Skin itching may have many causes, some of which cannot be pinpointed. Although a family physician or dermatologist can usually solve the puzzle in a short time, your pharmacist is adept at giving advice on selecting an over-the-counter product or the need to see a physician.
While itching, medically known as pruritus, can be caused by certain disease states or medication, it may often be the result of simple dryness of the skin. As we age, our skin loses some of its moisture due to the loss of sweat and oil glands; excess sun and tanning lamps will cause this condition prematurely, as will smoking. Add environmental factors to this, and the skin needs help. Dry skin is by far the most common cause of itchiness without an obvious rash.
If the itching is from dry skin, some suggestions for relief are: using a mild soap or skin cleanser with no fragrance, using warm instead of hot water when bathing or showering-shortening the time if you’re taking more than 5-7 minutes, avoiding overexposure to sunlight and using a sunscreen with a sun protection factor (SPF) of at least 15, or 30 if used for children or fair-skinned people. In addition, use a good body cream or heavy lotion after bathing while the skin is still a little moist. The skin consists of a water phase and an oil phase, so it is wise to use a product that will penetrate both. This is usually an emulsion of oil in water and is formulated into creams and lotions, but I favor a heavy cream such as Vanicream, Cetaphil or Eucerin. These creams are very mild, and can be used on the face, including the eyelids. Whatever you use, purchase a product that is made with no perfume, dyes, lanolin or preservatives. This is to help prevent allergy, and yet be nourishing to the skin. If this is done on a daily basis, dryness and itching should ease.
People who use cosmetics will be aided by using a moisturizer under makeup. New formulations contain products with an SPF of at least 15 to protect you from the sun while moisturizing. Whenever cosmetics are used, removal and cleansing at bedtime is essential.
Frequently, itching results from some type of allergy. Mild cases can often be relieved with 1% hydrocortisone cream not requiring a prescription. Some examples are temporary relief of eczema, insect bites, poison ivy, or allergic inflammation from soaps, detergents, cosmetics, or jewelry. Use the cream thinly and not over large areas, especially on children. If you are using this type of medication often, see a dermatologist. Medications called immune modulators (Elidel, Protopic) developed for eczema and other moderate to severe skin conditions, are available on prescription, do not contain steroids like cortisone products and are very effective in relieving a variety of skin conditions.
Ophthalmologists do not recommend hydrocortisone creams on the eyelid unless prescribed by a physician, as cortisone products have the potential to cause cataracts and glaucoma. Often eyelid itching from eye makeup can be prevented by thorough removal of the makeup and cleansing of the area daily. Afterward apply a mild eye cream containing no perfume on the external eye area; actually, a product called Aquaphor or even plain Vaseline will help. Do not use hydrocortisone cream on any bacterial infections including cuts, bruises or impetigo without medical advice. It is now recommended to use Aquaphor first. If an antibiotic is needed, let your health care provider decide.
Ointments are preferred for dry scaly lesions, whereas creams are better on oozing lesions or in folds of the skin. Gels, aerosols, lotions and solutions are useful on hairy areas. Generally, ointments and gels are more potent than creams or lotions.
If you have itching in the moist creases of the skin (groin, under breasts, back of neck, between toes), it could be a fungal infection. Your pharmacist or physician can help you choose the correct product to treat this condition. Lotrimin, Micatin and Lamisil creams are very effective, and are sold without prescription. Itching caused by insect bites or stings responds to hydrocortisone cream and oral diphenhydramine (Benadryl), and often the persistent itch of an insect bite will even respond to old-fashioned zinc oxide ointment with virtually no side effects. If itching is severe, prolonged, recurrent, or on large patches of skin, see your family physician or a dermatologist.