Do you have an itch you want to scratch? – Galveston County Daily News

Happiness is having a scratch for every itch. Ogden Nash

Itching is a common problem. Notice the dog furiously digging his fur with a hind leg or farm animal rubbing up against a tree or post. I similarly admit to often using the nearest door frame to scratch a persistent itch in my upper back.

As a primary care doctor, I treat many itching people. The medical term is pruritus. Usually, its a straightforward problem requiring little more than moisturizing or medicating a rash with over-the-counter salves, hydrocortisone or antihistamine creams or oral antihistamines.

So, what about the itch without a rash or the itch that doesnt go away? This is chronic pruritus. One of my patients, a delightful widow lady from Australia, is afflicted with a highly annoying itch on her upper back, at about the same place as mine.

Hers is more irritating, intrusive, continuous and significantly decreases her quality life. Its thought to be due to an irritated or entrapped nerve, a condition called notalgia paresthetica. She has visited all kinds of doctors, tried many topicals, oral medications, botox injections, acupuncture and even considered surgery without relief.

Rashless itches also can be a sign of underlying and serious disease. Chronic problems with the kidneys, liver, blood, thyroid and certain malignancies can lead to generalized itching. One peculiar challenging psychiatric problem is delusional parasitosis in which a person, against all evidence to the contrary, believes they have miniscule insects or parasites invading their skin.

These unfortunate folks often dig deep scratches and ulcers into their skin probing for their invisible, non-existent tormentors. Other psychiatric causes of pruritus include obsessive compulsive or bipolar disorders, anxiety, depression and schizophrenia.

Besides notalgia paresthetica, other neurological causes of itching include strokes, shingles, diabetes, compressed nerves, multiple sclerosis, among others.

Many dermatological conditions like dry skin, eczema, psoriasis, hives, contact dermatitis, and allergies cause chronic or intermittent pruritus.

When in doubt, see your primary care doctor or dermatologist. How we treat you will vary according to the cause of the itching, such as diagnosing and managing an underlying disease or removing a provocative cause. Laboratory work and imaging may be required.

A broad variety of anti-itch remedies are available. These can include steroids taken topically or orally, anti-histamines, nerve medication gabapentin, moisturizers, capsaicin cream, anesthetics such as lidocaine in a cream or patch, calcineurin inhibitors for psychogenic itch, psychiatric medications or phototherapy with ultraviolet A and B light.

Numerous traditional, herbal folk medicine remedies for itching include: marigold, chamomile, oatmeal baths, tea tree oil, slippery elm, marshmallow root, aloe, comfrey and witch hazel.

Always consider non-drug therapies for itching: taking baths in warm not hot water, applying emollients right after bathing to keep moisture in the skin, using hypoallergenic skin products, identifying soaps, detergents or other irritating substances, noticing association with certain foods, wearing cotton instead of wool, choosing loose fitting clothes, humidifying indoor spaces in the winter, avoiding excess sweating and managing stress as one more thing that makes itching worse.

Dr. Victor S. Sierpina is the WD and Laura Nell Nicholson Family Professor of Integrative Medicine and Professor of Family Medicine at UTMB.

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Do you have an itch you want to scratch? - Galveston County Daily News