Pruritus is the medical term for itching that causes the urge to scratch. Pruritus is generally not a serious condition, but it can be uncomfortable and lead to sores and infection.

Pruritus is a symptom on the skin due to a certain disease or condition. Even though it occurs on the skin, pruritus is not only caused by skin diseases, but can also be caused by problems in other organs or organ systems.      

Although it can affect all age groups, pruritus is more common in older people. This happens because the skin tends to get drier with age.

Causes of Pruritus

Pruritus is not a disease, but a symptom of another disease or condition. Pruritus occurs when the itch signaling nerves in the skin experience stimulation and send these signals to the brain.

There are various conditions that can trigger itching. Even so, sometimes the cause of pruritus is difficult to determine.

Based on the affected body part, pruritus can be divided into two types, namely:

Localized pruritus

Local pruritus is itching that occurs in certain parts of the body only. This type of pruritus generally occurs due to irritation or inflammation in the skin area. In addition to itching, pruritus will usually cause skin rashes.

The following is a further explanation of the causes of localized pruritus:

1. Pruritus due to skin conditions

Localized pruritus generally occurs as a result of a disease or disorder in the skin. Some skin diseases that can cause pruritus, namely:

  • Dry skin ( xerosis )
  • Ketombe
  • Urticaria (hives)
  • Psoriasis
  • Atopic dermatitis ( eczema )
  • Dermatitis herpetiformis
  • Seborrheic dermatitis
  • lichen planus
  • Bullous pemphigoid
  • Miliaria (prickly heat)
  • Pityriasis rosea

2. Pruritus due to infection

Skin infections can also cause localized pruritus. There are several causes of infection of the skin, namely:

  • Viral infections, such as shingles
  • Parasitic infections, such as scabies , fleas, and cutaneous larva migrans
  • Fungal infections, such as athlete's foot, candidiasis , and ringworm
  • Bacterial infections, such as folliculitis and impetigo

3. Pruritus due to allergies or irritation

Localized pruritus can result from allergies or skin irritation. Some things that can cause allergies or skin irritation are:

  • Bath soaps with harsh chemicals, such as fragrances and detergents
  • Cosmetic ingredients, such as perfume, hair dye and nail polish
  • Metal in jewelry
  • Clothing materials, such as woolen cloth
  • Use of topical medication

4. Pruritus due to certain exposures

Local pruritus can also occur due to exposure to the surrounding environment, including:

  • Direct sunlight
  • Dry air
  • It's cold
  • Scratches (causing dermatographia )
  • Insect bites

Localized pruritus can also occur without any visible skin problems. This condition is usually caused by interference with the nerves that carry the itch signal in the area or along the way these nerves travel to the spine. Examples of conditions that can cause this type of pruritus are multiple sclerosis and pinched nerves.

Systemic pruritus

Systemic pruritus causes itching all over the body. This type of pruritus occurs not because of a disturbance in the skin, but due to a disturbance in the system in the body. Some of these disturbances are:

  • Allergies to medications, such as aspirin and opioids
  • Metabolic disorders, such as chronic kidney failure and liver disease
  • Blood disorders, such as iron deficiency anemia and polycythemia vera
  • Endocrine disorders, such as thyroid disease and diabetes mellitus
  • Cancer or tumors, such as Hodgkin's lymphoma, leukemia, and tumors in the lungs, intestines, or brain
  • Viral infections, such as HIV and hepatitis C
  • Hormonal changes due to pregnancy or menopause
  • Use of drugs, such as ACE inhibitors
  • Mental disorders, such as depression, anxiety disorders, obsessive compulsive disorder ( OCD ), and trichotillomania

Risk factors for pruritus

There are several factors that can increase the risk of pruritus, namely:

  • Aged
  • Suffer from allergies, eczema, or asthma
  • Having a weak immune system, for example as a result of suffering from HIV/AIDS or cancer
  • is pregnant
  • Suffering from kidney failure or undergoing dialysis
  • Taking diuretic drugs

Pruritus symptoms

The main symptom of pruritus is an itchy sensation on the skin. Itching can occur only in certain parts of the body, such as the scalp, arms and legs. However, itching can also be felt all over the body.

In addition, there are also other symptoms that can accompany pruritus. Depending on the disease or condition that causes pruritus, these accompanying symptoms may vary, including:

  • Reddish skin
  • Scratches
  • Bumps, spots, or blisters
  • Dry to cracked skin
  • Thick or scaly skin

Symptoms can last a long time and get worse. The itchiness can get worse when scratched, causing the sufferer to want to keep scratching.

When to see a doctor

Check with your doctor if you experience more serious symptoms of pruritus, such as:

  • Itching lasts more than 2 weeks and does not get better despite trying to treat it
  • Itching that is so severe that it interferes with your daily activities so that you wake up from sleep or have trouble sleeping at night
  • Itching appears suddenly without a definite cause
  • Itching occurs all over the body
  • Itching accompanied by other symptoms, such as weight loss, fever, night sweats, changes in urination or bowel movements, fatigue, and anxiety due to the discomfort caused by the itching

If the condition has not improved after 3 months of receiving treatment from a doctor, an examination by an internal medicine doctor is necessary to detect the presence of diseases or other conditions that might cause pruritus.

Diagnosis Pruritus

Diagnosis of pruritus can be done by asking questions regarding the symptoms experienced and the patient's medical history. A thorough physical examination will also be carried out to see firsthand the condition of the skin.

If needed, the doctor will carry out further tests to confirm the diagnosis. Some of the inspection methods that can be carried out are:

  • Allergy test , to see if itching is caused by an allergen.
  • Blood tests, to detect conditions that can cause itching, such as anemia, thyroid, liver, or kidney disorders.
  • Scanning tests, such as a chest X-ray, to detect enlarged lymph nodes.
  • Swab test, to determine the cause of pruritus by taking a swab sample from the itchy part of the skin and examining it in the laboratory.
  • Skin biopsy, to see the condition of skin tissue that is experiencing itching by taking a skin sample and examining it using a microscope.

Pruritus Treatment

Treatment of pruritus is based on the cause and severity of the patient. Mild pruritus can generally be treated with independent efforts at home, such as:

  • Using moisturizing skin creams or lotions, especially those containing calamine or menthol, to relieve itching and prevent dry skin
  • Use an anti- dandruff shampoo to relieve itching on the scalp
  • Using sunscreen, to prevent sunburn and skin damage from sun exposure
  • Use mild soap and detergent to prevent skin irritation
  • Bathe with warm water (not hot water), to relieve itching
  • Avoid certain clothing materials that can cause itching, such as wool and synthetic fabrics
  • Avoid the heat and use air conditioners and humidifiers , to keep the environment cool and humid
  • Compress the itchy skin area with a cold cloth or ice cubes, to relieve itching without having to scratch the skin
  • Avoid drugs that have the potential to cause allergies or itching on the skin
  • Refrain from scratching the itchy area by covering the area
  • Doing meditation or counseling with a psychologist , to manage stress or anxiety that may be experienced
  • Make sure the body gets enough rest

If pruritus does not improve even after taking the steps above, it is advisable to consult a doctor. Treatment that can be given includes:

  • Corticosteroid cream, to relieve itching and redness on the skin
  • Antihistamines, to treat pruritus caused by urticaria
  • Tricyclic antidepressant drugs, such as doxepine , to treat chronic pruritus even in the absence of symptoms of depression
  • Phototherapy using exposure to ultra violet light, to reduce itching
  • Cognitive behavioral therapy , to help patients deal with stress or mental health issues that trigger pruritus

If the itching experienced by the patient is known to be a symptom of another disease, the treatment will refer to the management of that disease. However, topical medications such as calamine lotion or corticosteroid creams are also still given to relieve itching.

Pruritus complications

Pruritus can be very annoying and reduce the sufferer's quality of life. In addition, complications can also occur if the patient continues to scratch the itchy skin. These complications include:

  • Luka
  • Infection
  • Lichenification (thickening of the skin)
  • Neurodermatitis (lichen simplex)
  • Prurigo
  • Black scars

Pruritus Prevention

Pruritus can be prevented by avoiding the underlying cause. In allergy sufferers, pruritus can be avoided by avoiding allergy triggers or taking allergy medications regularly. Meanwhile, in diabetics, keeping blood sugar levels under control can prevent the onset of pruritus.

In addition, maintaining healthy and clean skin can also prevent pruritus. Some things that can be done are:

  • Eat a healthy and nutritionally balanced diet
  • Meet the needs of body fluids
  • Use a moisturizer regularly to keep the skin from drying out
  • Use warm water when bathing, not hot water
  • Use sunscreen
Back to blog