Written by: dr. Ravika Khaila Arrum
Supervised by: dr. Tjokorde Istri Nindya Vaniary, M. Ked. Klin., Sp.DV
Itching is a condition that has been known to mankind for many centuries. It is a nagging sensation that causes you to scratch. Itching and scratching have turned into vicious cycles that are difficult to break. To learn more about the interdependent relationship between the two, let’s check this article out
What causes your skin to itch?
- Dermatological Itch
The type of itch that originates from the skin’s layers is the most prevalent type found in dermatology. Multiple receptors, pruritogens, and chemokines, such as histamine, are involved in the mechanism of dermatological itch.
- Systemic Itch
Itch is caused by organs other than the skin with no evidence of neuronal damage or underlying psychiatric conditions. Patients with chronic kidney disease, polycythemia vera, or hepatobiliary diseases are more likely to develop a systemic itch.
- Neuropathic Itch
Occurs as a result of neuronal damage in the central or peripheral nervous system. Other neuronal sensations such as pain and paresthesia are frequently present. An example of the neuropathic itch is Post Herpetic Neuralgia.
- Psychogenic Itch
When there is no other cause for the itch and the patient displays psychiatric symptoms, an exclusion diagnosis is made. Symptoms vary from mild anxiety to hallucinations and depression. However, new research shows that psychogenic itch is caused by a true stimulation of the itch fibers, rather than being entirely a mental illusion.
So, why do we scratch?
Scratching is actually a protective instinct to keep “invaders” at bay. Animals that scratch to get rid of fleas exhibit this behavior. Human studies show that scratching relieves itching by causing local pain, implying that we would rather be in pain than itchy. Itchy stimuli activate the reward and motivation centers in the striatum and limbic region of the cortex, resulting in a reward-driven itch-scratch cycle.
Scratching, especially with tools that will harm your body, is not a good idea. Although scratching an itch appears to “reward” our bodies, we are harming our skin. Scratching causes trauma to the skin, disrupts the epidermal barrier, and facilitates infection.
There are three easy ways to get rid of the itchy feeling.
- Avoid scratching. We’ve already talked about what scratching does to your skin
- Use over-the-counter itch relievers. Calamine and menthol lotions are widely available for you to use
- Consult your physician. Don’t be afraid to see your doctor if your symptoms don’t improve.
References
- Sutaria N, Adawi W, Goldberg R, Roh Y, Choi J, Kwatra S. Itch: Pathogenesis and treatment. Journal of the American Academy of Dermatology. 2022;86(1):17-34.
- Yosipovitch G, Rosen J, Hashimoto T. Itch: From mechanism to (novel) therapeutic approaches. Journal of Allergy and Clinical Immunology. 2018;142(5):1375-1390.
- Rinaldi G. The Itch-Scratch Cycle: A Review of the Mechanisms. Dermatology Practical & Conceptual. 2019;9(2):90-97