even worse.
- Use moisturizing hypoallergenic soap.

What does it mean if you have red spots or rash?

If you notice that the itchy spots are red or there is a rash this can be the sign of:

- Mycotic and bacterial infections such as impetigo and folliculitis.
- Insect bite: it’s easy to notice when you are bitten by a mosquito or spider because you can feel an instant itching and see a small red bump. But if you are bitten by flea or tick, it’s harder to know since they look like a rash and can develop not instantly.
- Eczema or atopic dermatitis are characterized by dry, peeling, or purulent rashes on the skin that over time form crusts. These are considered allergy manifestations because they can get aggravate due to consumption of certain foods.
- Contact dermatitis: This is also an allergic reaction to something your skin is in contact with. If it occurs in the places where you wear jewelry, for instance, fingers, neck, it could be the materials your jewelry is made of, or chemicals in cosmetics, cleaning products, perfume, and so on. Stop applying or wearing what you think might be the reason for itch and see if it gets better.

The skin disease or an internal problem of the body?

Our skin often reflects the internal condition of our bodies, so itching can be a sign of internal problems in the body.

- Urticaria (Hives): This is a form of allergy. It is manifested in red or reddish isolated or merging bumps that are usually very itchy. This disease can occur due to various causes, for instance, stress, heat, exercise, sun exposure, intake of certain medicines and even vitamins.
- Psoriasis: A chronic, recurring condition that affects the skin and the joints. This happens when the skin cells start to multiply too fast. The skin looks like it is covered with scales and red patches that sometimes.
- Pregnancy: More than 10% of women expecting a baby encounter unexplained itching. It could be a harmless rashes or more serious conditions (such as liver disease). Thus, it is important to notify your doctor and get tested.
- Medications: Some drugs can cause itching even without rash or irritation. If you have started using a new medication and itching appeared, talk to your doctor – it could be a sign that the drug is unsuitable for you. The common medicines that can cause itching are:
- Medications for high arterial tension are called ACE inhibitors;
- Allopurinol (gout medication);
- Amiodarone (heart arrhythmia medication);
- Medications for the urinary tract;
- Estrogen;
- Hydroxyethyl cellulose (used during surgery);
- Pain killers acetaminophen, ibuprofen, opioids;
- Statins to lower cholesterol level;
- Antibiotics, and others.

Skin itching caused by nervous system disorders

Our nervous system sometimes can send out wrong signals from the nerves that connect to the skin, so we feel itchy but there is no rash. This can happen with the following diseases:
- Shingles;
- Multiple sclerosis;
- A brain tumor;
- Nerve damage.

Skin itching due to psychological reasons

If a healthcare provider can not find an organic cause, the cause may be psychological. Some disorders can make people feel like something is crawling over their skin. In this case, rash is absent, but the skin can be damaged by scratches. This happens can happen in:

- Depression;
- Anxiety;
- Obsessive compulsive disorder;
- Psychosis;
- Phobia (for instance, fear of insects), and others.

Rare causes of skin itching

If the most obvious reasons for skin rash are excluded, the reason can be one of the rarest ones:

- Kidney disease;
- Liver disease;
- Thyroid dysfunction;
- Certain cancers, especially Hodgkin's disease;
- Diabetes;
- Iron deficiency;
- HIV.

Itching can also occur as a result of certain therapies, for instance:

- Renal dialysis;
- Chemotherapy;
- Radiotherapy.

What are the most common skin diseases that cause itching?

- Psoriasis or lichen scaly is a chronic inflammatory skin disorder characterized by papules or plaques on the skin. Psoriasis affects about 2% of people on the planet. There are winter, summer and mixed forms of the disease. The causes of psoriasis can be many factors: heredity, nervous breakdowns, changes in endocrine status, excessive alcohol consumption, and others. This disease is based on the predisposition of skin cells to accelerated division - therefore, due to metabolic disorders, they do not have time to mature and fully function.  Psoriasis can occur at any age and in the future proceed "in waves", with exacerbations. In the period of exacerbation of the disease, treatment implies a complex therapy, which includes taking various groups of drugs (vitamins, antihistamines, hepatoprotectors that improve blood circulation and increase immunity), as well as various external agents (ointments, creams, pastes, and many others). Artificial UV radiation is used.
- Eczema is a chronic recurrent disease with acute inflammatory symptoms caused by serous inflammation of the skin and polymorphism of elements of rashes.

Varieties of eczema:

- The true (idiopathic) form is accompanied by acute inflammatory edematous erythema with a rash of a group of tiny seropapules or vesicles, weeping and crusting;
- Microbial eczema develops at the site of chronic foci of infection, forming acute inflammatory, sharply delimited large-festoral foci.
- Seborrheic eczema develops in patients with seborrhea on areas of the skin (the so-called seborrheic areas), rich in sebaceous glands (scalp, ears, etc.) in the form of erythematous scaly spots with confluent papules of a yellowish-brownish color.
- Occupational eczema occurs mainly on exposed parts of the skin as a result of exposure to occupational hazards.
- Eczema in children is distinguished by the severity of the exudative component, the abundance of rashes. It is treated by the allergy medications and topical medications to reduce itching. Diet with the exclusion of provocative foods can be prescribed.
- Atopic dermatitis is an allergic skin disease that first manifests in childhood in persons with a genetic predisposition to allergies, which has a chronic recurrent course. It is distinguished by itching caused by hypersensitivity to both allergens and to nonspecific irritants. The severity of atopic dermatitis is determined by the intensity of itching, the spread of the inflammation, localization, sleep disturbance, and the presence or absence of a skin infection. 

The disease typically manifests in an alternation of remissions and exacerbations. Factors provoking exacerbations are overheating, excessive sweating or, conversely, dry skin, wearing rough clothes, scratching. With an exacerbation, erythema first occurs, then edema and oozing, often an infection. The lesion can involve large areas of the skin or be generalized. The chronic stage is distinguished by lichenification, desquamation and hyperpigmentation. It is treated in the same way as eczema.

- Pyoderma - purulent-inflammatory skin diseases caused by a variety of pathogens (staphylococci, streptococci, pneumococci, Escherichia coli, Proteus vulgaris, Pseudomonas aeruginosa, etc.). They can occur primarily on healthy skin or secondarily - as a complication of various, especially itchy, diseases. Predisposing factors - minor injuries (cuts, injections, scratching), skin contamination, overheating or hypothermia, dysfunctions of internal organs, central nervous system, metabolism, individual hypersensitivity to pyogenic infection. The treatment implies antibacterial therapy both orally and topically, prevention of skin damage, and use of antiseptics to avoid bacteria development in scratches, cuts, etc.

- Demodicosis is a chronic disease of the skin of humans and animals widespread throughout the world. Its causative agents are parasites - demodicide mites (acne mites). The complexity of dealing with a subcutaneous tick is determined by the fact that it is our symbiont, that is, its presence is the norm, not pathology. These mites are found on the skin of 90% of people and animals and usually do not cause any problems with a normal immune system, because a healthy human body maintains the number of ticks at a level that is safe for it. Previously, this tick mainly affected livestock, and the disease it caused was commonly called the red iron. But with the "help" of our smaller brothers - cats and dogs, which are carriers of this parasite, Demodex migrated to humans. Parasitizing a small number of ticks is sometimes asymptomatic. But if conditions are created that promote reproduction and increase their activity (in particular, with a decrease in the level of immunity with certain types of skin), then clinical manifestations of demodicosis appear in the form of various inflammations of the skin, eyes, hair (depending on where the tick has settled). This also occurs with certain skin diseases, for example, with rosacea, with vascular diseases, with oily, porous skin. The skin in the area of the nasolabial folds, nose, chin and eyelids is mainly affected. Cases of detection of mites on other areas of the skin (scalp, lips, neck, ears, chest, back, abdomen and pubic region) are few and are regarded by specialists as atypical.

The disease is characterized by the appearance of red spots on the skin, dilated blood vessels, swelling of the skin, peeling, pink or red nodules, small vesicles, and pustules. Sometimes the eyelids are affected, especially the lash area. With advanced forms of the disease, thickening of the skin, bloody-purulent crusts are observed. The skin disorder is also accompanied by itching, burning, tightening of the skin, a decrease in its elasticity and softness. A feature of demodicosis is that it usually occurs against as a companion of existing diseases. The course of demodicosis is aggravated by gastric ulcer and duodenal ulcer, gastritis, enteritis, cholecystitis, diabetes, rheumatism, tonsillitis, dysfunction of the endocrine glands, and the presence of foci of chronic infection. Thus, it is important to treat not only the skin manifestations but also the underlying disease.

Infectious skin diseases  

- Mycosis.  The general name fungus or mycosis usually means a whole group of different skin diseases. This uninvited guest can settle on the body, head, hands or feet, nails, but most often, according to statistics, there are cases of fungal infections of the feet. While a fungal infection is not a serious health threat, it is far from harmless. Over time, the affected skin of the feet can become deeply cracked and the process can move to the legs. In addition, fungal infection predisposes to the development of plantar warts. Fungal diseases can also contribute to the development of allergic reactions or aggravate the course of existing diseases, worsen the general state of immunity. Fungal diseases are found only in humans, and, therefore, they can only be infected from a sick person. Therefore, hygiene is the main prevention of mycoses of the feet and hands. Foot fungus usually begins with the skin of the interdigital folds, then it spreads to the skin of the soles, lateral and dorsal surfaces of the feet, palms and nail plates. The skin of the affected areas becomes dry, begins to peel off, grooves are clearly marked on it. The nails also change: spots or stripes of white appear on them, they turn yellow, fade and thicken, the edges are deformed and loosened. In the interdigital folds of the feet (most often between the fifth and fourth, fourth and third fingers), inflammation occurs with the formation of bubbles, after opening, which remain skin cracks - all this is accompanied by itching and pain. Since the clinical manifestations of fungal diseases are very diverse, attention should be paid to both minor skin peeling and painless cracks in the depth of the interdigital folds. Thus, the disease can be detected at an early stage and the necessary measures can be taken in time.

- Scabies. The disease is transmitted through close contact with the carrier, in most cases when they are together in bed. This is how family foci arise. Similar conditions of transfer exist in boarding schools, dormitories, orphanages, kindergartens, etc. Infection is also possible through clothing, personal items, handshaking and sexual intercourse. It can take up to 1.5 months from the moment of infection to the onset of clinical symptoms. The main signs of this skin condition are: itching, intensifying in the evening and at night, the presence on the skin of characteristic scabby passages, scratching, blisters, and rashes. Favorite places for an itch mite are hands, wrists, feet, male genitals, and torso. Children may have manifestations on the face and scalp.

- Microsporia (Ringworm) is a contagious skin disease caused by tiny parasites - fungi that are visible only under a microscope. Fungi, penetrating the surface layer of the skin, hair, and sometimes nails, multiply and cause disease. There are several types of ringworm fungi. Some of them affect only people, and the infection occurs through direct contact of healthy people with sick people and through things infected with fungi (clothes, linen, towels, combs). Other fungi are parasites of animals (cats, dogs, etc.), and people can become infected with this type of ringworm if they come into contact with sick animals. When infected with ringworm, flaky, round or oval patches of pink-red color appear on the skin. Round scaly spots also appear on the scalp, the hair on them breaks off, becomes whitish, as if sprinkled with flour.

Sexually transmitted infections

- Human papillomavirus (HPV) is the name for a large group of viruses. The disease is transmitted mainly through sexual and contact-household routes, when a newborn passes through an infected birth canal.

  Factors contributing to the appearance or recurrence of HPV are:

- Lowered immunity;
- Hypothermia (overcooling);
- Colds, hormonal disorders;
- Abortion;
- Introduction of intrauterine devices.

 Some types of HPV cause warts on the hands and feet, and some cause genital warts. On the external genitalia, they can be seen with the naked eye. If they are located inside, then only a doctor can see them. A characteristic feature of this pathology is that it affects patients at a young age. The appearance or recurrence of genital warts during pregnancy and spontaneous regression of genital warts after childbirth is observed. The characteristic location of genital warts: perineal region, perianal region, external part of the urethra, as well as the region of the posterior commissure, vulva, and cervix - in women; the head and body of the penis, foreskin and scrotum - in men. The lesions caused by HPV are morphologically very different. There are several clinical and morphological types of manifestations of HPV infection in the anus and genitals: genital warts, papillary varieties of warts, flat warts, etc. They are in general not itchy but can sometimes be accompanied by itching and other unpleasant sensations.

Types of skin diseases and their treatment

Post by: Jacob Hansen, General healthcare practitioner, National health centre, Stavanger, Norway