Itchy skin, Pruritus

Diagnosis

The following will assist the healthcare provider to properly diagnose pruritus.

• Physical examination: A physical examination and questions about your medical history are the first steps in determining the cause of pruritus. Should your healthcare provider believe that a medical problem is the cause of your itchy skin, you may undergo confirmatory tests. 
• Blood test: A complete blood count may reveal indications of an underlying condition, such as anemia, that are the source of your itching. 
• Tests of liver and kidney function: Itching can be a symptom of thyroid issues like hyperthyroidism as well as liver or kidney problems. 
• Imaging test: If you have itchy skin and enlarged lymph nodes, an X–ray of your chest can reveal the condition. 
• Skin biopsy: Skin biopsy to determine what skin problems are causing the itchiness. In this test, a tiny sample of skin is taken, and it is examined under a microscope. 

Treatment

Each person’s experience with itching (pruritus) is unique, and treatment approaches differ based on the underlying cause of your symptoms. The primary aim of treatment is to address the root cause of the itching. Your healthcare provider may recommend prescription medications or alternative therapies if home remedies fail to provide relief. Managing itchy skin symptoms can be challenging and may require ongoing treatment. Some options include:

• Corticosteroid creams and ointments: Your healthcare provider might recommend applying a medicated cream or ointment to areas of your skin that are itchy and swollen. Following that, you could cover the treated area with a damp cotton cloth. Moisture helps to cool the skin and enhances the absorption of the cream. 

Your healthcare provider may recommend the following nighttime regimen if you experience severe or persistent itching. After 20 minutes of simple, lukewarm bathing, apply triamcinolone. Apply a 0.1% to 025% ointment over damp skin. This helps the medication absorb by retaining moisture. So put on your pajamas. For several evenings, repeat this process before going to bed. 

• Other creams and ointments: Additional skin treatments include calcineurin inhibitors like pimecrolimus (Elidel) and tacrolimus (Protopic). Alternatively, topical anesthetics, capsaicin cream, or doxepin cream might provide some comfort. 
• Oral medicines: Your healthcare provider may recommend various medications to alleviate pruritus, which could include antihistamines, oral steroids, and immunosuppressant drugs like cyclosporine A. 

Selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants, may be useful in treating some chronic itching conditions. Sertraline (Zoloft) and fluoxetine (Prozac) are two SSRI examples. Tricyclic antidepressants, such doxepin, are an additional choice. Some of these medications may not start to take effect for 8 to 12 weeks after treatment begins. 

• Light therapy (phototherapy): Phototherapy is the application of a particular kind of light to the skin. For some who are unable to take oral medications, this may be a useful alternative. It is probable that several phototherapy sessions will be required until the irritation subsides.