Pruritus (Itchy Skin)

What is pruritus?

Pruritus is a medical term that means itching. It refers to a feeling or sensation on your skin that you want to scratch. Pruritus can be painful or irritating and could be localized to one area of your body or spread throughout several areas.

Pruritus can be a symptom of an underlying condition. It has many possible causes; the most common being contacting an allergendry skinpregnancy and your body’s reaction to a medication. Pruritus can be chronic if your itching persists for six weeks or more.

What are the types of pruritus?

There are several different types of pruritus categorized by the cause of itchiness and the location of the itch on your body. Some of the most common types of pruritus include:

• Brachioradial pruritus: Itching of the upper arm caused by nerve damage.
• Nocturnal pruritus: Itching that occurs at night with several possible causes that include a reaction to your body’s natural functionsa reaction to a medication or contacting a skin irritant.
• Pruritus ani: Itching of the skin surrounding your anus caused by hemorrhoidsan infection or a skin irritant.
• Senile pruritus: Itching caused by changes to your skin that affects people over the age of 65.
• Uremic pruritus: Itching occurs as a symptom among people diagnosed with renal disease who receive dialysis.

Who does pruritus affect?

Pruritus is very common and will affect everyone during their lifetime. The severity and frequency are different for each person. You may be more at risk of pruritus if you:

• Are 65 years or older.
• Have allergies.
• Have an underlying condition like eczemapsoriasis or diabetes.
• Are pregnant.
• Are on dialysis.

What does pruritus feel like?

Pruritus causes your skin to feel itchy. This can be an uncomfortable or bothersome sensation that will only resolve if you scratch your skin. Sometimespruritus can be painful and other timesit could feel like something is tickling your skin. Scratching your itch can lead to more pain and irritation and won’t always resolve your itch. If your skin is frequently itchycontact a healthcare provider.

What are the symptoms of pruritus?

The main symptom of pruritus is an itch. An itch is a feeling or uncomfortable sensation that causes you to scratch your skin to get relief. Scratching the itch doesn’t always provide relief.

If you scratch your itchy skinyou could have additional symptoms that include:

• Dry or cracked skin.
• Scratch marks (excoriations).
• Thickleathery patch of skin (lichenification).
• Localized pain at the site of your itchy skin.
• Skin breaks open and bleeds.
• Broken skin leaks a yellow to white fluiddoesn’t heal or has a scaly or crusty texture (infection).

Additional symptoms of pruritus include:

• Skin discoloration that’s lighter or darker than the skin surrounding it.
• A rash forms on your skin that’s elevated or swollen (inflammation).
• Small pimple-like bumps on your skin (papules).
• Large bumps on the affected area of your skin.
• Blisters or fluid-filled bumps on your skin.

Sometimesyou could experience itchy skin along with additional symptoms like a rash or swollen skin. Other timesyou’ll only experience itchy skin without other symptoms. Your provider will diagnose your condition and offer treatment options based on what caused your skin to itch.

What makes me want to itch my skin?

Pruritus symptoms cause you to feel itchy. Your immediate reaction is to scratch your skin. An outside stimulus usually triggers this itchy sensation. Outside stimuli could include something touching your skinfibers in your clothing or moving your body naturally. Peripheral sensory neurons are nerve fibers in your nervous system that relay a message from your skin to your brainand vice versato activate movement. When a stimulus triggers your body’s sensation to itchyour brain responds by telling you to scratch your skin.

What causes pruritus?

There are several causes of pruritus that include:

• Dermatologic: The itching is the result of inflammation or swelling within your body.
• Systemic: The itching is the result of an underlying medical condition that can affect your skin or your internal organs. This could include natural changes to your body with age or hormonal changesamong others.
• Neuropathic: Nervous system conditions or nerve damage causes itching.
• Psychogenic: Psychiatric conditions or conditions that affect your brain cause itching.
• Environmental: An irritant in your environment causes itching. This could be clothing materialan insect bitea reaction to a drugtemperature or touching something uncomfortable.

The most common cause of pruritus is dry skin.

Is pruritus a sign of an underlying condition?

Several conditions have itching as a symptom. Some of the most common conditions that cause itching include:

• Diabetes.
• Liver or kidney disease.
• Pregnancy.
• Eczema.
• Psoriasis.
• Cholestasis.
• Obsessive-compulsive disorder.
• Allergies.
• Dermatitis.
• Thyroid disease.

How is pruritus diagnosed?

To diagnose pruritusyour provider will physically examine your skin and will gather more information about your symptoms and your medical history. Your provider might ask you questions including:

• When did the itching start?
• Did you make any changes to your personal care products (soapslotionsetc.) before you started itching?
• Have you had other symptomssuch as weight lossfeeling very tirednight sweats or increased thirst?
• Did you start taking any new medications?
• Did you touch something specificsuch as a plant or a new pet?

What tests diagnose pruritus?

Your provider might offer tests to confirm a diagnosis. Testing can help determine what caused your symptoms. Your itching might be the primary problem or it might be a symptom of another condition. Tests may include:

• Allergy tests to indicate if you’re reacting to something in your environment.
• Blood tests to reveal vitamin and mineral deficiencies or problems with your internal organs like your liverkidneys or thyroid.
• Imaging tests (chest X-ray) to reveal conditions that extend beneath your skinlike cancer.
• Skin biopsy to identify skin conditions that cause itching. This test involves taking a small sample of skin and examining it under a microscope.

How do I get rid of pruritus?

Treatment for pruritus is unique to each person and varies based on what caused your symptoms. Treatment could include:

• Using a creamlotion or ointment on your skin.
• Taking medicine to stop itching.
• Stopping or changing a medicine that causes symptoms. Don’t stop taking a medicine until your provider tells you it’s safe to do so.
• Treating or managing any underlying conditions that cause itching.
• Using nonmedical therapies to relieve itching like acupuncturelight therapy or transcutaneous electrical nerve stimulation therapy.

Are there at-home remedies to treat pruritus?

You can take steps to treat pruritus at home by:

• Regularly using creams and lotions to keep your skin moisturized and prevent dry skin.
• Wearing sunscreen to prevent sunburns and damage from the sun’s UV rays.
• Using unscented or sensitive skin products like detergent and soaps to avoid skin irritation.
• Taking a warm (not hot) bath or shower to relieve itchiness.
• Avoid wearing fabrics that cause skin irritation like wool and synthetic fabrics. Cotton clothing usually doesn’t cause skin irritation.
• Placing a cool washcloth or ice wrapped in a towel over the area of your skin that itches to calm your skin.

What medications treat pruritus?

Your provider may prescribe medications to treat pruritusincluding:

• Antihistamines.
• Topical steroids or oral steroids.
• Immunosuppressant medicationssuch as cyclosporine A.

Some studies suggest that antidepressant medicines can offer relief to your itchy skin by relaxing the receptors in your body that cause itchiness.

What anti-itch creams treat pruritus?

To treat pruritusyour provider might recommend anti-itch creams to relieve your symptoms. You don’t need a prescription for some types of anti-itch creams and you can purchase them over-the-counter. Look for creamslotions or ointments that are fragrance-free and contain at least one of the following ingredients to help relieve your itchy skin:

• Hydrocortisone: A drug that stops swelling and inflammation.
• Antihistamines: A drug that relieves symptoms from an allergic reaction.
• Capsaicin: A drug that treats minor aches and pain.
• Aloe vera: A substance extracted from a plant that soothes irritated skin.
• Menthol: A plant-based product that provides a cooling sensation when applied to your skin.
• Petroleum jelly: A mixture of mineral oils and waxes that provides moisture to your skin.

If your itchy skin persists or gets worse after using an anti-itch creamcontact your provider.

How soon after treatment will I feel better?

The length of time you’ll have pruritus depends on the cause of your itchy skin. Some diagnoses are long term and you’ll experience symptoms that come and go throughout your life. For othersyour condition could be a temporary irritant that could go away within a couple of days. Talk to your provider about your diagnosisthe cause and how to treat your symptoms to help you feel better faster.

What can I expect if I have pruritus?

Pruritus will cause skin irritation and discomfort that can make it difficult for you to sleep. Severe cases can prevent you from completing normal activities because your itchy skin distracts you from the task at hand.

You can use at-home remedies like applying moisturizing cream or lotion to your skin regularly throughout the day. The most effective time to apply moisturizer is after a bath or a shower when your skin is slightly damp to lock in the moisture.

Sometimespruritus can be persistent (chronic) and last for more than six weeks or it can be a sign of an underlying condition. Talk to a healthcare provider about treatment options to relieve your symptoms.

How long does pruritus last?

Everyone’s body is different. You could experience relief from your itchy skin within hours after treatment or it could take several weeks. The length of time for your body to heal depends on what caused your symptoms. For a better time frame as to when your symptoms will go awaytalk to a healthcare provider.

How can I prevent pruritus?

While you can’t prevent all types of pruritusyou can take steps to reduce your risk of getting itchy skin by:

• Wearing sunscreen when you go outside or wearing UV-protective clothing and accessories.
• Drinking plenty of water.
• Moisturizing your skin daily or multiple times per day.
• Using warm (not hot) water when taking a shower or bath or washing your hands.
• Managing any chronic conditions you have.
• Using a humidifier in your home.
• Avoiding allergens.

When should I see my healthcare provider?

Contact your healthcare provider if:

• You have itchiness that lasts longer than a couple of weeks.
• The itchiness interferes with your sleep.
• Treatment that your provider recommended makes your symptoms worse.
• Your skin is swollen and oozes pushas a crusty texture and you have symptoms of nausea and vomiting and fever (infection).
• You develop new symptoms like weight loss or gainchanges to your body functions like bowel movementsfatigue or mood changes.

What questions should I ask my doctor?

• What types of lotions or creams should I use on my skin?
• Can I use over-the-counter anti-itch cream to treat my pruritus?
• What caused my itchy skin?
• How often should I apply anti-itch cream or the treatment you recommend?

What is the difference between itching and pruritus?

Pruritus is the medical term for itching. There’s no differenceas both terms refer to the same symptom.

What’s the difference between pruritus and urticaria?

Pruritus is itchy skin that could have many different causes. Urticaria is a skin condition that causes hives and a stingingtickling or burning sensation in areas of your skin. A symptom of urticaria is pruritus.