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Itching is no joking matter.

Like pain it serves as a protective mechanism against external and internal agents. Pruritus can be a symptom of a skin disease or of an underlying systemic disease. More than 50 per cent of patients attending a skin clinic complain of itching and more than 15 per cent with generalised itching have an underlying internal cause.

Severe itching, though it is a butt of jokes, can be as disabling as intractable pain. Itching can be localised, generalised, paroxysmal or unremitting and can be qualified as tingling, burning or pricking.

Itch is mediated by a complex neurophysiological reaction under the control of distinct nerve path ways. Certain chemicals are also responsible like histamines and cytokines. When it itches you scratch, but there are hundreds of possible causes for the ordinary itch!!

Some of the common causes of itching

Dry skin

Allergies to various factors in the environment including food and drugs

Insect bites, skin Infestations and infections, fungal, bacterial, viral

Specific skin diseases including some types of skin cancers

Psychiatric disorders, drug addictions, anorexia nervosa

Nerve disorders -- multiple sclerosis, diabetes mellitus, shingles Internal diseases:

Liver disease, kidney failure, iron deficiency anaemia, thyroid problems, cancers like lymphoma, leukaemia


Complications of itching

Prolonged itching may lead to skin changes with thick dark leathery appearance. Sometimes raw areas with oozing can occur, even a secondary bacterial infection, permanent scars or change in skin colour.

When to see a specialist

Itching lasting more than two weeks not improving with self-care measures

Severe and uncomfortable itching disturbing sleep and other daily activities

Cannot be explained or no visible skin problems

Affects whole body

Associated with other symptoms like fever, weight loss, change in bowel and bladder habits or skin redness.

When you decide to meet your doctor keep a detailed record of all the medications taken including over-the-counter drugs and home remedies, history of any changes in daily routine, food habits, any worsening factors, travel details and personal habits.

An examination of the skin as well as the entire body systems might be necessary to detect subtle evidence of certain skin diseases. It is the patient who presents with itching with no associated rash who can pose a particularly challenging therapeutic dilemma.

Treatment -- Anti-histamines play the major role in relieving almost all itchy disorders. Topical smoothening agents and anti-pruritic medications are also prescribed for symptomatic relief. Long term relief is achieved only if the underlying cause is identified and treated.

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Publication:Khaleej Times (Dubai, United Arab Emirates)
Date:Mar 23, 2013
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