WHAT’S IN AN ITCH
“Let me tell you, Cassius, you yourself are much condemned to have an itching palm,” declared Brutus during a feisty encounter with his coconspirator in Shakespeare’s Julius Caesar. By indulging his corrupt impulses, Cassius earned the condemnation of his more honorable partner.
In life as in art, scratching a persistent itch, while pleasurable in the moment, can condemn you to greater discomfort bi the long run. Far better to get to the root of the itch. There’s often an underlying problem that can be corrected.
WHAT MAKES YOU ITCH?
The itch sensation travels the same nerve fibers that carry pain signals to the spinal cord and brain. Apparently, scratching brings relief by overwhelming the itch with an even stronger sensation.
When the cause of itching is not obvious, a physician may be tempted to diagnose a “nervous itch.” But while emotional stress can aggravate itching, psychological factors are rarely the underlying cause. There’s usually a medical explanation.
It’s easiest to find the cause when itching is limited to one particular area of the body.
Itching feet or an itch in the groin area is usually due to fungal infection. A mild case may turn the skin reddish brown; in severe cases, the skin can crack, become raw, and even bleed. You can treat a mild infection with over-the-counter antifungal creams and powders, such as clotrimazole (Lotrimin AF) or miconazole (Micatin). Severe inflammation could indicate a bacterial infection on top of the fungal infection. In that case, an antifungal product could make the problem worse; see your doctor instead.
Anal itching can also be caused by fungal infections—as well as by hemorrhoids, skin fissures, sweating, worms, or poor anal hygiene. Each problem has its own treatment, ranging from careful cleansing to hydrocortisone cream.
Scabies, which can cause intense itching just about anywhere on the body, is caused by a microscopic mite that burrows under the skin. If you look closely, you’ll see little ridges or dotted lines ending in tiny blisters. Treatment consists of using a pesticide-containing cream or lotion. Even after the mite has been successfully eradicated, though, die itch can persist for weeks.
WHEN SCRATCHING HURTS
Sometimes, localized itching can actually be caused by scratching. This condition, known as neurodermatitis, is not an actual nerve disorder but rather a vicious spiral of itching and repeated scratching that leads to gradual thickening and darkening of the skin; the area then itches more than ever. Neurodermatitis is seen most often on the nape or side of the neck, but can develop anywhere.
The only way to eliminate neurodermatitis is to break the itch-scratch cycle:
• Don’t wear irritating fabrics such as wool, silk, or rough synthetics. Instead, try to wear absorbent, nonirritating materials next to the skin.
• To suppress the urge to scratch, apply an ice-cold compress.
• You might want to apply an over-the-counter hydrocortisone cream (Cortaid) and cover with a bandage. (But don’t use such drugs for longer than two to three weeks, since they can thin the skin.)
• If itching makes it hard for you to fall asleep, try an over-the-counter antihistamine such as diphenhydramine (Benadryl Allergy). A simple over-the-counter pain reliever—such as aspirin, acetaminophen (Tylenol), or ibuprofen (Advil, Motrin-IB)—can also bring relief.
• Since many sufferers scratch when they’re asleep, keep your fingernails short.
WHERE THERE’S A RASH
A widespread itchy rash indicates other problems. Sometimes, an allergic reaction to a certain food or medication will lead to a sudden bout of hives—a raised red rash that spreads over the body and itches like crazy. Although such a reaction usually occurs within just a few hours after ingesting the offending food or drug, it can take as long as a week to show up after a final dose of certain antibiotics, including penicillin. Many times, expert detective work is needed to track down the culprit.
In addition to things that you ingest, things that you touch can also make you itch. Contact dermatitis can be brought on by plants, cosmetics, chemicals, even rough clothing and harsh soaps or laundry detergents. Hours or possibly days after contact, a very itchy, red, blistery rash develops. Again, the trick is to identify and avoid the offending item.
Silvery, scaly patches are a sure sign of psoriasis. While the condition commonly occurs on the elbows or knees, it can also affect the entire body, including the scalp. The rash isn’t always itchy, but it can be—very. Psoriasis usually clears temporarily in response to ultraviolet light, either from sunlight or a special lamp. If there are only small patches, a hydrocortisone cream can help. Or your doctor may prescribe a more potent corticosteroid cream.
ITCHING ALL OVER
When there’s no sign of a rash, itching “all over” can be a symptom of an internal disorder. Such itching can signal diseases of the liver, kidneys, or thyroid gland. If lab tests detect such a disease, proper treatment can resolve the itch as well.
By far the most common cause of generalized itching without a noticeable rash is simply dry skin. As you age, your skin thins and oil glands produce less of a protective barrier on the skin surface. This leaves your skin more vulnerable to minor irritations. The problem is especially severe in wintertime, when humidity is low.
Fortunately, there are several ways you can protect your skin:
• To preserve your natural protective oils, take shorter and less frequent baths or showers, and use lukewarm water.
• Use a mild soap—one that’s low in alkaline, such as Dove or Neutrogena. Apply the soap only to your face, armpits, genital and anal areas, and hands and feet.
• If you bathe rather than shower, add a little water-dispersible bath oil, such as Alpha Keri. (Be sure to use a rubber mat in the tub to avoid slipping.)
• Immediately after bathing, apply bath oil to your moist skin. Avoid alcohol-containing lotions, which dry out the skin.
• Don’t air-dry after bathing; that tends to chap your skin. Pat dry with an absorbent towel.
• Use a room humidifier during winter.
• Keep room temperatures on the cool side, since warmth can worsen an itch.
• In cold weather, wear gloves and a scarf or ski mask to limit the evaporation of moisture from your hands and face.
• Use a mild laundry detergent that has no enzymes or perfumes. Rinse clothes well.
Health handbook introducing you to read the article: DERMATITIS FROM HAIR DYE
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