Severe itching of the skin of the body
Itching of the skin of the body is a sign of a disease: systemic or dermatological. In addition, itching on the skin can occur due to excessive dryness, insufficient hygiene, etc.
Among the causes of itching are:
- Diseases of the liver and biliary tract. Pathologies that lead to pruritus - cirrhosis, hepatitis, cancer of the pancreatic head, primary sclerosing cholangitis, obstruction of the large bile duct and large duodenal papilla with tumors or stones, infection with lamblia, cholestasis (see also: liver treatment with folk remedies);
- Kidney disease, particularly renal failure. Patients with uremia, especially in the terminal stage of the disease, suffer from severe itching. The more impaired the functionality of the kidneys, the more itchy the skin will be. Dialysis contributes to its weakening, however, such a procedure is not able to completely eliminate renal itching;
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Diseases of the thyroid gland. Up to 10% of patients with thyrotoxicosis indicate a pronounced persistent generalized itching. Most often, people with diffuse goiter, which is not treated for a long time, suffer from itching. Scientists believe that itching occurs in this case due to increased blood flow to the skin, which entails a local increase in temperature;
Another cause of itchy skin with hyperthyroidism is the development of chronic urticaria. If the patient is diagnosed with urticaria, it makes sense to suspect the autoimmune nature of the thyroid pathology. In addition, patients with myxedema (an extreme form of hypothyroidism) also complain of itching. It is caused by excessive drying of the skin and gives the patient serious anxiety;
- Carcinoid syndrome. Itching occurs due to frequent hot flashes in the head and neck, especially against the background of previous stress, overeating or drinking alcohol;
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Diabetes. Patients with elevated blood glucose levels most often suffer from genital itching. It is caused by the developed candidal lesions of the mucous membranes. In the area of the scalp, itching occurs with diabetic neuropathy. As for generalized itching, in diabetes it, as a symptom, is quite rare. If patients complain of generalized itching, then most often it is associated with metabolic disorders in diabetes mellitus against the background of kidney damage;
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Hematological diseases. Among such pathologies: lymphogranulomatosis, various lymphomas, polycythemia vera, leukemias, non-Hodgkin's lymphoma, myelomas, mastocytosis, paraproteinemia, Waldenstrom's macroglobulinemia.
- In polycythemia vera, almost 50% of patients complain of generalized itching. Most often, it occurs after contact with the liquid. That is why this itch is often called aquagenic. Sometimes itching appears much earlier than the disease itself and may precede it several years in advance. Taking aspirin helps to reduce itching, antihistamines are ineffective, although the level of histamine in the blood of such patients is increased;
- Itching can also accompany iron deficiency anemia. Its severity is not associated with the degree of anemia, however, after starting treatment for the underlying disease, this symptom quickly disappears;
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With lymphogranulomatosis, up to 30% of patients complain of itching. He pursues a person both during an exacerbation of the disease and during remission. Most often it is localized in the region of the lower extremities, gradually passing to the lower part of the body, and then spreading to the whole body. Itching is accompanied by a burning sensation, most of all disturbing the patient at night;
- In lymphomas, itching is not so common, although in patients with Cesari's syndrome it is always recorded as a complaint. Moreover, patients talk about excruciating itching that arose many years before the onset of the disease;
- Sometimes itching is accompanied by paraproteinemia, mastocytosis, lymphocytic leukemia. In some cases, scientists associate its occurrence with an increase in the concentration of serotonin, in others - with an increase in the level of histamine and other amines.
- If the course of the disease can be brought under control, then the itching, as a rule, becomes easily eliminated.
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Senile or senile itching. By the age of 70, more than 50% of people experience itchy skin. Most often, it is associated with excessive dryness of the skin, when they are no longer able to retain fluid, and the performance of the sweat and sebaceous glands is impaired. Additional risk factors for itchy skin are overheating of the skin (in old age people begin to dress warmer), dry air, and frequent shower. In addition, older people become more susceptible to histamine, their skin's regenerative function decreases, nutrition is insufficient, and they are more likely to experience depression. These or other factors lead to itching after the age of 70;
- Itching with human immunodeficiency virus. Often, HIV-infected people complain of itchy skin that bothers them. In 92% of cases, it is associated with concomitant infections that develop due to a drop in immune forces. With the progression of the underlying disease, itching can cause excessive dryness of the skin. Itching is especially troubling for patients in the cold season;
- Mental disorders: psychogenic itching. Itchy skin may well be triggered by conditions such as stress, overwork, increased anxiety, depression. It is the latter factor that most often affects the onset of itching. With the development of depression in the blood, the level of dopamine, serotonin and other internal opioids increases, which leads to the development of itching. In addition, people with mental illness are able to experience generalized itching, which they attribute to parasitosis, which is actually an illusion. Parasitophobia can be quite intrusive, and patients even provide the doctor with a wide variety of evidence of their own infection.
- Periarteritis nodosa and other systemic diseases;
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Diseases of the nervous system: brain tumors, multiple sclerosis. In multiple sclerosis, itching starts suddenly and stops after a few seconds. With a pronounced attack of itchy skin, a person may wake up in the middle of the night.
- Itching may appear some time after suffering from cerebral hemorrhage. It manifests itself on the opposite side of the site of brain damage, in addition, motor and sensory disorders are observed;
- Postherpetic neuralgia is another cause of itching, which is accompanied by painful sensations.
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Allergic reactions. Contact dermatitis can occur due to the application of various medications to the skin, due to the use of unsuitable cosmetics or detergents. It can be provoked by contact with clothes, chemicals at work, wearing jewelry and bijouterie.
- Allergic urticaria occurs after ingestion of allergenic products inside, during therapy with drugs that are unsuitable for a person, from exposure to dust, due to insect bites, as a result of temperature changes, under the influence of cold and light;
- Eczema often occurs in people prone to allergic reactions. It can also develop against the background of chronic diseases, after vaccination or taking medications, it can be the body's response to stress or to the consumption of allergenic foods.
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Infection with parasites. In this case, we are talking about helminthic invasion, in which itching occurs in the anal area, but can also spread throughout the body.
- Itching of the skin leads to head lice, when the scalp, temples and the back of the head itch predominantly. Sometimes eyebrows and eyelashes are affected by lice. The longer the hair, the more itchy;
- Itchy clothes is another cause of itchy skin. In this case, the parasites live in the folds of clothing and affect the places where the skin and things most often come into contact;
- Phthiriasis or pubic lice is another cause of itchy skin. In this case, it is mainly the groin area that itches. However, lice can also affect the ears, mustache, beard, eyebrows and eyelashes;
- With demodicosis, itching is caused by ticks - glands. They infect human hair follicles and sebaceous glands;
- Itching can be caused by scabies when the skin is affected by a microscopic mite. The mite damages the skin of the hands, elbows, the skin of the abdomen, buttocks, thighs, and mammary glands.
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Fungal skin lesions. Keratomycosis, in which the stratum corneum of the skin is affected. Itching can cause diseases such as erythrasma, actinomycosis and pityriasis versicolor.
- Itching can also be triggered by dermatophytosis that affect the epidermis. Among such diseases are epidermophytosis, favus, trichophytosis;
- Skin candidiasis most often develops in people who are overweight, as well as in children if hygiene rules are not followed;
- Severe itching of the skin of the body can also be triggered by a fungal disease such as ringworm.
- Avitaminosis. Most often, itching is associated with drying out of the skin. It can be provoked by a lack of vitamin A, B vitamins, vitamin C. In addition, zinc deficiency negatively affects the skin condition. With its lack, a person begins to have skin problems - acne, boils appear, which causes itchy skin;
- Hygiene violations. Failure to comply with the rules of personal hygiene is the most obvious cause that can lead to itchy skin;
- Menopause. Itching during menopause most often affects the genitals and is associated with hormonal changes in the body;
- Folliculitis. One of the symptoms of the disease may be severe itching in the area of folliculitis. Itching is especially difficult in the presence of many inflamed follicles;
- Neurodermatitis. With neurodermatitis, there is itching, rashes and redness of the skin, its peeling;
- Insect bites, including flea bites at night;
- Psoriasis. Itching in psoriasis most often worries a person with a progressive course of the disease. In addition to itching, the patient suffers from severe peeling in the affected area.
Skin spots and itching - what does this mean?
If the onset of itching is accompanied by the appearance of spots, then most often this indicates a skin disease, and not a systemic pathology. The person may be suffering from allergies or inflammation, including contact dermatitis and atopic dermatitis. See also: Atopic dermatitis in adults and children.
- With contact dermatitis, itching and spots are localized in the place where the allergen came into contact with the skin. Redness has delineated boundaries. To determine the allergen on your own, you should remember about new hygiene products, about buying a new washing powder or thing, etc. Contact dermatitis differs in that after removing the allergen, the inflammatory reaction on the skin and itching are eliminated on their own.
- As for atopic dermatitis, it is most often diagnosed in childhood, although it sometimes affects adults. The reason also lies in an allergic reaction, but it occurs in response to an allergen that has entered the body. If in children, cheeks turn red first, then in adults - elbows, knees (at the folds), as well as wrists.
- If a red spot appears on the skin, it itches and is located at the site of a previous injury, then this symptom often indicates diabetes mellitus. Mostly such spots are formed on the lower limbs.
- Sometimes red spots are signs of psoriasis, they may itch, but they may not cause any discomfort.
- Itchy red spots on the lower limbs, which subsequently become darker, may indicate trophic disorders.
- Photodermatosis is another reason for the appearance of various types of itchy spots. They can rise above the surface of the skin, they can look like bubbles, they can be located at the same level with the rest of the skin.
- Lichen planus also appears as itchy patches that rise above the skin. Often such spots form on the feet and in the lower leg area, they can have a purple tint, and also merge, forming larger spots.
- Ringworm also appears as patches that are well-defined and rounded. On the periphery of such an itchy spot, there is a pink roller, represented by bubbles and nodules.
- As for eczema, it is also characterized by red spots, which, as the disease progresses, transform into blisters and then open. Itching may be present, but sometimes eczema does not make you want to scratch the inflamed area.
- Urticaria is characterized by the appearance of itching and blisters protruding above the surface of the skin.
- Bullous pemphigoid occurs most often in areas of maximum friction with clothing and accessories.
- Also, the cause of the appearance of itchy spots may be limited or diffuse neurodermatitis.
Itchy skin rash in adults
An itchy rash on the skin of an adult can indicate the following conditions:
- Eczema manifests itself as a spot on which bubbles subsequently form, and after their opening - crusts;
- T-cell lymphoma is accompanied by a rash and appears in places that are most often in contact with ultraviolet rays;
- Folliculitis is characterized by the formation of small vesicles, which are subsequently filled with purulent contents;
- Scabies manifests itself as blistering eruptions that are red and transparent. Tick-borne passages are visible under the skin;
- Allergic dermatitis can also appear as a small or large rash. Its appearance is accompanied by itchy skin;
- Diseases of internal organs (liver, kidneys), blood diseases can manifest themselves in the form of a small itchy rash on the skin.
When rashes appear, which are accompanied by itching, it is necessary to consult a doctor and clarify the cause of their occurrence.
Types of itchy skin
Depending on the cause and origin of itching, the following types are distinguished:
- Proprioceptive (arising in response to stimulation of C-fibers by a pruritogen), for example, itching with scabies, insect bites;
- Neuropathic (arising from damage to the nervous system), for example - itching with neuralgia and vascular thrombosis;
- Neurogenic (has a central genesis, does not depend on nervous pathologies), for example, cholestasis;
- Psychogenic (accompanied by mental disorders), an example is parasitophobia;
- Mixed, an example is itching with uremia.
Depending on the prevalence of the symptom, itching can be localized when itching can be clearly identified, and generalized when the whole body itches. An example of localized itching is scabies, head lice, ringworm, atopic dermatitis, etc. Generalized itching occurs with renal failure, helminthic invasion, diabetes mellitus, gout, etc.
Treatment for itching
In order to get rid of the itching, you must first of all decide on the tactics of treating the disease that provoked this symptom. It is important that the vicious circle in which patients with itching are often found (itching - scratching - more pronounced itching) is broken.
Medical treatment is selected individually, however, if the skin is excessively dry, the following rules must be adhered to:
- The room where the sick person spends most of the time must be thoroughly ventilated. It is important that the air stays cool;
- Blankets that are too warm should not be used during the night, and it is also important to wear lightweight clothing made from natural fabrics. This will avoid overheating;
- During bathing it is necessary that the water is not too hot;
- Taking a shower is often undesirable, especially with the use of soaps or gels;
- Alkaline soaps should be banned.
As for the treatment of itching for specific diseases, there are the following recommendations:
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Renal itching. As a rule, performing regular hemodialysis can relieve the excruciating itching of kidney failure. Uremic pruritus can be eliminated by UVB therapy. It can be done even before the drugs have been prescribed. Usually 12 minutes of radiation is enough once a day. The number of sessions varies from 6 to 8, the duration of the course is 3 weeks. Longer treatment with UVB therapy is impractical, as the risk of developing cancer increases, especially in old age.
You can also take the following medicines:
- Activated carbon (less often Cholestyramine is prescribed);
- Thalidomide, taken before night rest, can reduce itching in 50% of patients with renal failure. However, the development of side effects is possible, in particular, drowsiness and peripheral neuropathy;
- Opioid receptor antagonists such as Naltrexone. Possible use in patients with extremely severe itching;
- Ondansetron, can be used in the form of candles;
- If itching is of a localized form, then Capsaicin cream is prescribed;
- Antihistamines such as Tavegil are taken for 3 weeks.
However, most doctors are inclined to believe that it is possible to completely get rid of itching only by performing a kidney transplant operation.
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Itching due to cholestasis. To get rid of discomfort, drugs are prescribed that help reduce the concentration of bile acids in the blood.
This could be:
- Ursodeoxycholic acid;
- Cholestyramine (will not help get rid of itching, which is triggered by a blockage of the bile duct with a stone);
- Phenobarbital, which relieves itching through sedative effects;
- Rifampicin, a potent drug that must be used with caution so as not to impair liver function
- Naloxone, Naltrexone and Nalmefen. It is advisable to start with these drugs the treatment of chronic itching;
- Tavegil, Feksadin, Trexil are used quite rarely, since there is not enough data on their effectiveness.
UVB therapy can help relieve itching after 8 sessions.
- Endocrine diseases. Since in hypothyroidism, itching appears against the background of dry skin, sufficient skin hydration is necessary, which is carried out against the background of treatment with hormonal drugs. After compensation of diabetes mellitus, itching usually goes away on its own.
- Blood diseases and itching. Therapy of iron deficiency anemia with preparations containing iron can relieve the patient from itching. Improvement can come from the first day of treatment.
- If the itching is provoked by polycythemia vera, then the patient is recommended to take Aspirin, Cholestyramine, Cimetidine.
- Senile itching. To get rid of senile itching, it is important to perform general measures aimed at relieving this symptom. Sedatives are sometimes prescribed, but in older people, even in small doses, they can cause unwanted symptoms.
- Skin diseases. Treatment is carried out depending on the specific skin disease causing itching. After its elimination, this symptom, as a rule, is eliminated on its own. Therefore, if you find rashes or spots on the skin, you should seek the advice of a dermatologist.
Itchy skin can be a symptom of various diseases, not just dermatological pathologies. Its causes are varied, ranging from dry skin to cancer. The itch itself can be both minor and pronounced, seriously impairing the quality of human life. Therefore, itching is always a reason to seek qualified medical help.
The author of the article: Kuzmina Vera Valerievna | Endocrinologist, nutritionist
Education: Diploma of the Russian State Medical University named after NI Pirogov with a degree in General Medicine (2004). Residency at Moscow State University of Medicine and Dentistry, diploma in Endocrinology (2006).