Dermatologist's General Tips to Relieve Skin Itch
By Cynthia Bailey MD.
A dermatologist's tips to relieve skin itch are something you really care about when you are vexed by itch. Itch is crazy-making! Until you are trapped inside itchy skin, you underappreciate the torture of itch. The medical term for itch is pruritus and it is clearly uncomfortable and important. One medical paper describes itch as,
unpleasant cutaneous sensation provoking the desire to scratch. It is often an uncomfortable, subjective sensation responsible for decreased quality of life.....
As a dermatologist who has practiced for over 30 years, I know that itching decreases a patient's quality of life, interrupts sleep and the itch-scratch cycle leads to anxiety and even depression. Itch is important.
Why does my skin itch?
Itching is the most common symptom of skin diseases. There are many causes of skin itching, but the most common reasons that I see in my dermatology practice are,
- dry skin that is flaky, even without dry skin eczema,
- eczema (there are different causes of eczema including dry skin eczema, contact allergic dermatitis such as poison oak or ivy, atopic dermatitis and stasis dermatitis from poor circulation to name a few),
- notalgia paresthetica and brachioradial pruritus (I call these 'ghost itches' because the skin is normal and the itch comes from nerve root impingement of a localized itching area of skin, often on the back or forearm, due to spinal nerve root impingement).
Itching can be localized to one area or generalized to the entire skin surface. Generalized itch should be evaluated by a physician and never trivialized as there are important causes such as endocrine hormone imbalances, cancer, neurologic conditions, kidney diseases, liver and gallbladder problems, anemia and other serious conditions that need treatment. The older we get, the more reasons we have to itch. Itch is a common fact of life.
The scientific mechanism of itch is complex involving epidermal skin cells, nerve endings, a cascade of chemistry that happens in the body and the processing of it all in the brain. Scratching somehow gives temporary relief by causing pain - but that's clearly not ideal. While there is still much more that scientists and doctors have to learn about itch, we do have good skin care tips that can give relief if you are suffering from itchy skin.
Dermatologist's 3 tips for the best way to soothe itching skin.
Antihistamines are the first medicine people turn to in an attempt to relieve itch. Unfortunately, antihistamines alone are often ineffective for treating itch. No matter why your skin itches, cooling the itching skin, and moisturizing it well, can help relieve some of the itching:
- Use cool showers or cool soaks (tap or refrigerated water used as a skin compress on a soaked towel) to cool skin.
Use only hypoallergenic and gentle skin soaps and cleansers on itchy skin. This helps to prevent and heal skin dryness and reduces risk of allergic eczema. Options include my Naturally Best Bar Soap and VaniCream Cleansing Bar.
- Immediately after toweling skin dry apply a hypoallergenic and deeply hydrating moisturizer. I list some of my top choices below.
- If you have just one location of skin that is itching, an ice pack can sometimes provide relief.
What is the best skin cream to stop skin from itching?
Hydrating hypoallergenic moisturizers help relieve skin itch from many causes. That's because dry, dead skin cells are like little feathers tickling you. As fabric or a breeze moves the dry scale, it send tickle messages to your brain. Also, dry skin itches all by itself.
Use moisturizers with rich hypoallergenic oils. Classic dermatologist-approved skin creams were petroleum based for many years. That has changed and we now have great plant-based moisturizers that work well. I like these products made with botanical oils because they are also rich in antioxidants and naturally anti-inflammatory compounds.
If you are struggling with itchy skin, it is important that the moisturizing cream you choose is fragrance-free and hypoallergenic. I commonly see allergic skin rashes to fragrance or harsh preservatives in products that patients are using in an effort to gain relief of itch. In my dermatology practice, my top choices are my Natural Face and Body Lotion or Natural Face and Body Butter Cream. Most of my patients struggling with dry skin and itchy skin opt for the Natural Butter.
Another great tip is that you can cool your moisturizer in the fridge so that it goes on your skin with a soothing cool temperature. That also helps to relieve itch.
Should you use anti-itch creams?
No! As a dermatologist, I want to warn you to avoid products with anti-itch ingredients because these can cause skin allergic rashes. Allergic skin rashes itch and add insult to injury when you have itchy skin. Common anti-itch ingredients that can do this include benzocaine and diphenhydramine (Benadryl). These are allergens, yes even the Benadryl, and I don't recommend them.
The one exception is pramoxine, which is a is a good anti-itch ingredient to use. It is not a notorious allergen; it is effective and well tolerated in my experience. Hydrocortisone can also be helpful, but this ingredient can cause permanent skin thinning, damage eyes and will make some forms of itching worse, such as skin fungal reactions. Fungal infections itch so this is where getting an accurate diagnosis becomes important. I recommend that if you are turning to hydrocortisone, it is time to see your doctor.
Why is it bad to use hot water on itchy skin?
Hot water increases skin circulation (which is why skin turns red), bringing in more inflammatory mediators to fuel the skin itch. Hot water may seem to relieve itch temporarily while it runs over your itchy skin, but your itch will be worse when you stop.
Taking a bath or shower followed by application of your rich moisturizer is very healing to itchy skin. But, try to bathe in tepid to cool water until your itch has gone away.
Should you exfoliate itchy skin?
If your skin has no obvious rash at the site of itch, you may benefit from exfoliation. This helps to remove dry dead cells that can cause itching.
My Ultra-Fast Body Smoothing Triple Action Kit has the perfect combination of physical and chemical exfoliation to polish skin and help relieve some forms of itch such as notalgia paresthetica and brachioradial pruritus. It's what I use on my notalgia paresthetica and my dryness-prone skin. This kit is not appropriate for sensitive skin such as in a skin fold or skin with an active rash.
Why does sun make skin itch more?
Sun can trigger the itch in notalgia paresthetica and brachioradial pruritus. We don't know why. Sun protection is an important part of controlling itch in these two conditions. Sun also heats the skin which can worsen itch.
In other forms of itch, sun may provide some relief. Doctors even use UV treatment to control some forms of total body itching. UV rays suppress the skin's immune system that may play a role in driving some inflammatory skin rashes and itch. UV exposure, including from sun light, will damage skin irreparably and I don't recommend it until one gets an accurate diagnosis and is prescribed light treatment by their dermatologist.
Please note, that if skin itching is not easily relieved with the gentle and hydrating skin care I described above, it's advisable to see your doctor for a specific diagnosis - there are many other causes of itchy skin, and the best treatments always starts with an accurate diagnosis.
Mohammad Jafferany MD, FAPA Maryam E. Davari MD, Itch and psyche: psychiatric aspects of pruritus, Int. J of Derm, January 2019, Volume58, Issue1,
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