Types of itching
Doctors divide itching by duration and origin. Itching is considered acute if it lasts up to 6 weeks, chronic - longer. According to the mechanism, itching is classified into skin itching for skin diseases, systemic - for diseases of internal organs, neurogenic - for nerve damage, and psychogenic, associated with anxiety and depression. It is not uncommon for one person to have a combination of several causes, for example, dry skin in an elderly patient with diabetes and taking several medications.
- Local and generalized itching
- Itching with and without rash
- Cutaneous (dermatological)
- Systemic - for diseases of internal organs
- Neurogenic - with damage to the nerves
- Psychogenic
Possible reasons
The most common cause of itching without a rash, especially in the elderly and during the cold season, is dry skin. Among internal diseases, itching is caused by chronic kidney disease, bile stasis due to diseases of the liver and bile ducts, diabetes mellitus, thyroid dysfunction, iron deficiency, blood diseases, including lymphoma. Itching can be a side effect of medications. In pregnant women in the second half of the term, itching of the palms and feet requires the exclusion of intrahepatic cholestasis.
- Dry skin (xerosis)
- Atopic dermatitis, urticaria, scabies
- Liver diseases and bile stagnation
- Chronic kidney disease
- Diabetes mellitus and thyroid diseases
- Iron deficiency and blood diseases
- Side effects of drugs
Associated signs to look out for
A description of the itching helps the doctor narrow the search. Itching, worse at night and affecting several family members, is characteristic of scabies. Itching after a hot shower occurs with dry skin and certain blood diseases. Itching of the palms and feet with jaundice indicates stagnation of bile. Itching with thirst and frequent urination prompts you to check your sugar. The combination with weight loss, night sweats and enlarged lymph nodes is a reason to immediately rule out blood diseases.
- Appearance time: at night, after a shower, after eating
- Presence of rashes, scratches, blisters
- Itching in loved ones
- Yellowness, change in color of urine and stool
- Weight loss, weakness, sweating
- New drugs in recent months
What examinations are needed
The examination begins with examination of the skin and questioning. If there is no rash or it does not explain the itching, a basic set of tests is prescribed that helps identify the most common systemic causes. Based on the results, the doctor decides whether consultations with an endocrinologist, gastroenterologist, nephrologist or hematologist and additional studies are needed. For persistent itching in older people, chest x-rays and abdominal ultrasounds are sometimes performed so as not to miss hidden diseases.
- Complete blood count with leukocyte formula
- Blood glucose and glycated hemoglobin
- ALT, AST, bilirubin, alkaline phosphatase
- Creatinine
- TSH
- Ferritin
- Scabies scraping if suspected
Treatment and skin care
Treatment is aimed at the cause: correction of sugar levels, treatment of liver, kidney and thyroid diseases, discontinuation of the culprit drug, replenishment of iron. Skin care is important to relieve symptoms: daily emollients and avoiding hot water. Antihistamines are mainly effective for urticaria; For other types of itching, the doctor may prescribe medications from other groups. Scratching increases itching and damages the skin, so keep your nails short.
- Short warm shower instead of hot bath
- Mild detergents without soap or fragrance
- Emollient cream immediately after shower
- Cotton clothing, no body hair
- Cool room to sleep
- Cool compresses for itching attacks
