Itching

Key points

1. Many things cause itching. Sometimes it can be hard to work out the exact cause. 
2. Itching may be felt in one area of your body or your whole body, depending on what is causing the itchiness.
3. Treatment usually depends on the cause of your itchiness.
4. There are things you can do to help relieve your symptoms. 

Image: 123rf

What causes itching?

There are many possible causes of itching, including:

• dry skin
• a skin condition such as eczema, allergic reaction, psoriasis, hives or fungal skin infections – these are usually accompanied by a skin rash
• a health condition such as anaemia, liver disease, chronic kidney disease or thyroid disorders
• hormonal changes such as pregnancy or menopause
• the side effect of medicines, eg, opioids, lamotrigine or some antibiotics
• psychological conditions such as anxiety or depression.

Sometimes the exact cause of itching can't be found.

What are the symptoms of itching?

The feeling of the itch can be unpleasant and uncomfortable. You may feel the sensation of itching in one area of your body or your whole body, depending on the cause.

In severe cases, itching can cause sleep disturbance, anxiety and depression. 

How is the cause of itching diagnosed?

Your doctor will ask you questions about the itching, including whether you have any other symptoms and any allergies. Your doctor will also examine you and check your skin to see if you have a rash.

Some tests may be done, depending on what your doctor thinks is causing your itching. These include:

• blood tests such as full blood count, renal function tests or liver function tests
• imaging tests such as a chest x-ray or abdominal ultrasound
• a skin swab or biopsy.

How is itching treated?

Treatment depends on the cause of your itchiness. Your doctor may prescribe some medicines or treatment to relieve your itchiness. These include:

• moisturisers or emollients to keep your skin moist 
• topical corticosteroids or oral steroids
• antihistamines 
• amitriptyline
• gabapentin
• cholestyramine
• rifampicin
• phototherapy
• cognitive behavioural therapy to break the itch-scratch cycle. 

Your doctor may also refer you to a dermatologist if your symptoms are not relieved by these medicines or you have complications. You can also find a private dermatologist here. 

How can I help myself with itching?

There are some self-care measures that you can do to help relieve the symptom of itching.

• If you have dry skin, use moisturisers or emollients often. You can keep these in the fridge for an extra cooling treatment.
• Avoid use skin irritants such as soaps or foaming body washes. Your doctor can prescribe soap substitutes to clean your skin.
• Heat will make the itch worse. Keep yourself cool especially at night.
• Make sure the water isn’t too hot in your shower or bath. Bathe quickly in cool or tepid water not more than once a day.
• Scratching makes itching worse. Try not to scratch your skin when you feel itchy and avoid situations that can trigger the desire to scratch. 
• Scratching worsens itching.
• Keep your nails clean and short to reduce the skin damage caused by scratching.
• Wear cotton gloves at night to reduce scratching in your sleep.

Learn more

The following links provide further information about itching. Be aware that websites from other countries may have information that differs from NZ recommendations. 

Pruritus DermNet, NZ
Itching Patient Info, UK
Itchy skin NHS, UK
Pruritus British Association of Dermatologists, UK

References

1. Pruritus Auckland Regional Health Pathways, NZ
2. Pruritus DermNet, NZ

Reviewed by

	Dr Sharon Leitch is a general practitioner and Senior Lecturer in the Department of General Practice and Rural Health at the University of Otago. Her area of research is patient safety in primary care and safe medicine use.