• What is pruritus
• Symptoms of itching
• Diagnosis of pruritus
• Skin itching treatment

What is pruritus

This is an independent disease. Its main manifestation is a long-term itching, leading to scratching on the body. Subjective sensations itching are caused by the participation of all sensitive apparatuses of the skin.

Pathogenesis (what happens?) during pruritus

Itching is divided, depending on its prevalence, into generalized, or universal, and localized, or limited. Localized itching most often affects the vulva in women, the scrotum in men, and the anus. Also limited pruritus happens in the area of ​​the inner surfaces of the thighs, legs, neck, head.

Localized itching is based on:

• helminthic invasion (especially pinworms),
• inflammation of the vulva
• inflammation of the vagina
• inflammation of the rectum,
• inflammation of the anus.

Also great importance has vegetative neurosis, neuropsychic, neurosexual, endocrine disorders. Generalized itching is based on metabolic disorders in elderly patients (senile itching), intoxication (itching in pregnant women), as well as unexplained causes.

Symptoms of itching

Manifestations of itchy skin are secondary morphological elements, such as: excoriations, crusts with point and linear hemorrhages. Itching appears paroxysmal, more often in the evenings or at night, less often during the day.

It can be of varying intensity: from weak to debilitating, leading to a decrease in the patient's performance, insomnia. Long-term itching in some patients leads to changes in the nails, which acquire a honed or "polished" appearance. If, as a result of a long-term severe itching, lichenification appears, then we are already talking about the transition of skin itching into neurodermatitis.

Diagnosis of pruritus

Diagnosis This disease is placed after the exclusion of all diseases of the skin, blood, diseases of the liver, kidneys, metabolic disorders, i.e., all pathologies in which, among other symptoms, there is a fairly pronounced itching of the skin. With skin itching, there are no primary morphological elements.

Skin itching treatment

Antihistamines are prescribed: diazolin 0.05-0.1 g 2-3 times a day, suprastin, pipolfen 0.025 g 3 times a day. All these drugs can also be used in the form of intramuscular injections for a more pronounced calming effect. Calcium preparations are also used in the form of a 10% solution of calcium chloride intravenously or a 10% solution of calcium gluconate intramuscularly.

Elderly people are recommended herbal medicine in the form of a decoction of horsetail (1 tablespoon per 1 cup of boiling water, leave for 1.5 hours and drink in sips during the day). Duration of admission - 2.5 weeks. With particularly persistent and painful itching, glucocorticoid drugs are prescribed, if there are no contraindications to their use.

If the patient has neurotic disorders, then it is advisable to use sedatives such as bromine, valerian, as well as tranquilizers (seduxen, elenium, trioxazine, librium). Physiotherapeutic treatment is widely used in the form of hydrogen sulfide or radon baths, sea baths, as well as baths with a decoction of oak bark, string, bran. With generalized itching, wipe the skin with a 1-2% alcohol solution of thymol, carbolic acid, menthol. In order to reduce dryness of the skin, vitamins A, B2, B3 are prescribed, and externally - emollient creams. With limited itching, corticosteroid ointments are used: "Sinalar", "Locacorten", 1-2% prednisolone ointment, 3-5% boron-tar ointment, creams with sex hormones (primarily androgens) - methyltestosterone or testosterone propionate .

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"Medical Bulletin", No. 24/25 (451-452) dated 08/08/2008

Clinician School

Doctors encounter the problem of pruritus in patients quite often, and this phenomenon can manifest itself in patients not only with a dermatological profile, but also with a very wide range of diseases. general. Information about this disease can be useful for doctors of various specialties. We asked the Head of the Department of Skin and Venereal Diseases of the Military Medical Academy named after M.V. CM. Kirov (St. Petersburg) Professor, Doctor of Medical Sciences Alexei Viktorovich SAMTSOV

Alexey Viktorovich, please tell us how modern medicine defines pruritus. Can this disease be considered an independent disease?

This is a really important question, the answer to which has not only theoretical, but also applied significance. Very often, doctors are faced with the need to answer: what is itchy skin - an independent disease or a symptom of another disease? And the answers will vary every time, because this problem occurs both as an independent disease, characterized only by itching of the skin and excoriations (scratches), and as one of the symptoms of various dermatoses. In some cases, it determines the clinical picture or is one of the main symptoms of the disease. In this regard, a number of authors distinguish a separate group of so-called pruritic dermatoses, which include, in addition to itching, neurodermatitis, pruritus, and less commonly, atopic dermatitis.

To give a strictly scientific definition of itching is not easy, and today it sounds, as before, somewhat philistine. Nevertheless, such a definition is given in all major domestic and foreign manuals: itching is a special unpleasant subjective sensation that causes the need to scratch.

- What is the mechanism of manifestation and development of itching?

Unfortunately, much of the pathophysiology of pruritus is currently unclear. For a long time, it was believed that itching is a modified sensation of subthreshold pain resulting from exposure to neuroreceptors of the skin and mucous membranes of various irritants (pruritogens). The fact that the skin does not have specific itch receptors was confirmed in experiments. For example, injection of a solution containing a low concentration of histamine into the skin caused an itching sensation, while a high concentration of the same substance initiated a sensation of severe pain. At the same time, there is an opinion that itching and pain are separate and distinct sensations, although they are transmitted along C-fibers through the same neural channels (spinothalamic tract in the spinal cord). The following data testify in favor of this: itching causes a desire to scratch, pain - to move away; morphine relieves pain, but can cause itching; itching and pain can be felt at the same time in the same area; the nerve endings that cause pain are located deeper than the dermoepidermal junction. Chemical mediators of itching are histamine, substance P and vasoactive intestinal peptide, biogenic amines and kinins: serotonin, bradykinin, kallidinkallikrein.

Irritants (pruritogens) that cause itching can act on skin receptors both endogenously and exogenously when they regularly hit the skin surface. The former often cause the development of general (universal) pruritus, the latter - localized. In the development of universal chronic itching, functional disorders of the processes of excitation and inhibition of the cerebral cortex also play a role, which are first a consequence of itching, and subsequently ensuring the appearance of a vicious circle that causes more frequent attacks of the disease.

How is pruritus classified? What effects on the patient's body can cause its manifestation?

At present, there is no unified classification and there are very few proposals on this problem. In particular, some foreign scientists (for example, Bernhard) distinguish 6 variants of itching: 1) dermatological, occurring in psoriasis, eczema, scabies and urticaria; 2) systemic, manifested in diseases of various internal organs (kidneys, liver); 3) neurogenic, observed in lesions of the central or peripheral nervous system; 4) psychogenic, 5) mixed, and 6) itching of another origin.

The causes of general itching are very diverse. Acute single attacks are most often associated with ingestion of food or medicines(citrus fruits, tomatoes, strawberries, alcohol, aspirin, belladonna, morphine, amphetamines), to which the patient has an increased sensitivity (allergic reaction), industrial and household chemicals, the heat of an open fire (for stokers, blacksmiths, blast furnace workers), change in temperature during undressing.

In some people, due to changes in barometric pressure, when climbing to a height of 10 thousand meters or more, the so-called. altitude itching.

There are also senile and seasonal itching. The first is observed mainly in men over the age of 60 and occurs in the form of seizures, more often at night. The causes of senile itching are mainly endocrine disorders, atherosclerosis, dehydration of the skin. Seasonal itching occurs during the transitional season (spring, autumn).

Localized itching occurs most often in the anus and genitals. Anal itching occurs predominantly in men. Its causes: untidiness, hemorrhoids, constipation, proctitis, prostatitis, vesiculitis. The cause of anal itching may be erythrasma, which is not always possible to diagnose due to increased skin pigmentation in the anus. In this regard, with anal itching, attention should be paid to the condition of the skin of the femoral-scrotal folds, the defeat of which is typical for erythrasma.

Genital itching is a predominantly female affliction. Its causes: leucorrhoea, trichomonas, pinworms, skin irritation with urine in diabetes or gout, inflammatory diseases of the genital organs, menopause, sexual neuroses. With the latter, itching of the genital organs in men is sometimes associated. Most often, its causes are prostatitis, vesiculitis. Itching of the head of the penis is due to the increased acidity of the vaginal secretion in the sexual partner, the use of local contraceptives.

With anal and genital itching, complications such as fissures, streptococcal and candidal diaper rash, and hydradenitis often develop.

- In what cases can a doctor diagnose pruritus? What is the clinical picture of its manifestation?

The clinical picture of general itching is characterized by the absence of primary morphological elements. On various parts of the skin, linear excoriations (scratches), linear blood crusts are found. The nails of the fingers of the hands demonstrate polishedness and abrasion of the nail plates from the free edge. Patients, in addition to complaints of itching, suffer from sleep disorders and the general state of the nervous system.

Localized itching, as a rule, develops in the anus and genitals. It is characterized by excruciating itching (especially in the anus), often complicated by painful fissures, streptococcal and yeast diaper rash, folliculitis and boils, observed against the background of severe scratching and hemorrhagic crusts.

Some authors distinguish localized itching of rare localization: itching of the legs (in patients with varicose veins due to skin hypoxia), winter itch lower extremities (hypoxia from prolonged hypothermia), itching of the scalp, itching of the palms, soles, forehead, eyelids, cheeks, shoulder blades, armpits (usually due to local vascular or nervous disorders), itching as a trace reaction after treatment of a wide variety of dermatoses.

As a nosological form, pruritus is diagnosed during the initial examination of the patient. Diagnosis of the disease is based on a characteristic clinical picture: intense itching and the presence of excoriations in the absence of rashes of primary morphological elements.

In some dermatoses, itching is a particularly serious problem. First of all, of course, with neurodermatitis - chronic itchy dermatosis, characterized by the appearance of papules and the development of lichenification due to constant scratching. It is with intense itching that the disease begins, and then its manifestations on the skin develop. The disease is associated with functional disorders of the nervous system, which are joined by organic changes nerve fibers and receptor apparatus of the skin. Disturbances in the function of the gastrointestinal tract, endocrine disorders are also important.

Itching as one of the leading symptoms is characteristic of atopic dermatitis or atopic eczema. It is a chronic relapsing inflammatory dermatosis that develops in patients with hereditary hypersensitivity and is characterized by pruritic papular and vesicular rashes. The disease is based on hereditary IgE-type hypersensitivity to various aero-, food and drug allergens.

It is impossible, of course, not to mention pruritus, since the very name of dermatosis contains the idea of ​​​​intense itching. The term prurigo (prurigo) combines a group of diseases, the primary morphological elements of which are severely itchy vesiculopapules, urticarial papules, hemispherical papular and nodular elements. It includes pediatric papular urticaria, adult strophulus, and prurigo nodosum.

Finally, itching almost always accompanies scabies, urticaria, many forms of which are associated with allergic mechanisms of development. Intense itching is observed in chronic skin diseases such as lichen planus, Dühring's herpetic dermatitis.

Itchy papules may be caused by flea or tick bites. Patients sometimes do not pay attention to the fact that rashes appeared after contact with pets.

How is pruritus treated?

First of all, I would like to note that the treatment of pruritus as a dermatosis, and not a symptom of the disease, is a very difficult problem, since success is based on the identification and elimination of the cause of the disease, which requires a full-fledged qualified examination, and if an etiological factor is identified, its elimination. Unfortunately, this is not always possible, therefore, in such cases, as well as in all dermatoses accompanied by itching, symptomatic therapy is prescribed.

General therapy includes the use of sedatives and anxiolytics, antihistamines. Of the physiotherapeutic methods, electrosleep, adrenal induction, contrast showers, sulfuric and radon baths, sea baths are used.

External therapy plays an important role in the treatment of itching. With universal itching, rubdowns are used with solutions of antipruritic agents (2% tincture of salicylic or carbolic acid, menthol or diphenhydramine, as well as table vinegar diluted three times). In the treatment of localized itching, antipruritic agents are used in the form of powders, creams, ointments or pastes, which are applied after preliminary thorough rubbing of the affected area with disinfectants. Diphenhydramine (1-2%), anestezin (5%) and glucocorticosteroid external agents are used. In persistent cases, local novocaine blockades of the corresponding nerves are performed.

You have described the traditional methods of treating itching. What's new in this area lately? What new drugs can be recommended to doctors?

In this regard, I would like to highlight the group of antihistamines. Their effectiveness is determined by the very mechanism of development of itching, in particular - itching of an allergic nature. As you know, when exposed to an allergen on the mast cells of the body, degranulation occurs, resulting in the release of inflammatory mediators, the most important of which is histamine. Histamine interacts with the H1 receptor and initiates the so-called allergic cascade. Antihistamines mainly block H1 receptors and thus prevent the development of allergic inflammation.

Antihistamines have been used in this area of ​​therapy for a long time. They are usually taken by mouth and used alongside traditional itch treatments. However, recently a new remedy has appeared, the healing qualities of which are in many ways unique. This is Psilo®-Balm, an antipruritic antihistamine used externally. It is available in the form of a gel, which makes it very effective for the treatment of pruritus of various etiologies. The dosage form significantly increases the effectiveness of the drug. The gel as a form in itself has a certain pharmacological effect and reduces inflammation, and in combination with the active drug component, this ability increases many times over.

Itching is one of the most common dermatological complaints, and it can manifest itself not only in patients with dermatoses, but also in a wide range of general diseases. This is an unpleasant sensation, which is accompanied by a continuous need for reciprocal mechanical irritation of the skin. Itching can significantly affect the general condition and quality of life of patients, causing insomnia, anxiety, and in severe cases even lead to depression and suicidal thoughts.

Itching is one of the forms of the skin analyzer, close to other types of skin sensations (touch, pain). In contrast to pain, which causes a “withdrawal, avoidance” reflex, itching causes a “processing” reflex. Scratching, rubbing, kneading, warming, pinching the itchy areas leads to instant, but not long-term satisfaction. This is due to the fact that in the process of scratching, stronger impulses are modeled in the nerve endings, which suppress the conduction of weaker itching signals from the affected areas. Severe itching is relieved only by severe self-injury, resulting in the sensation of itching being replaced by a feeling of pain. If itching exists for a long time, then a focus of pathological excitation and itching from defensive reaction turns into a standard skin reaction to various external and internal stimuli. At the same time, in response to prolonged scratching, the state of peripheral nerve receptors also changes, which leads to a decrease in the itch perception threshold. Thus, a "vicious circle" is formed, the presence of which explains the difficulties of treating itching.

Itching is caused by mechanical, thermal, electrical or chemical stimulation of unmyelinated nerve fibers, the free nerve endings of which lie at the border of the epidermis and dermis. They are excited either directly or indirectly, by releasing various mediators (histamine, serotonin, proteases, neuropeptides, etc.).

Physiological itching occurs in response to stimuli environment(insect crawling, friction, temperature change, etc.) and disappears after the cause is eliminated. Pathological itching is due to changes in the skin or throughout the body and causes a strong need to get rid of itching by scratching or other means.

Itching can be a symptom of various dermatoses (scabies, pediculosis, atopic dermatitis, allergic dermatitis, eczema, fungal infections, psoriasis, lichen planus, etc.) or occur on intact skin in diseases of internal organs. Endogenous causes of pruritus are very diverse:

If the cause of itching, even with a thorough examination, cannot be identified, then it is defined as itching of unknown origin (pruritus sine materia).

For a correct assessment of itching, it is necessary to carefully collect an anamnesis and question the patient. Attention should be paid to the following characteristics of itching: the time of occurrence, provoking factors, intensity, course, localization, nature.

The intensity of itching can be different - from mild to very pronounced. For a more objective assessment, it should be clarified: does itching interfere with falling asleep; whether the patient wakes up with itching; does itching interfere with performance daily work. Itching, leading to sleep disturbance, is regarded as severe.

Depending on the time of occurrence, they are distinguished - night, day, permanent, seasonal. For example, in scabies and widespread eczema, the itching is worse when the patient lies down in bed; anal itching caused by pinworms occurs between two and three in the morning; with psychoneuroses - permanent.

Limited itching of the skin of any one anatomical region, as a rule, is caused by local causes. The presence of a widespread and symmetrical itch suggests its internal nature.

The sensation of itching may be "deep" or "superficial", may be tinged with burning, tingling (for example, dermatitis herpetiformis is characterized by burning itching, especially of the scalp). Itching - parasthesia - a feeling of tingling, mild burning, crawling, etc., develops with increased pain sensitivity of the skin and decreases with stroking or light pressure on the itch. Biopsy itching leads to deep damage to the skin.

As a result of prolonged itching and scratching, excoriations, pigmentation, scars, lichenification, and pyoderma occur. The free edge of the nail plates is ground off, the nails look like polished. Objective signs are not required to make a diagnosis of pruritus.

Features of itching in syndromes of different origin

Cholestatic (hepatic) itching- one of the most painful and constant symptoms of chronic cholestasis. It occurs in 100% of patients with primary biliary cirrhosis of the liver and in almost 50% is the reason for visiting a doctor. Often precedes all other symptoms of cirrhosis. Usually generalized, more pronounced on the limbs, thighs, abdomen, and with obstructive jaundice - on the palms, soles, interdigital folds of the arms and legs, under tight clothing.

uremic itching, in chronic renal failure, it can be local or diffuse, more pronounced on the skin of the neck, shoulder girdle, limbs, genitals, in the nose. Intense, aggravated at night or immediately after dialysis, and also during the summer months.

diabetic pruritus more often occurs in the anogenital region, the auditory canals, in some patients it is diffuse.

Hyperthyroid pruritus observed in 4-10% of patients with thyrotoxicosis, diffuse, dim, unstable.

Hypothyroid itching is caused by dry skin, generalized, sometimes very intense, up to excoriations.

Menopausal itching observed mainly in the anogenital region, in the axillary folds, on the chest, tongue, palate, often has a paroxysmal course.

Itching in hematological and lymphoproliferative diseases. Generalized or local: Hodgkin's disease - over the lymph nodes, anogenital - with iron deficiency anemia, with polycythemia - on the head, neck, limbs. In polycythemia, a stabbing, burning, aquagenic itch may precede the disease by several years.

Paraneoplastic pruritus sometimes manifests itself several years before the onset of the disease. It can be local or generalized, of varying intensity. For some forms of cancer, specific localization of itching is observed: with prostate cancer, itching of the scrotum and perineum; with cervical cancer - itching of the vagina; with cancer of the rectum - perianal region; with a brain tumor infiltrating the bottom of the IV ventricle, itching in the nostrils.

Psychogenic itching often associated with depression, anxiety. It is characterized by: the absence of skin changes, common or limited to some symbolic, significant area for the patient, intensifies in stressful situations, conflicts, sleep, as a rule, is not disturbed, patients often describe their feelings bizarrely, exaggeratedly. Itching is relieved when taking sedative or antipruritic drugs, it is much worse stopped by external means. The presence of deep excoriations, bizarre self-harm, parasitophobia rather indicates the presence of psychosis rather than neurosis. The conclusion about the psychogenic cause of itching is possible only after the exclusion of skin and systemic diseases.

If we talk about the harmless causes of such phenomena, they include bites from domestic insects, mild allergic reactions and prickly heat. However, if such a nuisance is chronic, this is a good reason to contact a dermatologist for an internal examination and consultation. In most cases, itching and flaking of the skin are of a neuro-allergic nature.

Complications

Remember that itching can signal the development of serious diseases: eczema, psoriasis, dermatitis or scabies, which entail a number of complications and tend to evolve into chronic forms. In addition, generalized and localized itching can be a symptom of a severe allergic reaction.

If the irritant is not detected and excluded in time, the allergy can be complicated by Quincke's edema and even death. It is necessary to consult a doctor in cases where the itching becomes literally unbearable, complicates night sleep and lasts over two weeks.

Our qualified dermatologists will help you accurately diagnose and understand the true etiology of the symptom, after which you will be prescribed adequate and effective treatment.

Varieties of pruritus

First of all, you should understand what character your skin itch has.

Physiological itching occurs due to exposure to the skin of external stimuli - mechanical, chemical and thermal. It can be associated with insect bites, changes in air temperature, skin contact with certain caustic substances.

Pathological itching indicates the presence of a serious skin disease, often chronic. It may also be associated with neurological disorders and hormonal changes during pregnancy.

Generalized itching characterized by diffuse distribution throughout the body. It is often associated with intolerance to certain food sources, reaction to temperature changes, and rejection of medications. For the category of elderly people, permanent generalized itching is characteristic due to dry skin due to partial dysfunction of the sebaceous glands. This syndrome is called "senile itching".

Generalized itching may also indicate numerous internal diseases. Among them are diabetes mellitus, leukemia, hepatitis, lymphogranulomatosis, oncological processes and manic-depressive psychosis.

By the nature of the occurrence, itching is characterized as constant and paroxysmal.

• paroxysmal itching can occur at any time under the influence of external stimuli or on its own;
• Constant itching is observed throughout the day and tends to worsen in the daytime and evening. At a later time of the day, permanent itching becomes literally unbearable, often brings impressive discomfort to the patient and even interferes with sleep.

The symptom may be accompanied by visual changes in the skin. So, in places of itching, severe redness can be observed, a weeping rash and severe peeling can form.

When should you visit a doctor?

You need to see a dermatologist urgently if your itchy skin:

• Continues for a long time (two weeks or more);
• Causes impressive discomfort throughout the day and prevents healthy sleep in nighttime;
• Has a tendency to gradually spread over the entire area of ​​the body;
• It is combined with a number of other symptoms: apathy, increased fatigue, anorexia, a sharp decrease in body weight, stool disorders, reddening of the skin, the formation of a weeping rash, vesicles and plaques on it.

peeling skin

Peeling of the skin is a relatively normal physiological factor. However, if it is accompanied by itching, it can be a sign of a serious illness. In this case, larger scales are separated, localization sites can become wet and cause severe discomfort in the form of burning and pain.

Causes of dry and flaky skin

• Allergy to external irritants and food;
• Local irritations on the skin;
• Mechanical and chemical damage to the skin;
• Sunburns resulting from the abuse of insolation;
• Skin diseases: eczema, seborrhea, psoriasis.

In what case should you contact the doctor?

• Peeling is combined with a strong, literally unbearable itching;
• The symptom is complicated by an infectious or inflammatory process;
• Separation of large fragments of skin in the lower part of the legs, like fish scales;
• Local home treatment has not been successful and the desquamation is progressing.

What diseases can itching and peeling indicate?

The number of diseases associated with the appearance of the symptom is extensive. Discomfort can signal the following problems:

1. Bites of household insects;
2. Allergic reactions to food sources and medications;
3. contact dermatitis (metal allergy);
4. Infectious diseases;
5. Severe illnesses blood;
6. Jaundice;
7. seborrhea;
8. Eczema;
9. Psoriasis;
10. Dermatitis;
11. kidney disease;
12. Diabetes;
13. Haemorrhoids;
14. Skin aging and decreased productivity of the sebaceous glands.

It should be noted that the reasons may be more harmless. Itching and peeling are often observed in the hot season due to increased sweating. Some complain of discomfort after using cosmetics and hygiene products with a high content of fragrances and chemicals. However, in this case, the symptoms tend to self-eliminate after contact with the irritant is eliminated.

If you find yourself with an unpleasant symptom that only progresses, we recommend that you contact our experienced dermatologists. In our clinic, you will be assigned a series of diagnostic studies, after which effective therapy will begin. If your problem is related to diseases of the internal organs, our doctor will refer you to a highly specialized specialist. We will carefully and effectively deal with your problem, eliminate your discomfort and cure the underlying disease.

The sensation of itching is one of the types of skin analyzers, similar to such forms of skin sensations as touch, burning, tingling, pain, in which there is a physiological reflex of scratching the skin. This article will tell you in detail about the types, causes and treatment. folk remedies localized itching of the skin, providing the text with useful photos.

What is localized pruritus

Along with pain, itching has an extremely important protective function, being a sign for the immediate elimination of substances that damage the skin. Localized itching, in contrast to generalized (common), develops in a limited area of ​​\u200b\u200bthe skin.

• The state of itching - unpleasant, irritating, similar to painful - is provoked by mechanical, chemical, thermal, electrical stimulation of nerve fibers that extend into the border area between the epidermis and dermis.
• Excitation of nerve endings occurs either directly or indirectly - with the release of such mediators as histamine, adrenaline, serotonin, kallikrein, neuropeptides, opioids, cytokines, eicosanoids, as well as under the influence of helminthic, tick-borne, tumor and other toxins.
• If the pain causes a natural reaction of "removal" from the source, itching acts on the person as a skin irritant "object" that needs to be eliminated. It provokes the “treatment” reflex of the itchy area in the form of scratching, rubbing, pinching, which leads to quick but brief satisfaction.

This is due to the fact that in the process of scratching, the nerve endings receive stronger impulses that suppress weak signals from itching. Intense excruciating itching, for example, with neurodermatitis, patients often relieve by causing severe damage to the skin, tearing it, which leads to the replacement of severe itching by a feeling of severe pain.

His classification

The classification of itching in practical medicine is based on the types of mechanism of its occurrence. There are the following forms of itching:

• pruritogenic arising from or with tick-borne lesions, bites, skin pathologies, such as psoriasis;
• systemic or neurogenic, developing as one of the signs of internal diseases (hepatic, endocrine disorders,);
• neurological (neuropathic), manifested against the background of damage to the nerve trunks, squeezing compression, brain tumors, abscesses, herpetic;
• psychogenic observed in mental disorders without signs of dermatological pathology, depression, which is associated with an increased content of the hormone corticotropin in the blood;
• multifactorial (with a combination of two or more causes).

How to spot a symptom in yourself

The patient often does not pay attention to short-term attacks of itching of moderate severity or to constant, but not severe itching. Intense itching is impossible not to notice, especially when it is accompanied by the following external manifestations:

• excoriations (scratches) in the form of scratches, abrasions, small and large spots;
• the appearance of blood crusts on drying skin lesions;
• the occurrence of the “polished nails” syndrome, which is explained by constant scratching of the skin, in which the nail plates are ground and polished and become very smooth and shiny;
• irritability caused by exhaustion of the nervous system.

The video below will tell you about the causes of localized skin itching:

Diseases and disorders

Local itching affecting certain parts of the body may be a common physiological condition after an insect bite or a sign of regeneration (healing) of damaged skin, but is often one of the manifestations of a dermatological or systemic (concerning the whole body) pathology, requiring immediate diagnosis with the discovery of the cause.

Since limited itching often acts as a symptom of serious illnesses, a comprehensive examination is mandatory, accompanied by a consultation with a general practitioner, dermatologist, endocrinologist, allergist, neurologist, urologist, gynecologist.

The most common causes of localized pruritus are:

• dry skin;
• skin infections (folliculitis,);
• allergic, as a reaction to certain drugs, chemicals, insect bites;
• dermatoses - psoriasis, dermatophytosis, lichen planus; , pruritus, ;
• , measles (itching on the background of skin rashes);
• liver disease, accompanied by yellowing of the skin, mucous membranes, sclera;
• chronic kidney failure;
• endocrine pathologies (diabetes mellitus, thyrotoxicosis, hypothyroidism);
• oncological pathologies.

With many diseases of internal organs, malignant tumors, vascular pathologies, localized itching manifests itself in certain areas.

Diseases and their corresponding localization of itching (excluding the anogenital area):

Disease / type of itching	Localization other than anogenital area	Features, other affected areas
Cholestatic (hepatic) itching with biliary cirrhosis (100%), hepatitis, chronic cholecystitis, sclerosing cholangitis, giardiasis, jaundice (25%),	Limbs, thighs, abdomen, palms, feet, skin between fingers.	Whole body, anus, genitals. Intense, often permanent.
Uremic in chronic renal failure, chronic glomerulonephritis	Skin of the neck, shoulder girdle, limbs, genitals, nasal mucosa.	Often the whole body itches. Increase immediately after dialysis, at night, in summer
diabetes mellitus (diabetic)	Ear canals, eyelids, skin around the eyes	All skin, anus area
Menopausal period (climacteric)	Armpits, chest skin, tongue, palate	genital area. More often - seizures
Oncology (paraneoplastic spontaneous pruritus, more often moderate, increasing at night), including the following diseases:
Polycythemia (erythremia)	Limbs, head, neck.	Stinging, burning. Aquagenic (in contact with water). May itch the whole body
(lymphogranulomatosis)	Area of ​​lymph nodes, scalp	Intensive
	External and internal area of ​​the nose
	Scrotum, perineum
Carcinoma,	Limbs, chest, upper back, arms	Accompanied by burning
Tumors with metastases to bone or skin	Areas affected by cancer
Neuropathy, mental disorders, including:
A form of peripheral neuropathy (paresthetic notalgia or so-called persistent pruritus)	Medial zone of the border of the scapulae	Involving 2 - 6 thoracic nerves
	Segment of skin corresponding to the area of ​​spinal cord injury	paroxysmal
Postherpetic neuralgia	area affected	often accompanied by pain
Thrombosis of cerebral vessels, focal lesions	Side of the body opposite the brain damage
, asthma, obstructive pulmonary disease	Front neck, chest, back	Whole body
Nose, skin and mucosa	Pollinosis, intestinal helminthiases, brain cancer
Fingers, wrists	Eczema, scabies, contact dermatitis
oral mucosa, tongue	Deficiency of iron, folic acid, vitamin B, allergies, candidiasis, stomatitis, herpetic sore throat, pemphigus, neuropathy
Skin on the face	Rosacea, demodicosis, psoriasis, diseases of the gastrointestinal tract, cold, food, medication, sun, cosmetics
Buttocks	Scabies, intestinal dysbacteriosis, stomach diseases, allergy to synthetic fabrics, washing powder

How to deal with such a symptom

The presence of itching affecting isolated areas of the skin is often a sign of a banal allergy. But, if all possible factors leading to such a reaction are eliminated (medicines, food, chemicals, including cosmetics, temperature factor), and itching continues, this condition can be an early or leading symptom of any disease, skin pathology, and even oncology. .

For this reason, detailed diagnostic studies should be carried out in order not to miss a serious disease.

Diagnostics

During the initial examination, the condition of the skin and the presence, in addition to itching, of other signs are revealed:

• rashes, scratching, scabies, cortical formations, bites;
• redness, peeling, swelling;
• cyanosis, redness, yellowing.

If a rash, inflammation, pustules, bloody crusts, spots are found, a dermatological examination is necessary.

If the skin does not show signs of dermatosis, dermatitis, tick-borne lesions, the examination includes the following tests:

• total and (leukocyte count, ESR);
• urinalysis (presence of protein and fractions, sugar, bacteria, cholesterol, ALT, bilirubin, creatinine, urea, serum iron);
• determination of blood viscosity (clotting);
• feces for the presence of blood, helminths;
• radiography and ultrasound of the chest, pelvis, peritoneum;
• thyroxine level.

This video will tell about folk methods in the fight against skin itching:

Treatment

First of all, eliminate possible factors provocateurs of itching, which include:

• overheating, temperature changes, direct sunlight, cold, hot water;
• synthetic and wool fabrics;
• contact with allergen substances - detergents, cosmetics, hygiene products, household and industrial chemicals;
• medicines and products that can provoke skin allergies;

Treatment of itching, which is one of the symptoms of a skin or general pathology, consists in the treatment of the disease itself. The cure immediately affects the symptoms, which means it allows you to get rid of the itching.

Intensity reduction

In the treatment of pruritus of various localization, the following groups of drugs are distinguished to reduce its intensity:

• anti-tick drugs for scabies (Benzyl benzoate, Paxil, Fluvoxamine);
• Cholestyramine, Colestipol, Rifampicin, Essentiale, Rezalyut, Karsil, Heptral with cholestasis (bile stasis) against the background of hepatic pathologies;
• sorbents Polysorb, Polypefan, white and black coal, removing toxins;
• probiotics Bactistatin, Bififor, Bifiliz, Probiofor - for any pathologies associated with the release of toxins or a violation of the intestinal microflora.

Local

Local treatment includes the use of the following agents:

• anesthetics - Anestezin 5-10%, Phenol 1-2%, Diphenhydramine solution 5-10%, in combination with menthol, the antipruritic effect increases;
• Capsaicin with red pepper extract;
• creams and ointments with Lidocaine, Prilocaine (preliminary use with Capsaicin significantly reduces its side effect - burning);
• corticosteroid ointments - Pimafukort, Doxepin cream, Sinaf-ointment, Elocom, Celestoderm, Bufeksamak, Lorinden A, C, Mezdoderm;
• calcineurin inhibitors - Elidel (Pimecrolimus), Tacrolimus (Protopic), Advagraf, Prograf
• , Akriderm GK, Boromenthol, Radevit, Psilo-balm, menthol ointment, Nizulin, Advantan, Baneocin, Fucidin, Gistan,;
• local preparations for fungal infections of the skin: Exoderil, Tinedol, Zalain, Mykospor.

Non-specific adjunctive therapy

• cold compresses (with urea) - softens, moisturizes, reduces xerosis, relieves itching;
• ointments, creams with menthol, camphor, zinc;
• in the presence of a bacterial infection, general and local antibacterial drugs are required;
• physiotherapy: UV radiation, including PUVA, UVA and UVB phototherapy;

Some itchy rashes, such as prurigo, are removed with a laser, cryotherapy, Triamcinolone injections.

A specialist will tell about itching in a child in the video below:

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