Help, My Skin Itches

8–20 percent of the population suffers from chronic itching. Anyone who has ever had lice or intensely itching insect bites knows how tormenting this sensation can be.

A number of skin diseases typically cause itching – the best known are atopic dermatitis, allergies, psoriasis, and shingles. At least as often, people scratch without the skin showing any changes. Then it is often difficult to find out why the skin itches.

Itching and pain are related in the body: both are largely conducted to the brain via the same nerve fibers, and painful counter-stimuli such as pressure, heat, or capsaicin can suppress itching. Numerous messenger substances in the tissue trigger itching – which explains why it comes in the most varied qualities, from tickling to burning, and why we seek short-term relief by scratching, rubbing, blowing, or cooling.

The most common triggers are dry skin and intolerance of personal care products, which can also cause contact eczema – reactions of the uppermost skin layer with redness, flaking, small bumps, and itching. In allergic reactions the immune system is involved; in toxic ones it is not.

Common itching skin diseases are hives (urticaria), atopic dermatitis (atopic eczema), psoriasis, infestation with scabies mites or lice, fungal infections, and insect bites; rarer are blistering diseases or lichen planus with small itching nodules.

If the skin itches without visible changes, a drug intolerance may be present – often blood pressure medications, drugs for diabetes or gout, painkillers, or antibiotics. Metabolic diseases such as diabetes, thyroid disorders, impaired kidney or liver function, chronic infections, and rarely tumor diseases can also trigger itching. That is why, with chronic itching, not only the skin but the entire body should be examined, including blood tests – your family doctor and dermatologist can work together here. Pregnant women, too, frequently suffer from hormonally driven itching.

The psyche also plays a role: stress increases the skin’s itch-triggering messenger substances. Histamine-rich foods likewise lead to itching; smokers break down histamine poorly, so it accumulates in the skin.

Histamine Intolerance

Some people cannot break down histamine sufficiently. Then it is important to avoid histamine-rich foods or restrict them drastically. These include smoked, cured, fermented, marinated, and poorly stored foods: canned fish, caviar, smoked fish – especially mackerel, anchovies, tuna, and sardines.

Long-aged cheese such as Emmental, Parmesan, Harzer, Gorgonzola, or Camembert, cured and raw sausage, salami, raw ham, well-hung meat, vinegar, as well as wine, liqueur, and beer also frequently cause itching. Also rich in histamine are strawberries, citrus fruits, tomatoes (including ketchup and tomato paste), spinach, avocado, eggplant, sauerkraut, pickles, and celery.

Some foods release histamine when consumed – especially preservatives, gelling agents, emulsifiers, flavor enhancers, and dyes. These, too, should be consumed less often with chronic itching, and especially with hives.

What to Do About Itching?

First, review your personal care habits: the skin’s protective barrier is frequently destroyed by excessive washing – the skin’s own fats are washed out and the skin dries out.

Tips for itchy skin

• Shower only briefly and lukewarm.
• Use soap very sparingly and only on hands, scalp, armpits, groin, and feet – elsewhere, water is enough.
• Cleansers should be mild, non-foaming, and free of dyes and preservatives. Skip perfumed shower gels!
• Care for the skin with a preservative-free body lotion without dyes or fragrances from the pharmacy. For dry skin, a lipolotion, lipocream, or ointment helps, ideally with urea, which binds moisture in the skin.
• Products with skin-identical lipids need no chemical emulsifiers and are very well tolerated.
• With a predisposition to atopic dermatitis and eczema, skin care can contain microsilver: it reduces the skin-irritating staphylococci – without the side effects of antibiotics.
• If the skin is not dry, a hydrolotion is suitable; sometimes no cream is needed at all.
• Itch-reducing ingredients in care products include polidocanol, niacinamide (vitamin B3), PEA (N-palmitoylethanolamine), and urea.

If these measures do not help, see a dermatologist, who will look for the causes and choose the right therapy – from treating a metabolic or internal disease to infection therapy to adjusting your medication, plus cortisone creams, UV light therapies, and itch-suppressing tablets.