>

Itch, how to stop it

Itching prompts scratching, but the temporary relief scratching brings may actually increase skin irritation

High on the list of things that drive patients mad is a persistent itch. Pemphigoid patients with crusty lesions, in particular, are plagued by it.

Besides pemphigus and pemphigoid, itch is a symptom of many medical conditions. The possibility of one or more causes should be considered. Here we provide some general tips and techniques designed to lessen itch. Patients are advised to discuss itch, and any remedy used to lessen it, with their dermatologist, who can prescribe prescription medications or creams.

Itching prompts scratching, but the temporary relief scratching brings may actually increase skin irritation, creating a vicious cycle. Scratching can damage the skin, increasing the risk of bacterial infection. Some itch is psychological, brought on or aggravated by stress, anxiety, anger frustration, fear or loss of sleep. Try doing something to change your mood or otherwise get your mind off the itching.

Use a mild soap such as Dr. Bronner’s liquid soap or Ivory. Fatty soaps such as Dove, Basis or Tone are good for dry skin. Soap film can cause itching so rinse off thoroughly.

Dry skin is a very common cause of itch. Washing more than once a day may increase skin dryness. Consult your dermatologist about moisturizers that won’t cause problems with open wounds. Some patients find relief with colloidal oatmeal baths; one product is ActiBath, a tablet dropped in bath water.

Heat and sweating increases itch; a cool cloth, a fan or air conditioner may help. In winter, a humidifier could be useful. Some fabric causes irritation to sensitive skin. Cotton is preferred; wool and some polyester is not. Of course, going without clothes is an option, at least at while you are home. Throw a sheet over a scratchy sofa or sticky leather chair.

Use mild laundry detergent and run clothes and sheets through an extra rinse cycle. For some patients certain food can cause itch. Garlic, onions and leeks have been reported to irritate skin or even cause lesions in pemphigus patients.

Medications such as anabolic hormones, aspirin, B complex vitamins, captopril for blood pressure, cocaine, estrogen, erythromycin estolate, morphine, phenothiazines, progestins, quinidine, testosterone, tolbutamide, are linked itch.

Alcohol changes the blood flow to skin and increase depression, both affect itch threshold by changing the blood flow to the skin.

External options

Ice packs (purchased or made from ice in a plastic baggy), cool water from the tap or shower or even a cool cloth lessen itch, because cold and itch travel along the same nerves. Hot water (like in the shower) feels good temporarily, but often leaves you feeling itchier later. So if you like a warm shower, finish with a blast of cool water. Pat skin dry, don’t rub. Apply lotions, if advised to do so, and leave the skin a little moist. Lotions can be applied as often as needed. An over-the-counter lotion called Sarna is excellent for itch relief, as are other lotions that contain camphor, menthol, phenol, pramoxine, diphenhydramine, or benzocaine (or one of the other “caine” anesthetics). Topical steroids reduce itch too.

Hydrocortisone-containing lotions are often advertised as itch-reducers, but this ingredient is primarily for eczema, seborrhea or other conditions responsive to cortisone. Even so, they do not have a reputation as being very effective.

Internal options

The traditional oral treatment for itch are antihistamines. The most popular are diphenhydra-mine (25 milligrams, 1-3 times a day) and chlorpheniramine (4 milligrams). Both can be taken 3 times daily.

Antihistamines may cause drowsiness which can be dangerous if one is driving or otherwise needs to be alert. If itch keeps you up at night, an antihistamine could be the perfect answer.

These techniques can be applied in combination. Try a number of remedies to see which work best.