Complaints & connections · borters.ch
Pruritus
Scratching relieves briefly and worsens long-term — breaking the circle is half the treatment.
Also known as: itching · pruritus
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Itching is usually harmless and often has a simple cause: dry skin (especially in winter and with age), eczema, an allergy or an insect bite. Sometimes, though, an internal cause is behind it — such as iron deficiency, a thyroid, liver or kidney disease, or certain medicines. A useful distinction: does it itch with a visible rash (more likely a skin problem) or without a rash (more likely an internal cause)? If the itching lasts, affects the whole body or disturbs sleep, a check is worthwhile.
An itch that has sat for months exactly under one shoulder blade and does not respond to creams comes from the nerve and not from the skin.
Dry skin is the most common cause of itching — and it has a form of its own with a very characteristic picture and a fixed season.
Worst at night, between the fingers, at wrists, navel and belt line — and several in the household are scratching. Then it is about a mite, and everyone is treated on the same day.
Rich moisturisers, not too hot or long showers, mild soaps.
Scratching worsens itch — cool it, tap instead of scratch, keep nails short.
Especially without a rash: check iron, thyroid, liver and kidney values.
Persistent, generalised or sleep-disturbing itch should be assessed.
Itching that starts in the evening and at night at the back passage first suggests worms in children — checked with tape in the morning, not in stool.
If the itching is mainly at the back passage, different rules apply there — above all that cleaning more thoroughly makes it worse.
Apply a cool, damp cloth or rinse with cold water; keep nails short, thin cotton gloves at night.
Hang a cup of fine oat flakes in a cloth in the lukewarm bath water, bathe for 10 to 15 minutes, then only dab dry and moisturise at once.
Itching at night that also affects others in the household, with small burrows between the fingers, at the wrists, in the armpit and at the belt line: that is scabies and not dry skin. It is often treated for months with moisturiser — everyone in the household has to be treated on the same day.
Itching that is worst at night, sits between the fingers, at the wrists and at the belt line and affects several people in the household needs to be looked at — not creamed.
The itching only comes weeks after the infestation and sits in two typical places. Look with the wet comb; only what cannot be wiped off speaks for lice. Pubic lice do the same in the pubic hair; they sit lower and leave blue-grey spots.
A winding, raised stripe on foot, buttock or back that advances a few millimetres a day comes from a hookworm larva in the sand. A single tablet ends it. Persistent itching with thickened skin after years in the tropics comes instead from filariae and needs a blood test.
Itching without a visible rash lasting more than six weeks counts as chronic and has an internal cause in about ten to twenty-five out of a hundred cases — liver, kidney, thyroid, iron, blood count. Dry skin is the single most common reason and increases with age. Scratching feeds the itch through a circle of its own: the skin is damaged, releases more messengers and then itches more than before.
Antihistamines work against itch that comes from histamine — so in hives and allergy. In the itch of dry skin, or from liver or kidney causes, they do little, except through the drowsiness of the older ones. What works there is fat and water in the skin: a rich base twice a day, applied within three minutes of showering while the skin is still damp. Cooling interrupts the signal; scratching strengthens it.
At night skin temperature rises and distraction falls away — both amplify the itch. Shower cool, moisturise straight away, keep the bedroom cool, nails short.
Scratching sets a stronger stimulus that briefly covers the itch — afterwards the skin is irritated and it itches more. The circle is the problem, not willpower.
A visible rash points to eczema, allergy or dry skin.
If it itches without skin changes, blood tests are worthwhile.
Especially in winter and with age — improves well with care.
The most common internal causes of itching without a rash.
Skin and lining renew themselves quickly and need zinc for it. With places that heal badly, cracked corners of the mouth and frequent skin infections a lack is a serious possibility.
Without vitamin C no stable collagen forms — the wound closes but holds less well. With a very one-sided diet, smoking and alcohol the intake is often tighter than assumed.
Steers the horn-forming of the skin. Too little makes it rough and dry, too much over longer periods harms liver and bone — and in pregnancy a strict upper limit applies.
Every healing needs building material. Anyone eating little during an illness loses exactly that — a sufficient amount spread across the day belongs to the treatment.
With atopic eczema and dry skin an improvement in itch was measured when the starting value was low — 20–50 µg (800–2000 IU) a day over 8–12 weeks. At a normal level nothing showed.
1–2 g EPA+DHA a day over at least 8 weeks; the studies in atopic eczema show small effects. Itch without a rash over weeks often has an internal cause — a blood count says more there than any capsule.
Iron deficiency is among the causes of itch without a visible rash, even without anaemia. Ferritin therefore belongs in the first row of values.
The best-known road — but only one of several. Itching that does not respond to antihistamines at all mostly runs along other paths; then other remedies help.
Both directions itch: the underactive thyroid through dry skin, the overactive one through the circulation. The value belongs alongside with itching without a rash.
After the menopause the skin becomes thinner and drier — that is the commonest explanation for itching without a rash in this phase of life.
Both directions of the thyroid itch: underactivity through dry skin, overactivity through warmth and widened vessels. With itch and no rash TSH belongs among the first values.
Itch in pregnancy, above all on palms and soles and above all at night, belongs looked at at once. It can come from a bile backup, and then the timing matters for the child.
Lasting itch without a rash often has a measurable cause: iron deficiency, kidney or liver disease, thyroid, more rarely a lymphoma. Before adjusting the diet, measuring is worthwhile.
All three widen skin vessels and intensify itch short term. The effect lasts minutes to hours — which explains evening scratching after the meal.
The cooling effect interrupts the itch — strongly diluted and not over large areas.