Itchy Skin

by Dee
(Farmington, MI)

My adolescent son of 12 has been complaining of itchy skin. He regularly gets scratching sensation. This irresistible desire to itch arises from within, like from head, stomach or back. Sometimes it gets very intense. He feels very uncomfortable.

I have taken him to our local doctor, but his advice has not helped. Does anyone know what could be causing this? Has anyone heard anything like this before?

The Expert, Ren Chats Answers

Since you have already been to your doctor with no obvious benefit, I will not start with the common skin infections that are associated with itchy skin.

Characteristics of problematic pruritus:

Itch, called Pruritus in Latin, is described as sudden recurrent desire to scratch. These paroxysms are severe enough to awaken the patient from sleep, and they often stop as unexpectedly as they start. Most commonly, itching is provoked by emotional triggers, or by slight sensory provocation of skin such as by light touch. Therefore, severe scratching sensation often starts as the child begins to change into night clothes and goes to lie in bed. High temperature of the room and bed are likely to further aggravate pruritus. In addition, chemical, mechanical, and electrical stimuli can also set in uncontrollable itching episode.

Neurologic cause of itchy skin:

A large group of neuro enzymes are found to cause itchy skin, but no single one is yet attributed to this exasperating symptom. Neurologically speaking, itch is very similar to pain, but they give rise to very different involuntary response. Pain makes the person retract from the offending stimulus. Itchy skin brings about an unpleasant feeling of something irritating the skin, and so the affected individual vigorously tries to scratch off the irritant. The pleasure of scratching is so much that it makes the person ignore the skin excoriations they incur. And most are unable to stop short of inflicting such self-injury. The intensity and duration of itching vary from one disease to another.

Diseases associated with itchy skin:

The diseases in which pruritus is a prominent feature can be broadly divided into five groups.

1. Primarily diseases of the skin, dry skin or stretched skin due to rapid weight gain.

2. Secondary to systemic sickness like that of liver, kidney, hormonal, variety of blood disorders and so on

3. Immune disorder that include HIV, food allergies and atopic dermatitis and more. Atmospheric irritants like tobacco smoke are known to aggravate itchy skin associated with these diseases.

4. Neuropathic itch due to central or peripheral nervous systems dysfunction.

5. Psychogenic itch: Emotional deprivation, stress, loneliness, anxiety, anger, depression, fear of insect bite, or general lacunae in fulfilment of social needs. Skin changes associated with scratching due to disturbed mental state (see the picture given above) are usually located in easy reach of patient’s hand, like face, arms, legs, abdomen, thighs, upper back, and shoulder. Effects of vigorous scratching are seen at different stages, from skin erosions and ulcers to thick, darkened nodules and colourless atrophic scars.

What to do?

In relation to treatment, every underlying disease has its specific treatment, but I am sure your doctor must have ruled out the diseases I have listed above. In my opinion from the information you have provided, your son is suffering from emotional imbalance.

He is at the brim of teenage. During this phase of development children react differently to increasing social and emotional challenges. Moreover, at different times same child may react differently to the same stimulus.

Peer conflicts and communication gap with adults are common cause of emotional imbalance during formative years. Children need to form their social identity. They need to have healthy relationships both with people at home and those out-side home.

Your son certainly needs help. I would strongly recommend you to read “Peers, a Peek at Peers' Psyche, Why They Do What They Do”. This book could resolve a lot of emotional and social issues of your son for now and future.

In addition, I would suggest few general tips for relief from itchy skin:

1. Keep cool

2. Avoid hot showers

3. Avoid woolen clothes next to the skin.

4. Be tender towards the skin –
a. Use shower gel for dry skin or good glycerine soap
b. Dry lightly with soft towel
c. Generously apply moisturizer after bath when the skin is yet slightly moist.

5. Avoid scratching, use ice bag instead to calm itchy skin.

6. Avoid tobacco smoke and other skin irritants like contact with feathers, animal hair, perfumes etc.

7. Several type of medicated skin creams are available for topical use, but are best when prescribed after having fully examined the patient. So please consult your local doctor.

8. Under medical supervision Phototherapy with ultraviolet light is prescribed if indicated.

9. Anti-allergic medications under medical supervision

10. Resolve peer conflicts. Please do consider to read the book on peer relationship issues and help your teenager through disturbing experience.

11. If none of the above help, please do not hesitate consulting a psychiatrist to help him out of this agonizing itch that rashes.

Hope this helps!
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