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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Chronic Itching Be Treated?

ichiness lasting 2 months. went to a skin doctor . I am now using zertec, cerve crème and sarna. No change in diet or soap. The rash started in neck and chest area. and near hips after taking this above medicine it stopped ther then moved to calves then moved to arms then back to stomach and hips.
Sun, 6 May 2018
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General & Family Physician 's  Response
Hello,

Chronic itching is found in many different diseases, the most common including chronic liver disease, renal failure, thyroid disturbances, anemia from iron deficiency, certain cancers, etcetera. Therefore, before starting to treat itching as a symptom, the cause of it has to be determined first.

For example, itching in chronic liver diseases may be caused by "bile salts accumulating under the skin", raised histamine levels, increased endogenous opioids and serotonin levels, a specific acid (lysophosphatidic acid), etcetera. Therefore, if the cause of itching is found then it is easier to treat it and in doing so the itching will ease as well.

A number of treatments are proposed for itching, including antihistamines (zyrtec in your case), antagonists of opioid receptors, rifampicin, bile salt resins, skin moisturizers, limiting contacts with skin irritants, change of environment (avoiding hot places), etcetera.

The literature concludes that there is no ideal treatment for itching because its pathophysiology is not entirely understood. It has to be treated individually and case by case, by combining topical (local) therapies with systemic ones, just as your doctor is doing with you. The main approach, though, stands in finding the cause of the disease-causing itching and treating it.

Hope I have answered your query. Let me know if I can assist you further.

Regards,      
Dr. Ervin Toçi

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How Can Chronic Itching Be Treated?

Hello, Chronic itching is found in many different diseases, the most common including chronic liver disease, renal failure, thyroid disturbances, anemia from iron deficiency, certain cancers, etcetera. Therefore, before starting to treat itching as a symptom, the cause of it has to be determined first. For example, itching in chronic liver diseases may be caused by bile salts accumulating under the skin , raised histamine levels, increased endogenous opioids and serotonin levels, a specific acid (lysophosphatidic acid), etcetera. Therefore, if the cause of itching is found then it is easier to treat it and in doing so the itching will ease as well. A number of treatments are proposed for itching, including antihistamines (zyrtec in your case), antagonists of opioid receptors, rifampicin, bile salt resins, skin moisturizers, limiting contacts with skin irritants, change of environment (avoiding hot places), etcetera. The literature concludes that there is no ideal treatment for itching because its pathophysiology is not entirely understood. It has to be treated individually and case by case, by combining topical (local) therapies with systemic ones, just as your doctor is doing with you. The main approach, though, stands in finding the cause of the disease-causing itching and treating it. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ervin Toçi