Itching

The decrease in the secretion of sweat glands and sebaceous glands is an age-related process. This results in a reduction of the hydrolipid film, i.e. the emulsion of sweat, water, lipids, keratin and protein cleavage products as well as horny cells, which naturally cover and protect the skin surface. If the hydrolipid film is no longer intact, the skin will dry out, itch, tighten and tend to develop eczema. The ability to retain water is reduced.

In addition to these environmental or age-related reasons, skin diseases in particular are the main cause of itching, for example allergic contact eczema, urticaria (hives), psoriasis and neurodermatitis. Insect bites and parasites such as fleas, lice, bed bugs or scabies mites sometimes result in severe localised itching. The psyche can also play a role. Some people react to stress and tension with itching in individual areas or on the whole body.

If the itching is mild to moderate and not due to an allergy or insect bites, pharmaceutical technicians and pharmacists can recommend specific care against dry skin so as to restore the impaired fat-moisture balance. This applies to dry winter skin just as much as to dry skin in older age.

Neurodermatitis or psoriasis often progress in episodes. When the disease is acute, patients need specific treatment – usually prescribed by a doctor – with topical and/or oral medicines. This is supplemented by basic care with active ingredient-free bases (emollients). Basic care has two main goals: to counteract itching and to restore or stabilise the skin’s barrier function so that irritants, allergens and pathogenic bacteria cannot penetrate. Consistent basic care helps to prevent or postpone disease flare-ups.

In many cases, W/O emulsions with a high fat content have proven sui­table. They should be applied generously at least twice a day. The basic therapeutics often also contain urea to bind water. Whether ointments or creams are used depends on the skin condition and also on the season. In summer, lighter products than in winter often suffice. The drier the skin, the fatter the base should be. For slightly inflamed skin, very watery topicals are recommended.

For psoriasis patients, urea is one of the most important substances in skin care, as the skin itself contains very little urea. For example, lipophilic urea cream (NRF) with 5 or 10 percent urea is recommended. Some patients how­ever do not tolerate urea well. Then allantoin can be an alternative for skin care.

In the case of pruritus caused by allergies or insects topical medicines are helpful. In self-medication, antihistamines such as dimetindene, bamipine and tripelennamine have been successfully used for a long time. They are, for example, contained in the pro­ducts Fenistil®, Soventol® or Azaron®. Also proven successful have been 0.25 or 0.5 percent Hydrocortisone preparations. Cortisol slows down excessive immune reactions and inflammations of the skin and thus also combats itching.

Gels cool immediately due to the evaporative effect and relieve itching. Local anaesthetics are also suitable for combating pruritus, as they numb nerve fibres that impart itching.

Polidocanol, for example, is contained in Soventol® Anti-Itch Stick. Due to the other ingredients ethanol and menthol, the preparation also cools for a short time. Polidocanol is also used in various lotions for dry skin and skin prone to itching, for example in products from Dermasence® Polaneth®, Doroderm®, Ducray® Sensinol or Lactel®. Due to the high water content typical for lotions, a slight cooling effect is produced here too by evaporation. Of course, in the case of infestation with parasites, these too should be combated specifically in order to remove the cause.

If the skin is very itchy or if itching persists for a long time, those affected should consult a dermatologist in order to clarify the cause and treat it specifically. The physician can also be a suitable contact person, because internal diseases such as hypothyroidism, diabetes mellitus and liver, gall bladder or kidney diseases can also cause itching. Neurological and psychological diseases can also be asso­ciated with pruritus. Last but not least, itching can be a side effect of a pharma­cotherapy. The number of drugs that can trigger pruritus is so large that they cannot be listed here. If they are suspected, pharmaceutical technicians and pharmacists can check the product information and, if necessary, suggest a change in treatment to the doctor.