Symptoms, Diagnosis, and Treatment for Pruritus
At some point in our lives, we’ve all suffered from an itch that just can’t be scratched. While a nasty bug bite may be an unpleasant nuisance, itching and burning symptoms tend to subside after a couple of days.
A persistent or widespread itch with no apparent cause, however, may be indicative of an underlying issue.
In this guide, we’ll discuss the symptoms associated with pruritus and describe the diagnostic strategies that healthcare professionals use to identify underlying causes. We’ll also describe the various methods, medications, and treatments used to ease symptoms and improve your skin’s health.
Table of Contents
What Is Pruritus?
A persistent burning sensation that provokes scratching is known as itchy skin, or “pruritis”. Pruritus is a multifaceted symptom that can cause significant negative impacts to one’s mental and physical well-being.
When a persistent or widespread itch presents alone, medical professionals must carry out a thorough evaluation and complex diagnostic process to identify the cause and guide treatment regiments.
What Are the Symptoms of Pruritus?
The primary symptom of pruritus is a persistent burning sensation on the skin that provokes an urge to scratch.
Pruritus may be accompanied by other symptoms such as:
- Redness or rash
- Dry, cracked, or flaky skin
- Hives, bumps, or blisters
- Scratch marks
- Broken skin
You may need to contact your healthcare provider if:
- Your pruritus persists for longer than two weeks
- Itching fails to subside after using at-home treatments
- Your symptoms prevent you from sleeping or completing daily activities
- You are experiencing an itching, burning sensation all over your body
- You are experiencing other symptoms such as those listed above
What Causes Pruritus?
The most common cause of persistent pruritus is dry skin. If you’re suffering from an itch but have not experienced other symptoms such as bumps, redness or rashes, it is likely due to dry skin.
Your skin’s moisture barrier may begin to deteriorate due to:
- Underlying skin conditions such as eczema or psoriasis
- Low humidity
- Extreme hot or cold temperatures
You may also notice more frequent or prolonged bouts of pruritus as you age. This is because our cells’ metabolic systems slow down over time resulting in decreased cell renewal and fewer natural oils. Aging skin typically becomes thinner, drier, and far less elastic.
Common signs and symptoms of dry skin include:
- Skin tightness
- Flaky, scaly, or rough texture
- Excessive itching
- Cracks or open wounds in the skin that are prone to bleeding
- Raw, irritated, or painful sensations
Thankfully, you can help restore your skin’s moisture barrier and soothe skin inflammation by implementing a proper moisturizing routine into your daily regiment.
The ideal moisturizer will be an unscented, hypoallergenic option. You can couple this with an ointment or a cooling agent such as aloe vera.
Another common contributor to pruritus is dehydration.
Proper hydration improves your skin’s elasticity meaning it’s less likely to become itchy, flaky, red, or inflamed.
If dehydration or dry skin are not possible causes for your pruritus, you may consider contacting your healthcare provider or dermatologist to rule out underlying medical conditions such as:
Skin Conditions
- Eczema – Eczema, or atopic dermatitis, describes chronic inflammation of the skin. Symptoms of eczema may include dry, itchy, or bumpy skin. There are several types of eczema, but most variations appear during childhood and persist into adulthood.
The American College of Allergy, Asthma & Immunology (ACAAI) reports that approximately 10–20% of children and 1–3% of adults experience some form of eczema.
- Psoriasis – Psoriasis is a chronic disease that causes skin cells to build up, and flake off. Individuals with psoriasis may experience a rash with itchy and scaly patches on the elbows, knees, or scalp.
- Parasitic infections – Parasites such as pinworms, scabies, and lice can cause rashes and intense itching sensations.
Systemic Diseases
- Thyroid problems – Hypothyroidism and Hyperthyroidism both greatly impact your skin’s health. Thyroid disease may cause skin to become wrinkled, dry, itchy, or scaly.
- Anemia – Anemia often causes individuals to develop a distinctive rash. Those with iron deficiency anemia may experience pruritus and their skin may appear red or bumpy when scratched. Aplastic anemia also causes pruritus, but is accompanied by tiny red or purple dots under the skin (petechiae).
- Diabetes – Dry skin and poor blood circulation may cause individuals with diabetes to experience localized itching, primarily on the legs.
- Kidney Disease – A common symptom of early or end-stage kidney disease is an extremely itchy sensation on the skin. This symptom chiefly presents as a symptom of end-stage kidney disease. As the body attacks itself, skin becomes extremely inflamed. Nerve damage, chemicals, toxins and wastes may cause patients to feel extreme pruritus throughout all areas of the body.
- Pregnancy – Some conditions may develop during pregnancy and cause itchy skin, redness, rashes, and bumps. Skin conditions commonly experienced by pregnant women include: pruritic urticarial papules and plaques of pregnancy (PUPPP), prurigo gestationis, and obstetric cholestasis.
How Is Pruritus Diagnosed?
Healthcare professionals will begin by inspecting the site of concern, performing a physical examination, and collecting medical history. They may ask about:
- The location and duration of your pruritus
- Any associated symptoms
- Possible exposure to irritants or allergens
- Current medications
- Past procedures and diagnoses’
- Family medical history
After evaluation of your physical exam and medical history, the doctor may order laboratory tests such as:
- Complete blood count (CBC) with differential
- Creatinine and blood urea nitrogen tests
- Iron studies
- Fasting glucose or A1C level
- Liver and kidney function tests
- Thyroid function tests
- Chest radiography
- Or others
If a skin condition is suspected to be the cause of your pruritus, your doctor may take a skin biopsy for histological examination.
You may also undergo a patch test to identify allergies that could potentially be causing the itch.
How Is Pruritus Treated?
Treatment of pruritus will vary depending on the severity of symptoms and any underlying medical conditions.
If you’re experiencing mild itching, there are several at-home remedies that may provide relief and promote the healing process.
Home Remedies
- Establish a moisturizing routine – Applying hypoallergenic moisturizer throughout the day can greatly improve skin elasticity, soothe irritations, and restore dry, flaky areas prone to itching.
- Avoid contact with allergens and irritants – Steer clear of chemicals, use mild soaps, and wear loose-fitting clothing to allow your skin ample opportunity to heal. Reintroducing these items into your life one at a time may help you identify the primary cause of your skin irritation.
- Try using over-the-counter hydrocortisone creams or antihistamines – There are some great over-the-counter medicines on the market that can greatly reduce itching, swelling, and irritation caused by allergies or skin conditions. You can opt for a topical cream such as Hydrocortisone or a non-prescription oral antihistamine such as Claritin, Zyrtec Allergy, or Benadryl. Be sure to talk with your doctor before starting any new medications.
- Treat your scalp – If you’re experiencing persistent scalp dryness and itchiness, use a medicated shampoo such as Head and Shoulders or Selsun Blue.
Prescription Medications and Treatments
If at-home remedies have not eased your symptoms, your healthcare provider may prescribe other medications or treatments including
- Medicated creams and ointments – Prescription-strength creams or ointments such as Corticosteroids may be required to ease itching and burning associated with severe cases of pruritus. These topical medications are best used in tandem with hypoallergenic moisturizers to maximize anti-inflammatory benefits.
- Antidepressants or anti-anxiety medications – Oral SSRIs such as Prozac or Zoloft may be helpful in easing distress caused by prolonged itching and underlying medical conditions.
- Light therapy (phototherapy) – Phototherapy uses narrow-band UV light to reduce itching for conditions such as psoriasis or eczema. While the treatment doesn’t work for everyone, it is a great alternative for those who do not respond to oral or topical treatments.
Please note that treatments may vary depending on the condition and individual patient. Always consult with your healthcare provider to see which treatment is recommended.
Goodskin Dermatology Provides High-Quality, Patient-Based Care for Pruritus
Over time, persistent itching can take its toll on even the strongest individual.
At Goodskin Dermatology, we are dedicated to addressing each patient’s unique concerns with diligence and care. Our team values the importance of healthy skin.
Whether you’re seeking treatment for pruritus or other dermatology needs, you can trust our Portland-area practice to provide you with the care you need to regain control of your skin’s health.
Schedule an appointment at Goodskin Dermatology today by calling or visiting our website.
The content in this blog should not be used in place of direct medical advice/treatment and is solely for informational purposes.
The content in this blog should not be used in place of direct medical advice/treatment and is solely for informational purposes.