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What Are the Causes of Pruritus?

Pruritus is the relentless urge to scratch itching skin. It is attributed to dermatological diseases like eczema or dermatitis (Dr. Moses, American Academy of Family Physicians). The sensation of pruritus may become so severe that it may feel as if you need to constantly scratch to seek relief. There are dozens of conditions that can cause pruritus.

  1. Dermatologic Causes

    • The skin can itch due to conditions of dry skin such as xerosis or atopic dermatitis, such as eczema, involving the face or torso (Dr. Moses, American Academy of Family Physicians). When the skin becomes dry, the urge to scratch becomes intense. Children with eczema may also experience this urgency when their skin becomes sweaty or heated. Ten percent of children will have developed eczema before the age of six months (Dr. Moses, American Academy of Family Physicians).

    Allergic Reactions

    • Some causes of pruritus may be due to allergic reactions. If you are allergic to cosmetics, medications or metals such as nickel, this can cause itching. The allergic reaction will occur only in the areas that are affected by the allergen. The itching will occur immediately with contact, and manifest abnormal changes in the skin, where there will be distinct borders around the rash (Dr. Moses, American Academy of Family Physicians).

    Pregnancy

    • Pregnancy can cause severe itching as the skin begins to stretch. It is most noticeable upon the abdomen, breast, thighs and arms (Mayo Clinic). Pruritus can become most intense during the third trimester, and heat can exacerbate the severity of the itching. Other causes of pregnancy itching can be attributed to cholestatis. Cholestatis occurs when bile from the liver is blocked (Mayo Clinic). Symptoms of itching can become more severe at night. The most common sites of cholestatis are the hands or soles of the feet.

    Illnesses

    • Illnesses such as liver disease or cancer can lead to pruritus. The entire body may become affected rather than just a small area (Mayo Clinic). Due to the intensity of the scratching, your body may become inflamed, red, and irritated. Only the areas that have been scratched will look irritated, while the remainder of your body will look normal.

    Systemic

    • "Systemic" means the entire body is affected, rather than just a localized area. Systemic causes can include a host of diseases or infections, such as scabies and Hodgkin's lymphoma, and even HIV patients have been afflicted with itching (Dr. Moses, American Academy of Family Physicians).

    Complications

    • If left untreated, the severity of the itching can lead to a condition known as lichen simplex chronicus, or neurodermatitis. As the skin becomes severely irritated and scratched, it will develop a leathery, thick patch. In severe cases, persistent scratching can lead to bacterial infections or even scarring (Mayo Clinic). The constant itching can also cause insomnia.

    Treatment

    • It is important to see a doctor if you begin to experience itching that cannot be alleviated with ointments. The doctor may recommend medication to alleviate your symptoms. In many cases, your doctor will tell you not to take antihistamines to alleviate the itching, as this may create adverse responses (Dr. Moses, American Academy of Family Physicians).

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