Update: October 2018
The symptom, when it is scratched at some part of the body, is called in
medicine pruritus. He, like pain, is an attempt
body to convey to the consciousness of man that it appeared
problem requiring urgent solution. To some extent itching can
call a defensive reaction, since such mechanical stimulation
pathological focus helps to shake off the parasites that are poisonous
plants or stinging insects.
Often itching is caused by individual intolerance.
some substance that got either on the skin or inside
organism – through the mouth or by injection. May it arise
during thermal, mechanical or electrical stimulation of skin
receptors. The symptom also notifies of a surplus in blood and other
substances, except for histamine appearing in allergies. Some
such diseases can be life threatening.
Where does the itching sensation come from
An imperative desire to scratch a piece of skin occurs when
pain receptors (nociceptors), spread out as a network under the layer
epithelial cells, surges blood with a high concentration
dissolved in it:
- histamine and / or histidine. These substances are formed in excess
immune cells when injected into the body of some – for each
certain organisms – foreign proteins;
- bile acids formed in the liver. They enter the skin cells
and can not get out of them in the development of such a state as cholestasis
– when bile cannot completely enter the duodenum, and
forced to stagnate in the cells of the liver and biliary
- serotonin – a substance derived from an amino acid that
when isolated leads to a significant reduction in smooth muscle,
located in vessels and internal organs. it – нейромедиатор, то
there is a chemical compound that makes the connection
between nerve endings (the signal does not pass from the nerve to the nerve
electricity, namely as a vial with a chemical substance, in
depending on the structure of which the activity of the neuron can
decelerated or activated). It is very similar in structure.
psychoactive hallucinogen LSD;
- cytokines – molecules that make cell communication possible
- endorphins are natural analgesic molecules;
- nitrogenous toxins that accumulate in the blood in diseases
- some other bioactive substances: thyroid hormone
calcitonin glands, pancreatic enzymes (trypsin,
Kallikrein), VIP neuropeptides and substances P.
Since each person’s body has its own characteristics,
revealed a direct relationship between the concentration of the above substances and
the severity of the need to produce mechanical stimulation. So,
severe itching in one individual may accompany the initial stage
renal failure, while the other will not appear even when
terminal stage of uremia.
Itch “subject” only the skin and those mucous membranes, layer
epithelial cells which are in contact with the external environment and
located near the skin: gums, tongue, genitals. Signal from
underneath the pain receptors goes along the nerve fibers
Type C and A-Delta, reach the spinal cord and along with its
structures are delivered to the brain of the brain, to its sensitive
Itching may be of a different nature: from mild tickling to
pronounced, painful. Nature dictates it to man as needed.
�”Process” its localization:
- combing: it is more characteristic of skin pathologies such as
neurodermatitis or eczema;
- gently rub: inherent in the red flat lick;
- cool (typical for acute urticaria).
However, only on the basis of these characteristics, the diagnosis is not
is put. In determining the cause of itchy skin are important:
- its localization;
- the condition of the skin in the place of such sensations;
- conditions for the appearance and relief of itching;
- additional symptoms.
Consider a combination of these factors to make it easier.
be examined and select the specialist who can
pretty quickly ease your condition.
Types of itching
The prevalence of a symptom is the main criterion from which
diagnosis of the cause of pruritus begins. Based on this
The measure, pruritus (the so-called itch in medicine), may be:
- Localized (a person can indicate a specific place where
itching is felt).
- Generalized (in the whole body, optional
at the same time).
- Diseases of the liver and biliary tract: hepatitis, cirrhosis, cancer
pancreas, pregnant cholestasis, giardiasis.
- Renal failure.
- The presence of worms in the intestines.
- Diseases of the thyroid gland.
- Сахарный diabetes.
- Hypovitaminosis A.
- HIV infection.
- Oncological diseases: stomach cancer, multiple myeloma,
erythremia, iron deficiency anemia, leukemia, lymphoma,
- Mental diseases: depression, phobias, mnemodermia (itching,
associated with the mention of biting-stinging parasites).
- Old pruritus.
- Itching when rising to a height.
- Associated with neurological diseases: head tumors
brain, multiple sclerosis.
- Seasonal itching.
- With systemic pathologies, for example, nodular
|On the face||
|On the head||
|In areas subject to friction||Bullous pemphigoid|
|Wrist rest||Atopic dermatitis, lichen planus|
|In the area of the anus||
|In the genital area||
|In areas covered by clothing for more time of year||T-cell lymphoma|
|On the back, on the hips||Folliculitis|
|On the knees||Atopic dermatitis|
|Anywhere||Neurodermatitis, eczema, contact dermatitis, insect bites|
Itching, accompanied by changes in the skin
This symptom is in favor of pathologies that are in
competence of dermatologists. That is, local changes
accompanied by skin diseases that are less dangerous than diseases
Diseases accompanied by reddening of the skin
Itching and redness of the skin are more characteristic of inflammatory or
allergic diseases. it:
- Contact dermatitis: irritation and itching located in place
which contacted the allergen. The boundaries of reddening clear.
For the diagnosis you need to remember in what new places you have been,
what new household chemicals began to use, what
clothing or accessory is put directly on the skin. So,
redness in the axillary areas may be associated with wearing
A new wool sweater / dress or dress familiar, but
washed with new powder. And itchy skin of the hands – using
нового крема или другого химического facilities. Characteristic difference
this disease is the complete disappearance of symptoms
the termination of the allergen.
- Atopic dermatitis – заболевание, поражающее чаще детей, но
can atopic dermatitis occur in adults. The reasons его –
Allergen, most often ingested by mouth with food. In children
the redness is located mainly on the face (cheeks),
flexion of the knees and elbows. In adults: face
is ruled out; wrists, knees and elbows can blush on their
Combination of itching and rash
|Disease||Type of rash||Localization, особенности|
|Contact dermatitis||Redness with a clearly defined border, at the top of the redness
there may be bubbles
|Anywhere. You can recall contact with
clothing / accessory / chemical agent
If such protruding blisters appeared after
|Redness, having a border, protruding above the skin,
prone to merge among themselves, similar to the trail of impact
|Bullous pemphigoid||Initially, redness rising above the skin, then in this
there is a bubble of tensed properties
|In places where friction occurs with clothing or accessories
(strap bag, watch)
|Eczema||Initially, redness, swelling, with a clear form, then here
bubbles appear, some of which open, in their place
develop crusts. In one place are observed elements immediately
several stages (redness, bubbles, crusts)
|Symmetric skin, often – on the limbs (especially
– top), and also face
|Limited Neurodermatitis||Dry plaques, around which there may be red spots, are not
having clear boundaries with healthy skin
|On the side surfaces of the neck, in the folds|
|Neurodermatitis diffuse||In adults – dried spots on the skin, surrounded by reddish
a whisk, without a sudden transition to healthy skin
|Eyelids, feet, lips, hands. Maybe on the whole body.|
|Swelling and redness, swelling and peeling, can be red on top
rashes, blisters or crusts
|In children – после введения прикорма – на щеках, воротниковой
zone, upper limbs
|Small protruding spots on skin of various shapes,
|At 2 years of age, located in the fold area|
|T-cell lymphoma||Red skin rash with itching
|In places not exposed to sunlight|
|Red lichen planus||Purple, towering above the healthy cover of the sypny
polygonal shaped elements with scales
|Folliculitis||Vesicles and pustules||Hips, back, chest|
|Psoriasis||Silver plaques, on top of which – peeling||The extensor surface of the limbs, itching of the scalp and neck,
palms and soles
|Scabies||Visible pair of black dots||Hands, armpits, stomach, genitals|
The combination of itching and skin peeling
Itching accompanies skin peeling in such cases:
- The outcome of an allergic reaction that manifested itself as
hives. Allergy could be caused by:
- saliva of animals;
- household and other chemicals;
- insect bites;
- Eczema. At the same time, various types of bubbles and
redness. These elements are localized, like peeling after them,
more often symmetrically on the arms or legs, as well as on the face.
- Impaired ovarian, thyroid or
adrenal glands. In this case, there will be other symptoms.
For example, inadequate thyroid function is characterized by a set of
weight, dryness and itching of the skin of the body, in later stages – slowing down
mental reactions. To change the work of the ovaries – violations
cycle, difficulty getting pregnant and so on.
- �”Settlement” in the intestines of worms can also cause
itchy skin flaking of the whole body.
- If the face peels off mostly, it itches, itches,
there is rapid eyestrain, loss of eyelashes, frequent
�”Souring” of the eye, the reason may be in infection with ciliary tick,
- Another cause of skin peeling and itching can be sugar.
diabetes. In this case, there are no bulk elements, but there are common
symptoms: hunger, thirst, frequent urination, easy joining
pustular infection and poor wound healing.
- Appearing after signs of ARVI itching and peeling that occurs
spots of symmetric outlines, located more often on the body and
hips, can be signs of pink lichen. For setting accurate
diagnosis need advice from a dermatologist.
- Peeling and itching of the skin of the feet and palms can talk about fungal
- Dandruff and itchy scalp may be signs:
- Pityrosporum Ovale disease;
- psoriasis, in which dandruff is pronounced;
- buying bad shampoo.
If itching is accompanied by burning sensation.
Burning and itching most often occur at the site of inflammation of the skin. it
there may be a reaction to mechanical irritation when shaving,
using a depilator or wax. Perhaps also poorly healing
inflammation in diabetes that burns due to changed in
The result of this metabolic disease is the pH of the tissues. Burning and
itching may be accompanied by diseases of the veins of the lower extremities – then
skin may be swollen, slightly bluish, but without some visible
The combination of these two symptoms can develop in a person with
rash (see relevant section) – as an individual
reaction to eczema, neurodermatitis, urticaria or other dermatitis.
Other symptoms that may indicate the cause of the itch
A symptom may also indicate systemic illness:
- with cholestasis, except for itching, there appears yellowness, if not the whole
skin, then the whites of the eyes. Itching often occurs in places that rub
clothes, worse at night;
- the smell of urine from the body, powdered with white “powder” dry skin and her
itching, change in the amount or color of urine indicates kidney
- itching of the skin after taking a warm bath / shower is characteristic of
erythremia – pathology, when the number of red blood cells is much higher
However, if the skin itches for a while
bathing (shower, bath) only in the heating season, it is possible that
This is how the skin reacts to the “technical” hot water in the tap,
containing various harmful impurities. If itching is felt after
swimming and in the summer, perhaps the reason is that the water is very
hard, with high chlorine content.
Itching without other symptoms
When the itch appeared, and on the skin one cannot see either dryness or “powder”,
Neither stains, nor any change in its color, these can be:
- hematopoietic system disease in particular
lymphogranulomatosis. Need a consultation with a therapist who probes
human lymph nodes, assign and decipher the hemogram and other
blood tests and refer to a hematologist or oncologist;
- senile itching that appears after 60 years on unknown
the reason. But, even if you fit into this category, you need
eliminate more serious diseases;
- mental or neurological diseases whose symptoms
You may not notice;
- intestinal population of worms that can be excluded by analysis
feces on their eggs, as well as blood tests for antibodies to
worms. Assign such a diagnosis – the lot of the infectious diseases doctor (his
can be found in the clinic in the office with the abbreviation “KIZ”).
In any case, you may not notice the symptoms for which
A qualified doctor will notice, so when itching
Treatment зуда кожи назначается после обследования, цель которого
– identify the cause of this condition. The main analyzes that
will help to clarify the ethology will be:
- general urine and blood tests;
- blood glucose;
- skin scraping to determine fungi;
- liver and kidney tests (by blood);
- test for occult blood in feces;
- definition in the feces of helminth eggs.
While tests are being performed, to alleviate the symptoms of itching – if
there are no signs of renal or hepatic failure, as
the doctor must say – antihistamines are prescribed: “Eden”,
�”Fenistil”, “Diazolin”, not causing drowsiness or drugs
more powerful, but with this effect (Suprastin, Tavegil).
With localized foci can be used
antiallergic ointment for itching of the skin, for example, Sinaflan,
�“Akriderm”, “Apulein”, hydrocortisone ointment or other
corticosteroid facilities. Other local officials are sometimes appointed.
drugs of non-hormonal origin – “Prograf” or
If itching is caused by cholestasis, drugs are successfully used,
absorbable bile acids. When the cause of the symptom lies in
blood diseases, specific inhibitors are used
monoclonal antibodies. Psoriasis is treated by combining local and
systemic drugs that normalize the division of skin cells.
In the case of extremely severe itching, weak opiates are prescribed, and
treatment is complemented by hirudotherapy, ultraviolet radiation
skin and acupuncture.
Thus, the causes of itching of the scalp and body are different.
variety. Most often, these are various allergic reactions like
on the substance that got inside the body, and on the one that touched
skin. But there may be life-threatening diseases of the kidneys, liver, or even
blood diseases. To clarify the cause and choose the treatment you need
undergo a comprehensive examination.
Автор: Кривега Мария Салаватовна врач-реаниматолог