Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
196 Doctors Online

By proceeding, I accept the Terms and Conditions

Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

HCM Blog Instant Access to Doctors
HCM BlogQuestions Answered
HCM Blog Satisfaction
Article Home Skin Disorders Pruritus

Pruritus

Pruritus (itching) can be a symptom of primary skin diseases or of systemic disease. Skin diseases notorious for causing intense pruritus include scabies, pediculosis, insect bites, urticaria, atopic and contact dermatitis, lichen planus, miliaria, and dermatitis herpetiformis.

When pruritus is prominent without any identifiable skin lesions, dry skin (especially in elderly people), systemic disease, and drugs should be considered

Systemic diseases that cause generalized pruritus include

  • Cholestatic diseases
  • Uremia
  • Polycythemia Vera
  • Hematologic malignancies
  • Hyper- and hypothyroidism
  • Diabetes
  • Iron deficiency
  • Internal cancers
  • Pruritus is rarely psychogenic

Drugs that cause generalized pruritus

  • Barbiturates
  • Salicylates 
  • Morphine
  • Cocaine

Evaluation

History:  Key elements of the history include drug exposures and an occupational/hobby history


Physical examination: Examination should focus on identification of an underlying skin disease. Identification of lesions may be complicated by redness, papules, excoriation, fissures, lichenification, and hyper pigmentation that all may be a result of persistent scratching


Testing: complete blood count, liver function test, renal function test, thyroid function test, and biopsy testing

Treatment

Any underlying cause is treated


Supportive treatment involves proper skin care and use of topical, systemic, and/or physical agents

Skin care

  • Skin care involves use of cool or lukewarm (but not hot) water when bathing
  • Limitations on use of soap, bathing duration, and bathing frequency
  • Liberal use of emollients such as white petrolatum or other oil-based products
  • Avoidance of irritating or tight clothing

 

Topical agents may help localized pruritus, includes camphor/menthol lotions or creams containing 0.125 to 0.25% menthol, corticosteroids, Diphenhydramine etc


Systemic agents are indicated for generalized pruritus or local pruritus resistant to topical agents. Antihistamines like Cetrizine, Loratidine, hydroxyzine, fexofenadine, cholestyramine


Physical agents that may be effective for pruritus include ultraviolet (UV) phototherapy, transcutaneous electrical nerve stimulation (TENS), and acupuncture.

Related questions you may be interested in

doctor1 MD

I've been battling pruritus ani for several years now, I've been on Clotrimazole and Dipropionate lotion and I just can't get rid of it. Now they...

doctor1 MD

hi , i'm writing this query because of pin worms. around 3 weeks ago , i first noticed them , took 100 mg mebendazole for 3 days , 2 times a day....

doctor1 MD

I've been battling pruritus ani for several years now, I've been on Clotrimazole and Dipropionate lotion and I just can't get rid of it. Now they...

doctor1 MD

My wife is 37 weeks pregnant with twins and is experiencing severe itching on her stomach, which is also covered with rashes. Her gynaec prescribed...

doctor1 MD

Hi I have a strange rad here and there on my body. Some red small raised spots that itches. Under the breasts and on my hands and yesterday it was...