Itching of the skin is an unpleasant subjective sensation that leads to the urge to scratch. It can be local, for example in the case of a skin disease, but it can also be generalised, where it is a symptom of another disease.
Itchy skin is a very unpleasant, subjective sensation that leads to the urge to scratch. If it lasts for a long time, it significantly reduces the quality of life.
Professionally, it is referred to as pruritus.
The causes of itching are manifold. It occurs locally, but also in a generalised or generalised manner.
You know... We itch on our fingers, palms, face, all over the body. And at any time of the day, after a shower, during stress or after eating certain foods. Why?
In its localised form, it occurs mainly with skin problems. On the other hand, the generalised form can be a symptom of a more serious disease.
What do we know about itching?
We know that itching occurs with a skin problem, but also without an obvious skin cause.
There is also itching without seeding of skin pimples.
Sometimes, after a few hours or days, there is a skin rash. At this point, it is obvious what caused it.
It can itch anywhere. On the head, face, neck, hands, back, but probably the most unpleasant itch is all over the body.
According to this, pruritus is also divided into:
localized (local, mainly as a manifestation of skin inflammation)
generalised (when the whole body itches, as in some systemic diseases)
To find out the cause of this unpleasant subjective sensation, an examination is needed, especially if it persists for a long time.
According to the duration, it is divided into:
acute (arising suddenly)
chronic (long-term), if it persists for more than 6 weeks
Which groups of people are affected?
It affects children, young people, adults or the elderly. At older ages, over 65, its incidence is slightly higher and more common.
There is no difference in gender, but it is often found in pregnant women. Similarly in women with gallbladder problems.
There is also a difference in the place of origin and in the type of pruritus
Pruritus originates in the periphery, that is, in the skin, in the cutaneous nerve endings. The second type is when the itching sensation originates in the central nervous system.
The peripheral type is caused, for example, by touch, pressure, vibration, heat or electrical voltage
the central type is caused by the action of mediators
Itching is transmitted from the skin to the brain by unmyelinated nerve fibres - slow type C. It is caused by the action of mediators such as histamine, serotonin, acetylcholine or opioids on free nerve endings in the skin or mucous membranes.
The table below gives a breakdown of pruritus
Type of itch
Description
Pruritoceptive pruritus
arises in the skin, especially in the case of a skin inflammation or other local problem
the sensation is conducted by slow C fibres
from the skin to the spinal cord and then to the brain
the response is mainly scratching and negative emotions
peripheral type
Neurogenic pruritus
originates in the central nervous system, i.e. the brain
central type
Neuropathic pruritus
caused by nerve or brain damage
peripheral or central type
Psychogenic pruritus
under psychological stress
in psychiatric disorder, psychosis, neurosis
central type
Pruritus is the most common symptom of skin inflammation or disease. However, it also occurs in other diseases. Therefore, differential diagnosis is important to look for the real cause of this unpleasant symptom.
Classification of pruritus according to the provoking cause:
Primary (essential) is present in systemic, neurological and other diseases or psychiatric disorder. It is referred to as pruritus sine materia.
Secondary (symptomatic, pruritus cum materia) occurs as an accompanying manifestation of skin problems.
The table lists the main peripheral causes and pruritus in systemic disease
Cause
Description
Peripheral pruritus
Cutaneous causes
Most common accompanying symptom in various inflammations, dermatitis, allergic reactions or infectious diseases
Atopic eczema
as a typical manifestation of the disease
mainly in predisposing areas
Contact eczema
often occurs with allergies, after contact with an allergen
itching can be at a site other than the site of contact
aquagenic pruritus on contact with water and in polycythemia vera
Diseases of the rectum
as pruritus ani (itching of the anus)
in haemorrhoids
infectious diseases and sexually transmitted infections
Neurological diseases
e.g. in sclerosis multiplex, after cerebral infarction, in tumours
Another example is itching in the elderly, which is uncomfortable and persists for a long time. This type is referred to as bullous pemphigoid. In the young, it occurs, for example, in gluten allergy dermatitis herpetoformis Duhring.
The main representatives of neurogenic and neuropathic pruritus of the skin are, for example, notalgia paresthetica, multiple sclerosis, diabetes or other nerve damage. Notalgia paresthetica arises from pathological changes in the spinal nerves T2 to T6, when persistent itching is present.
For unpleasant itching, the affected person scratches. This is the cause of skin changes such as pigmentation or thickening of the skin.
Itching present in HIV, AIDS disease is very common.
In the psychogenic form, itching occurs especially after increased psychological stress. Typical are attacks of itching, which escalate especially at night. Often this form occurs in anxiety or depression. But also in fear of dirt and parasites and other phobic disorders or obsessive-compulsive disorder.
Medication itch?
Yes, even some medications are responsible for this unpleasant symptom.
Examples include some:
beta blockers
acetylsalicylic acid
anticonvulsants
non-steroidal anti-inflammatory drugs
diuretics
insulin and oral antidiabetics
estrogenopioids
It is also seen in vitamin B12, iron or folic acid deficiency.
Non-serious causes of itching also include exposure to heat, cold, sun or dirt in our environment. In winter or, conversely, during hot days, when the skin becomes more dry, it becomes dry. Dehydration is also an example. Dry skin is present mainly in older age.
An example is the skin disease known as EBA (epydermolysis bullosa). It has several forms which can be non-inflammatory or inflammatory.
A common feature is the appearance of blisters.
Itching of the skin is also typical in inflammation of the veins of the lower limbs. In addition to inflammation, hardening of the vein occurs. Locally, the skin is painful, warmer to the touch.
A typical example of a full-body seeding rash is chickenpox. Another herpetic disease is cold sores, which itch unpleasantly. For more information, see the article on the disease cold sores.
Scarlet fever rash occurs with the infectious disease scarlet fever. It resembles strep throat and the symptoms resemble streptococcal strep throat with red coloration and purulent deposits on the tonsils.
Itchy skin in pregnancy
Itching due to hormonal changes is quite common and insignificant. Pregnant women itch on palms, hands or feet. Itching in the breast area is common, which becomes larger due to hormonal changes.
During this period, various other problems may also occur that trigger it. Therefore, examination is important, especially when it persists.
The expanding skin on the abdomen is also affected by itching. The whole body adapts. Especially the abdominal cavity, in which the space for the growing uterus and fetus shrinks.
The enlarged uterus can cause pressure in the liver and gallbladder. This increased pressure causes cholestasis, which is the impaired drainage of bile and its accumulation in the gallbladder and liver.
Consequently, bile acids also accumulate in the pregnant blood. This results in various complications.
The risk is not the pregnant woman, but the fetus, the baby. The risk is fetal damage and even death. This problem is also referred to as intrahepatic cholestasis of pregnancy.
Complications and symptoms of itching
Itching is, of course, an unpleasant subjective sensation. Especially with prolonged occurrence, it significantly reduces the quality of life.
Constant scratching results in symptoms, some of which we list:
The secondary medical school in Nitra gave me the basis for my career in the field of health and diseases. Thanks to it, I worked for 2 years in the traumatology clinic and outpatient clinic at the Nitra Hospital. Since 2006 I was employed in the emergency medical service, where I stayed until 2017.
I completed my bachelor's degree at the University of Constantine the Philosopher in Nitra in the field of emergency health care. The bachelor's degree allowed me to continue my mission as a paramedic. In the meantime, I got a job at the emergency line 155. I have been working in pre-hospital health care until today.
I had an interest in people, health and even diseases in my childhood, which gave me the prerequisite to pursue this topic in adulthood. Studying and acquiring new information in practice provided me with a great basis for writing professional texts, in the form of articles that can be understood by ordinary people. Thus, my interest in the Health Portal has a solid foundation in years of practice and personal interest. Similarly, I am also interested in healthy eating, nutrition and overall healthy lifestyle. I fill my free time with family and sports.
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