Pruritis, or itching of the skin, has many possible internal or external causes. Pruritus can be present with or without a rash. It may be localized or present all over the body. Because there are many different causes of itching, several modalities may be explored to produce results for you.
Pruritus is broken down into acute (present less than 6 weeks) or chronic (present greater than 6 weeks). Furthermore, it can be characterized by whether or not a rash is present.
Common causes of pruritus with a rash include urticaria (hives), insect bites, scabies, allergic reactions to medications, or allergies to products you may be exposed to during day to day living.
Without a rash, causes can include irritation to nerve endings occasionally due to problems with internal organs like your gall bladder, kidneys, liver or blood abnormalities. The brain can misunderstand signals from nerve endings causing feelings like itching, burning, stinging or crawling “like bugs all over.”
It is possible to have a combination of these two types of itching.
Finding the cause of the itch is the first step in successfully stopping it. Once the cause is determined, treatment is directed at this specifically. A biopsy may have to be performed or various blood tests ordered to help diagnose the cause. Sometimes, other doctors such as neurologists or psychiatrists may be asked to give their opinion on the cause of your itching.
Once the cause is identified, creams such as topical steroids or immunomodulators may be prescribed to help the itching and resolve the rash. Phototherapy may be used at times to help the itching. Sometimes, oral medication to treat the rash or control the irritation of the nerves may be prescribed.
Determining what type of itch you have and eliminating or controlling it can be a difficult process, but by working as a team with your doctor it can be done.