“I am so itchy!” is a common complaint in the allergy clinic. Chronic itching can be very bothersome and can significantly affect a person’s quality of life. It is typically defined as itching lasting longer than six weeks. By the time a patient gets to the allergy clinic, they are frustrated, often sleep deprived and looking for answers.
The causes of chronic itching are vast, and although we see many of these patients in the allergy clinic, allergy is often not the cause of chronic itching. Causes of itching may be divided into those associated with a rash and those without a rash. Itching with a rash may be caused by conditions such as ezcema, contact dermatitis, medications, psoriasis, insect bites or chronic hives. Itching without a rash is more likely related to an underlying systemic issue, such as a liver, kidney or blood disorder. Dry skin is a common cause of itching, particularly in the winter. On occasion, the chronic itching will eventually result in a rash typically sparing the back and often triggered by an underlying neurological or psychological cause.
Testing will depend on the results of history and physical exam findings, but it may include blood work, allergy testing by prick skin testing or patch testing, and X-ray studies. Treatment also depends on the underlying cause of the rash. Antihistamines, cool baths, nonfragrant moisturizers and topical steroids may be recommended. Often times the primary care physician must work together with an Allergist and/or a Dermatologist to diagnose and manage this frustrating condition.