The Problem with Itching
Everyone has developed an itch at some point in time in their life but sometimes an itch can be painful and intense. If you suffer from this type of itch without any discernable cause, it's time to see a health professional. You should receive a physical examination as well as answer any questions about your itching. Sometimes painful itching might be a symptom of an underlying illness. These include liver disease, kidney failure, iron deficiency anemia, thyroid problems, and cancers, including leukemia and lymphoma and many other illnesses. Multiple sclerosis, diabetes mellitus, pinched nerves and shingles (herpes zoster) may also cause painful itching. Itching skin can affect the quality of your life. Prolonged itching and scratching may increase the intensity of the itch. While excessive scratching may seem like it will give temporary relief, it actually can make matters worse due to damaging the skin leaving it exposed to other irritants. Chronic itching can cause a tremendous negative impact on your life.
A proper and correct diagnosis is the first step in treating a painful itch. Identifying the underlying cause can take time. Tests to determine the cause may include liver, thyroid, and kidney function test, blood work and x-rays. Once the cause has been determined, treatment may include corticosteroid creams, calcineurin inhibitors and/or antidepressants. Over-the-counter antihistamines may relieve some types of itching however they do very little for those who suffer from chronic, painful itching. Antihistamines only target histamine receptors which is why they may offer little to no relief. In a 2013 study published in the journal Nature Neuroscience, the researchers sought to end the decades-long debate on whether humans and animals possess separate pathways for pain and itch, or if those sensations travel along a similar route. Xinzhong Dong, a professor of neuroscience at Johns Hopkins and senior author of the study, says. “The sensory neurons that mediate pain and itch in humans are very much alike, so it’s hard to know which one mediates itch or pain, or if they are the same group. We still don’t fully understand the itch, although we appreciate the mystery more and more.” All itches, Dong says, are not created equal. They’re broken down into two forms: acute and chronic. Chronic itch can actually make people miserable. "So itching is very complex, and we are only just starting to learn the very basic mechanism of the itch right now,” Dong says. “You can imagine there are many stimuli, chemical and mechanical, that can induce itch, including itch mediators inside the body like histamine.”
You should see your doctor or dermatologist if the itching lasts more than two weeks, doesn't improve with self-care, affects your entire body, comes on suddenly and for no apparent reason, is severe enough to limit you from your normal daily routine, disrupts or prevents you from sleeping or is accompanied with other symptoms such as weight loss, change in bowels or urine, fever, redness, swelling, or extreme fatigue.