Stop the Itch

Ease Itching By Rehydrating Your Skin

itchy woman scratching arm
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Of all the symptoms that seriously ill patients can have, itching, or pruritus, can be one of the most disruptive and annoying. Itching can cause:

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

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 Causes Itching

Opioid pain medications frequently cause itching, especially when you first start taking them or your physician increases your dose. Sensitivities or allergies to other medications can also cause severe itching.

Kidney Failure Causes Itching

End-stage renal disease patients may develop uremia, a dangerous condition common in the final stage of chronic kidney disease. The pruritus associated with uremia can be disabling and affects about 80 to 90 percent of end-stage renal disease patients.

Dermatitis Causes Itching

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:

  • a rash
  • flaking and itching of dry skin
  • fungal infections (more common in obese patients and those with compromised immune systems)

    Sweating Causes Itching

    Sweating can be a real problem, especially in bed-bound patients. It can cause:

    Other Illnesses Cause Itching

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

    • metabolic diseases

    Simple Steps to Stop the Itch

    There are some simple steps you can take now to prevent or treat itching, including:

    • Avoiding excessive heat
    • Turning on a humidifier in the patient'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

    You can treat dry skin, also known as xerosis, with rehydration. The "soak and seal" rehydration technique is highly effective at relieving itching associated with dryness. To do this, the patient:

    • Soaks in a warm bath for 15 to 20 minutes. If the patient is bed-bound, you can modify this by applying warm, soaked towels to the skin, refreshing and re-warming the towels as needed.
    • Gently pat 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 patient in loose cotton clothing to avoid excess sweating.

    The Bottom Line on Itching

    The bottom line is you should never ignore itching. It can be just as distressing as pain for some patients and needs prompt assessment and treatment by your palliative care team. There are some simple things you can do to prevent or treat mild itching, but 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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