Pruritus (Itching) is one of the most common symptoms in dermatology and can arise from a wide range of underlying causes, from localized skin disorders to systemic medical conditions. Persistent or severe itching warrants thorough evaluation to identify and address its root cause.
Dermatological Conditions:
Eczema (atopic dermatitis), psoriasis, xerosis (excessively dry skin).
Scabies, fungal infections (e.g., tinea, candidiasis).
Urticaria (hives), lichen planus, contact dermatitis.
Systemic Diseases:
Liver disorders (e.g., cholestasis, hepatitis).
Kidney disease (chronic kidney disease-associated pruritus).
Thyroid dysfunction (hyperthyroidism or hypothyroidism).
Iron deficiency anemia, diabetes mellitus.
Allergic Reactions:
Food, medication, or insect sting allergies.
Contact allergens (e.g., nickel, latex, cosmetics).
Psychological Factors:
Chronic stress, anxiety, or psychogenic pruritus.
Detailed History: Onset, duration, location, and triggers of itching.
Skin Examination: Assess for rashes, dryness, or signs of infection.
Lab Tests: Bloodwork (e.g., liver/kidney function, thyroid studies, iron levels) to rule out systemic causes.
Biopsy or Allergy Testing: For refractory or unclear cases.
First-Line Care:
Regular Moisturization: Hypoallergenic emollients to restore skin barrier function.
Avoid Triggers: Harsh soaps, hot water, and known irritants/allergens.
Targeted Therapies:
Topical Treatments:
Corticosteroids (for inflammation).
Calcineurin inhibitors (tacrolimus, pimecrolimus).
Antifungals (if infection is present).
Oral Medications:
Antihistamines (e.g., cetirizine, fexofenadine) for allergic causes.
Immunosuppressants (e.g., cyclosporine) for severe eczema or psoriasis.
Antidepressants (e.g., SSRIs) for psychogenic pruritus.
Phototherapy: UVB light for chronic inflammatory conditions.
Systemic Disease Management:
Collaborate with specialists (e.g., hepatologists, endocrinologists) to treat underlying conditions.
Chronic itching can significantly impact quality of life and may signal serious health issues. A dermatologist will:
Identify the cause through comprehensive evaluation.
Prevent complications like lichenification (thickened skin) or secondary infections from scratching.
Provide personalized treatment plans to alleviate symptoms and address the source.