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Chronic itchy skin is a universal symptom of most types of eczema. Itch from eczema is different than itch from a bug bite or poison ivy. 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 the physical. People with chronically itchy skin are more likely to experience poor sleep, 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.
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 that replenish the skin barrier consistently and liberally throughout the day.
Natural remedies for itch relief include soaking in a bath with oatmeal or baking soda. These can also be applied directly to the skin in the form of a paste.
While antihistamines do not stop the itch sensation, 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.
Topical and immunosuppressant medications reduce symptoms of itch as does phototherapy. 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 skin affected by an eczema flare. 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.
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 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.