Dear Doctor,

Last month I was plagued by chronic itching all over my upper body. It hurts a lot and I end up getting sores all over my body. I consulted with my doctor but he seems not to know what causes the itching.

He prescribed menthol in aqueous cream and proper hygiene; I did that but the itching only goes away for a few days and comes back. I have changed my bathing soap, skin lotion and I always boil my showering water but it has not helped.

Right now, my skin is hard, very dark and I have developed scaly skin. Is there any medication that can help me? Or am I developing skin cancer?

Isabella

Dear Claire

Generalised itching all over the body occurs due to many reasons. The most common cause is excess dryness of the skin. Dryness of the skin may be due to hereditary factors. Excess dryness also occurs due to exposure to dust, very hot or cold weather, use of central heating or air conditioners.

Itching can also be due to allergy. This can occur due to clothes worn, particularly synthetic ones. Allergy may be due to cream, lotion, among others, some body care products, drugs like pain killers, antibiotics, some food items consumed or something present in the environment like dust, pollens, spores, insect droppings, etc. Affection of nerves, as in diabetes, herpes infection, alcohol induced nerve damage, can manifest as itchy skin. Presence of worms in the intestines can cause allergic reaction in the body manifesting as itching.

One can have itchy skin due to fungal infections of the skin. Those with reduced immunity as with uncontrolled diabetes, HIV infection, renal diseases, etcetera, are more prone to develop severe and extensive fungal infections. In scabies, a parasitic infection, itching mostly occurs during night.

Eczema dermatitis manifests as small eruptions along with itching over involved part. Psoriasis is yet another condition that can cause itching which mostly occurs in the dry season. White, itchy dusty flakes occur mostly over the backside of the body and limbs.

During pregnancy, some women experience dry itchy skin, while in some, dermatitis is exacerbated during pregnancy. Serious disorders like liver and kidney diseases, anemia, thyroid problems or cancers like lymphomas, leukemia can cause itching over the skin, but in these cases there will be other overlapping features like loss of appetite, weight loss, vomiting, weakness, etc.

Constant itching and scratching can lead to thickened and dark skin. Scarring and boils can occur as a complication. The condition can become embarrassing enough for one to become depressed and avoid social interaction.

Diagnosis of the cause of itching depends on the duration, periodicity, areas affected, and presence of associated rash, blisters, etc. skin lesions and features of any other underlying disease. Based on suspicion, relevant tests done help to pin point the diagnosis. Treatment lies in treating underlying cause.

Corticoid or anti-allergy creams are used locally to suppress the itching. It is advised to put damp cotton over the ointment so that moisture helps the ointment to be absorbed better.

In case of severe itching, one should use anti-allergy tablets like chlorphenaramine maleate, cetrizine and or corticoid pills. Dryness of the skin can be prevented by using moisturising lotions or natural oils over the skin. If itching is suspected to be due to allergy, one can try to assess what things are being used that are causing allergy and avoid it. Good hygiene, regarding food and body, helps prevent infections. One should avoid scratching to avoid scarring and secondary infections. If the problem is troublesome, a soft tissue can be used to scratch the part.

Dr. Rachna is a specialist in internal medicine at Ruhengeri Hospital.