Anyone who has suffered with chronically itchy skin knows that it can dominate your life. But there are steps you can take to get on top of it. We chatted with Vhi Consultant Dermatologist Dr Rupert Barry to understand the science behind itchy skin, some of the conditions that can cause it, and what you can do to soothe a flare-up.  

WHY DO WE SCRATCH ITCHY SKIN?

Put simply, we scratch an itch because it provides immediate relief to an itchy area of our skin. After we scratch our skin, our body releases chemicals such as endorphins, which make you feel good. However, Dr Barry explains that the physical action of scratching your skin actually causes further physical changes in the skin that can prolong the ‘itch-scratch’ cycle. If your itching is no longer subconscious but something you think about a lot, it’s time to get to the bottom of it.   

Not all itching is caused by a skin issue. If your itch is accompanied by a rash, it could be a strictly dermatological issue, like eczema or psoriasis. But if there is no rash, there may be other possible explanations. For example, a blood test can reveal an underlying issue that may have itching as a symptom. Anything from physical disorders, infections or hormones to psychological conditions may be the cause of your itch.

Thankfully, itching is not contagious in most cases. The two main possible underlying conditions that are contagious are impetigo (a skin infection that causes sores and blisters) and scabies (an infestation of the skin by a tiny mite). If you believe you could have either of those conditions, seek a medical or healthcare provider’s opinion. 

FIVE WAYS TO EASE THE ITCH

ONE: THE IMPORTANCE OF MOISTURISING

Moisturising is at the top of the list in the battle to beat the itch in the long term. Dry skin is an aggravator of most dermatological issues. In fact, Dr Barry says that any dermatologist can tell on first examination whether you moisturise regularly or not—that's how important it is. Many people think drinking water can hydrate their skin, but Dr Barry explains, ‘you would need to be profoundly dehydrated for it to visibly affect your skin. Most water loss is due to changes to the structure of the skin. Moisturiser adds a layer on top that helps reduce the amount of water loss.'

TWO: TRACKING YOUR PATTERNS

Next, you may want to get an accurate sense of how much you scratch. You can use special apps to track every time you scratch in a day or manually take note of it. This can really help bring the issue into focus for you. Then you might set a target to reduce the scratching by 10% weekly over four to five months. In addition, you might try to replace the scratching with a rubbing action, which will still give you some positive endorphin release without damaging the skin or potentially introducing infection from your nails. If you manage to replace some scratching with rubbing, you might try rubbing in moisturiser each time.

THREE: HOT AND COLD TREATMENTS

Heat and cold are useful tools too. Either a very cold shower or a very hot shower can provide relief. ‘There is quite a bit of overlap between the pain pathways to the brain and the itch pathways,’ says Dr Barry, ‘so introducing something sharply cold or hot can be a powerful distraction for the brain, as it is somewhat forced to focus on the temperature and not the itch’. For the same reason, some people like to keep moisturiser in the fridge for extra relief. Often, itchy symptoms are worse at night, as blankets can raise the temperature of the skin. As our body tries to regulate its temperature, we get an increase in peripheral blood flow just under the surface of our skin (to cool us down), but that increased blood flow to the skin can make the itching worse.

FOUR: CLOTHING CHOICES

It’s good to be mindful of what you wear. Loose-fitting cotton clothing is often the best first choice, though it’s not always about wearing ‘natural’ products. Sometimes a piece of wool clothing directly on the skin is intolerable due to an underlying lanolin allergy. When it comes to footwear, leather lets your feet breathe, unlike some synthetic materials, but some leather tanning agents can trigger flare-ups. It’s best to be mindful of how your skin reacts to materials, rather than feeling you must wear one material or another.

FIVE: ANTIHISTAMINES

When it comes to medicinal creams, antihistamine anti-itch creams are effective. This is because an itch is often driven by histamine, a chemical released by some of our skin cells. Frequently, the person will need to take a course of oral anti-histamine tablets, which may be either short or prolonged, depending on what a healthcare provider sees fit. If necessary, a healthcare provider may also prescribe topical steroids to tackle the inflammation.

WHEN TO SEE A DERMATOLOGIST

We all get itchy at different times. It’s a normal sensation, and we must be careful not to medicalise what is a regular part of life. But if you can’t control it with simple measures (like moisturisers) and if the itch is starting to affect your sleep pattern and reduce your quality of life, then it’s time to see a dermatologist. Sometimes you might not notice how much you are scratching or how hard, especially if the area is difficult for you to see.

As we’ve learned, while itchy skin feels like a very simple, tangible symptom to present to a doctor, the cause of the itching can be complex. But with the guidance of a healthcare provider, along with steady and consistent treatment, you can get on top of your itching and give your skin a chance to heal.

This content is for information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek advice from your GP or an appropriate medical professional if you have concerns about your health, or before commencing a new healthcare regime. If you believe that you are experiencing a medical emergency call 999 / 112 or seek emergency assistance immediately. 

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