Stop the Itch: Skin Hydration Solutions for the Seriously Ill

Ease Itching by Rehydrating Your Skin

itchy woman scratching arm
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Of all the symptoms that seriously ill people endure, itching—also known as pruritus—can be one of the most disruptive and annoying. Itching can cause:

  • severe emotional anguish
  • severe physical anguish
  • discomfort
  • skin damage and infections

Causes of Itching

Itching isn't a symptom you should ignore or view as less important than other symptoms. Severe itching needs prompt assessment and treatment. While it's easy to diagnose some causes of itching, other causes are not so easy to determine.

Medication: Opioid pain medications frequently cause itching, especially when you first start taking them or your physician increases your dose. Sensitivities or allergies to medications can also cause severe itching. Most drugs will note whether itching is a common side effect.

Kidney Failure: People managing end-stage renal disease may develop uremia, a dangerous condition common in the final stage of chronic kidney disease. The pruritus associated with uremia affects about 80 percent to 90 percent of ESRD patients.

Dermatitis: Dermatitis is an irritation or inflammation of the skin from any cause including skin reactions to soaps, creams, latex, and other chemicals. Switching to all natural, fragrance-free, organic health and beauty products may help. Complications of dermatitis include:

  • Rash
  • Flaking and itching of dry skin
  • Fungal infections (more common in obese people and those with compromised immune systems)

    Sweating: Sweating can be a real problem, especially in people confined to their bed. It can cause:

    Other Illnesses: Itching is a common symptom in many health conditions, including:

      Simple Steps to Stop the Itch

      Some simple and immediate steps you can take to prevent or treat itching include:

      • Avoiding excessive heat
      • Turning on a humidifier in the person's room
      • Applying all-natural mild lotions liberally, especially after a bath or shower
      • Avoiding skin irritants, such as wool, pet hair, most commercial soaps, and scented products
      • Applying a cool compress to itchy areas
      • Wearing clean, loose-fitting, 100 percent cotton clothing

      "Soak and Seal" to Prevent Itching

      Treat dry skin, also known as xerosis, with rehydration. The "soak and seal" rehydration technique is highly effective at relieving itching associated with dryness. 

      • Soak in a warm bath for 15 to 20 minutes. If the sick person is bed-bound, apply warm, soaked towels to the skin instead, refreshing and re-warming the towels as needed.
      • Gently pat the skin dry and apply an occlusive cream. Good examples of occlusive creams include petroleum jelly, vegetable shortening (like Crisco), and heavy moisturizers that are alcohol and fragrance-free, such as Eucerin, Aquaphor, and Cetaphil.
      • Apply the cream several times per day and dress the person in loose cotton clothing to avoid excess sweating.

      The Bottom Line on Itching

      Never ignore itching.

      It can be just as distressing as pain for some people and needs prompt assessment and treatment by your palliative care team. Although you can try a few simple remedies on your own to prevent or treat mild itching, you should always ask for professional advice from a physician you trust.

      Sources:

      Rhiner, M and Slatkin, N. Pruritis. Textbook of Palliative Nursing, Oxford University Press, 2006: 345-354.

      Pittelkow MR, et al. Pruritis and sweating. Oxford Textbook of Palliative Medicine, 2nd edition. Oxford University Press, 2004: 573-587.

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