Managing Itch
Chronic itchy skin is a universal symptom of most types of eczema. It is especially common with those suffering from atopic dermatitis, the most common form of eczema. However those with contact dermatitis, another form of eczema, may also experience itchy skin. The scientific term for itch is “pruritus.”
Skin itch from eczema is different than itch from other common causes. Other causes of itchy skin can include insect bites, hives, poison ivy or other skin diseases like psoriasis (which can be confused for eczema). Because of this, common medications used for itch, such as antihistamines, do not work well on the itch associated with eczema.
For many people, chronic itch from eczema goes way beyond just dry skin. People with chronically itchy skin are more likely to experience poor sleep, liver disease and mental health issues such as depression and anxiety.
According to researchers, itch and pain have a yin-yang relationship. When pain is present, the feeling of itch subsides. That’s why scratching can relieve the feeling of itchy skin because it causes low-grade pain.
Treating itchy skin
The first step to managing itchy skin is to reduce the risk of it happening in the first place. This can be done through a daily bathing and moisturizing routine and using prescription medications as prescribed. Wet wrap therapy also helps control itch. Outside of bathing, apply moisturizers or lotions that replenish the skin barrier you have consistently and liberally throughout the day. Always wear sunscreen when in the sun as well as sunburn can make itchy skin from eczema worse. Avoid products that include added fragrances.
If preventative measures fail, the next step is to identify the side effects of your skin conditions before deciding on a treatment plan. If you have other side effects such weight loss, an itchy rash, sweats, or signs of an allergic reaction, speak to your healthcare provider before trying to manage itchy skin on your own.
There are two types of treatments you can use without a prescription: home remedies and over-the-counter medication. Natural remedies for itch relief include soaking in an oatmeal bath with oatmeal soap or baking soda (colloidal oatmeal, in particular can help the affected area). These can also be applied directly to the affected skin or skin rash in the form of a paste. People with eczema often report that applying an ice pack to the itchy area can sometimes relieve symptoms of skin itch and skin pain around the affected area.
While antihistamines like Benadryl stop the itch sensation from skin allergies, blisters, and other conditions that cause skin damage, they do not work for eczema. However, they may be recommended to help people with eczema fall asleep. Cotton gloves or cutting finger nails short can help protect the skin from night-time scratching. OTC corticosteroids can also help with mild itch. A humidifier might help as well, though there’s less research to support this home remedy.
Topical and immunosuppressant medications reduce symptoms of itch as does phototherapy. The American Academy of Dermatology also provides a list of possible ways to reduce itch, including the use of menthol and calamine lotion. In severe cases, health care providers may prescribe mirtazapine, an antidepressant that is effective at relieving itch at night; pramoxine, a topical anesthetic; or certain oral antibiotics used for skin infections.
As much as possible, try not to excessively scratch the affected rea. Too much scratching can lead to more rashes, thickened skin and infections if the surface of the skin is broken. Scratching also can trigger the “itch-scratch cycle” where the scratching leads to more itchiness.
If your itchy skin problems still persist after trying these skin care changes and over-the-counter medications, it might be time to speak to your dermatologist. Some cases of dermatitis, or itchy skin, might need medical attention and prescriptions for steroids or another medication. Eczema cases can sometimes be a manifestation of thyroid problems or other underlying health conditions and your doctor can help you identify if further treatment is necessary.
It’s also important to make sure your itchy skin is from eczema and not from kidney disease, lymphoma, shingles, urticaria or another condition. This is especially important if you have symptoms not associated with eczema, such as welts, scabies, or scaly skin.
10 tips for itch relief
- Use skin cleansers with low pH
- Apply a cold compress
- Understand and avoid your itch triggers
- Pinch and pat the itchy skin (rather than scratching)
- Take an apple cider vinegar bath or dilute it and add to a cold compress
- Wear soft, breathable, natural clothing next to your skin
- Avoid sitting on grass, plastic chairs, or rough carpet and upholstery with bare legs
- Try acupuncture
- Do wet wrap therapy
- Moisturize frequently throughout the day with an ointment or cream that contains ceramides
Learn more about the mechanisms of itch and how to manage it in our webinar “Starting From Scratch” with Dr. Timothy Berger, MD.
Neurodermatitis
For some adults with eczema, the intense itching can lead to a diagnosis of the skin disorder, neurodermatitis (nur-OH-dur-muh-TIE-tis), sometimes called lichen simplex chronicus (LIEken SIM-plex KRON-ik-cus).
Neurodermatitis is fueled by the itch-scratch-itch cycle. The affected patch of skin becomes thick, leathery and even itchier the more it is rubbed or scratched because of irritated nerve endings in the skin. The affected skin may also appear darker than the skin around it and have pronounced lines.
Once the itching is brought under control and the skin heals, the symptoms of neurodermatitis typically improve. Read more about neurodermatitis.
