Dealing with itching

Itching is the desire to scratch. One having itching anywhere on the body feels uncomfortable as well as embarrassed, more so if he or she is with others. Moreover, one knows by experience how painful it is to scratch over certain sites such as knuckles or sole. Itching is mostly caused due to release of histamine, serotonin, e.t.c (chemical mediators of inflammation in the body) at that site or due to neurological infections. Itching can be local or generalized depending on the underlying cause. Some people may have itching intermittently, while some may have it, continuously which again depends on the cause. Allergy to a substance used is one of the most common causes for itching. But in this case the itching occurs only after exposure to the allergy producing substance. Moreover, when the offending substance is removed, it stops. The allergen can be anything in the environment like pollens, fungal spores, e.t.c. It can be a substance of local application like soaps, creams, e.t.c. or a food item eaten. Eczematous dermatitis is a classic example of itching due to allergy. There are vesicles and pustules with extensive itching over the skin in patches, more so in moist areas like palms and sole. Acne and pimples occurring in teenagers also cause itching over the face. Excess dryness of the skin or scalp is yet another cause of itching. This improves with improvement of the dryness by application of some lubricant. Many other skin infections like psoriasis occur with itching and multiple generalized flat white flake like visible lesions. Continuous itching occuring in patches or all over the body can be due to various infections of the skin. A wide range of fungal infections, manifest as itching over affected parts of the body. This itching is intermittent but troublesome. Parasitic infections like scabies cause itching which is more in the night. In scabies, there is itching over the inter digital spaces, i.e. in the web of fingers and is associated with eruptions. Viral infections like chicken pox and measles, e.t.c., are yet another cause of itching. Similarly louse infestation whether of the head or whole body is known to cause extensive itching. Liver and or kidney failure can have itching as one of the features. Itching can occur with brain tumors and neuropathies. Certain tumors like lymphomas are also associated with itching. Mental tension is also known to induce itching in some people. It is also one of the complaints used by malingerers as part of psychosomatic sickness. Thus it can be seen that there are a wide range of causes of itching. Irrespective of the cause of the itching, it is a very uncomfortable situation for anyone. Moreover, there is risk of secondary bacterial infection occurring due to scratching by nails as germs can be introduced from the nails to the affected site. This results in painful boils. Large number of boils can become a source of generalized infection and fever. Excess scratching over any site can become a source of permanent scarring, more so over the face. Therefore, it should be avoided. In case of severe unavoidable itching, it is better to brush with hands or use a soft tissue to scratch. This avoids the secondary bacterial infection. One having chronic itching should avoid wearing synthetic clothes and socks as these induce and aggravate itching. Using a local antihistaminic solution like chlorphenaramine or a stringent agent like calamine or camphor also helps to control the itching. Boils occurring due to secondary infection should be treated with a suitable antibiotic. Persistent or repeated itching should never be neglected. A person should always take medical advice to know the cause and for total amelioration. Dr. Rachna Pande is a specialist, Internal medicine-Ruhengeri Hospitalrachna212002@yahoo.co.uk