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Time to scratch

We have all heard about that itch that will not go away. The one that drives you mad and can be embarrassing depending on where it is and when it presents itself. Should we take it serious or just go to the pharmacy and buy some histal and call it George.

Itching of the skin is termed pruritis and is defined as a tingling sensation of the skin that causes a strong desire to scratch the area to obtain relief. Itching can either be confined to a certain part of the body (localised) or develop all over the body (generalised). This itching is caused by the stimulation of nerve endings.

What Causes Pruritis?

Pruritis may be the caused by several things. Common causes include fungal infections such as jock itch, athlete’s foot, thrush and candidiasis, chicken pox, hives, pruritis ani, and worms, also lice and scabies are very itchy. Internal conditions such as kidney failure, liver and thyroid disease hyperthyroidism and hypothyroidism, blood disorders or anemia can cause itchiness.

Neurologic conditions such as pinched nerves and infectious diseases like HIV can result in severe itching. Skin diseases or conditions such as dry skin, eczema, psoriasis and sunburn can also cause the skin to itch. It may even be due to hormonal changes which often occurring during pregnancy and menopause. Pruritis can also occur as a result of exposure to certain external irritants from chemicals or plants, insect bites and some medications. Psychological factors such as stress or anxiety can also exacerbate itching.

That itch, though, may be a sign that all is not well.

Determining the possible cause of an itch

1. If you feel as if ants are crawling on your skin, then it could be sign of menopause. Changes in the hormone balance can cause a skin itch, known as formication. Sufferers have the sensation of insects crawling on their skin, the reason is unknown. One theory is that fluctuating hormone levels may affect nerve endings in the skin.

Omega-3 fatty acids (found in oily fish) can help improve the skin condition, and if the skin is less dry it may be less prone to itching, says Dr Tabi Leslie, a dermatologist at St. Thomas’ and Barnet hospitals in London. Drinking plenty of water to keep the skin hydrated may help reduce irritation, as can avoiding smoking, excess sun exposure, stress and lack of sleep.

2. If you are feeling a fiery itch, with red and weepy skin, then possibly it maybe contact dermatitis this occurs when the skin reacts to something touching it — nickel jewellery, rubber gloves or a buckle from a belt. Soaps or perfumes can also be culprits. You should see your doctor about this, as they can help identify the probable cause and prescribe medicines to deal with the itch.

3. A prickly intense itchiness with a sudden rash could be eczema. Prime sites are behind the knees, elbows, side of neck or around the eyes and ears as these areas become hot and clammy. Moisturising the skin helps to sooth this, but again, your doctor should be involved in your treatment.

4. An itchy red-brown rash, particularly after taking medication. If the cause is medication related, it should happen pretty quickly after taking the medication. Call your pharmacist and doctor immediately and stop the medication until you have spoken to someone. Drink a lot of water as well.

5. If after 15 minutes exposure to sunlight you experience a burning rash, it could be sunlight related. Calamine lotion or Hydrocortisone cream would work a charm here. Advil or Ibuprofen would remove the pain and redness associated with the sunburn.

6. General itching with hot and painful skin, also known as hives or uticaria, happens when too much histamine is released by the skin cells. You will see white or red welts (a swollen mark about one cm in size), which can sometimes itch.

There are two types: acute and chronic. Acute uticaria occurs after a cold or flu, an insect sting or contact with chemicals in food such as tomatoes, tuna, strawberries and bananas. Chronic uticaria lasts more than six weeks, and occurs when antibodies from your immune system attack the body, causing the release of histamine. Alcohol, stress and high blood pressure tablets can make the condition worse. Over the counter antihistamines will help, but drugs such as Advil and aspirin may make it worse.

7. Prolonged itching in pregnancy can (rarely) be a sign of obstetric cholestasis- a dangerous liver condition. Discuss with your doctor about having complete liver function tests. This advice could save the life of your unborn child actually. Itching without a rash, in pregnancy should be investigated.

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