Itching (pruritus)

Itching, medi­cal­ly known as pru­ri­tus, is an unp­lea­sant sen­sa­ti­on of the skin that trig­gers the urge to scratch. It is one of the most com­mon sym­ptoms in der­ma­to­lo­gy and can have a signi­fi­cant impact on qua­li­ty of life, espe­ci­al­ly if it beco­mes chro­nic or dis­turbs sleep at night. Itching is cau­sed by the acti­va­ti­on of spe­cia­li­zed ner­ve fibres in the skin, which can be acti­va­ted by various mes­sen­ger sub­s­tances such as hist­ami­ne. The cau­ses are varied: skin dise­a­ses such as neu­ro­der­ma­ti­tis, pso­ria­sis, urti­ca­ria, cont­act ecze­ma, fun­gal infec­tions or dry skin are com­mon trig­gers. Sys­te­mic dise­a­ses can also cau­se itching, such as renal insuf­fi­ci­en­cy, liver dise­a­ses with bile con­ges­ti­on, thy­ro­id dise­a­ses, dia­be­tes mel­li­tus or hema­to­lo­gi­cal dise­a­ses. Medi­ca­ti­ons, espe­ci­al­ly opio­ids and cer­tain anti­hy­per­ten­si­ves, can also trig­ger itching. Para­si­tes such as itch mites or lice lead to inten­se itching. Psy­cho­lo­gi­cal fac­tors such as stress or anxie­ty can inten­si­fy itching. A distinc­tion is made bet­ween acu­te itching, which lasts less than six weeks, and chro­nic itching, which lasts lon­ger. The dia­gno­sis includes a detail­ed medi­cal histo­ry and skin exami­na­ti­on. In the case of gene­ra­li­zed itching wit­hout visi­ble skin chan­ges, an inter­nal inves­ti­ga­ti­on with blood tests is neces­sa­ry. Tre­at­ment depends on the cau­se. The the­ra­py of the under­ly­ing dise­a­se is the main focus. Skin-caring, itch-reli­e­ving creams, coo­ling, anti­hist­ami­nes for hist­ami­ne-media­ted itching, topi­cal or sys­te­mic cor­ti­cos­te­ro­ids for inflamm­a­ti­on are sym­pto­ma­ti­cal­ly hel­pful. It is important to avo­id scrat­ching, as this dama­ges the skin and leads to more itching. Short fin­ger­nails, cool slee­ping tem­pe­ra­tures and airy clot­hing made from natu­ral fibers can help.