What Is Pruritic Dermatitis?

"Pruritus" is the medical term for itching, so if you have pruritic dermatitis, you itch a lot. You may feel an intense need to scratch that can set off an itch-scratch cycle that is hard to break. Pruritic dermatitis is not a disease, it's a symptom of a number of different conditions.

How you treat it depends on what's setting off the itching. Find out about the causes, symptoms, and treatment for chronic itchy skin known as pruritic dermatitis.

Pruritic Dermatitis Causes

According to your brain, itching and pain are close relatives. Pain makes you pull back, like when you touch a hot burner. Itching makes you scratch, and may be an evolutionary development that helped our ancestors get rid of skin parasites.

In modern humans, there are many causes of pruritic dermatitis. Here's a look at some of the more common ones.

Irritation

Irritant contact dermatitis means you itch when your skin is exposed to certain substances in products, materials, and fabrics. Some of the more common irritants include:

• Textiles like wool or polyester
• Soaps, especially those with fragrance
• Cosmetics such as eye makeup and lip stains, balms, and lipsticks
• Hair dye, especially those containing p-phenylenediamine or ammonium persulfate
• Nail polish, especially those containing formaldehyde
• Henna containing para-phenylene diamine (PPD)
• Antiperspirants containing aluminum
  

Allergic Reactions

Allergic reactions that cause itching can be closely linked to or overlap with irritants, but they are due to an immune system response, which irritants aren't.

Histamine, a chemical your body releases when you have an allergic reaction, often leads to itching. An allergic reaction tends to be more severe than one from irritant contact dermatitis. The list of allergens that cause itching is long, but some common ones include:

• Plants like poison ivy, poison oak, and poison sumac
• Insect bites
• Nickel
• Medications, including aspirin, opioids, ACE (angiotensin converting enzyme) inhibitor blood pressure drugs, and some chemotherapy drugs
• Foods, including soy, tree nuts, peanuts, seafood, and wheat
• Latex
• Parasites that cause conditions such as scabies and swimmer's itch

Herbal remedies and ingredients in traditional Chinese medicine may also cause itching.

Skin Conditions

Pruritic dermatitis is a hallmark symptom of certain common skin conditions. Two of the most common are xerosis (dry skin) and eczema. Eczema is often called "the itch that rashes" because the itching precedes the rash. Common skin conditions that cause pruritic dermatitis include:

• Eczema: An itchy inflammatory skin rash
  
• Dry skin
• Psoriasis: An autoimmune condition causing inflamed, scaly patches
• Seborrheic dermatitis: A chronic inflammatory skin condition
• Ringworm: A fungal skin infection
• Hand, foot, and mouth disease: A viral disease often seen in childhood
• Folliculitis: Inflammation of the hair follicles

Internal Diseases

Some health conditions that affect your internal organs can cause a neurogenic itch. They lead to a reaction involving neuropeptides, which create many of the chemical signals in your brain. Up to 25% of people with chronic itching have an underlying disease associated with pruritic dermatitis.

Internal diseases that cause itching include:

• Liver disease with cholestasis (a blockage of bile, a digestive fluid)
• Kidney disease leading to waste buildup
• Thyroid disease slowing metabolism
• Human immunodeficiency virus (HIV) due to immune system damage
• Cancer (rarely), typically from blood or skin cancers

Nerve Disorders

Neuropathic itching is due to nerve damage. You may also have tingling sensations or numbness. Health conditions that can affect the nerves and cause pruritic dermatitis include:

• Diabetes: A condition of high blood sugar
• Shingles: A painful rash caused by reactivation of the virus that causes chicken pox
• Stroke: A blockage of blood flow or bleeding in the brain
• Burns
• Notalgia paresthetica: Itchy skin below the shoulder blade that may be due to pinched nerves

Mental Disorders

Some itching can be due to mental health concerns that affect certain chemicals in the brain including serotonin and norepinephrine. Psychogenic itching can be caused by:

• Stress
• Depression
• Anxiety
• Psychosis (loss of touch with reality) leading to delusional belief in parasite infestation
• Obsessive-compulsive disorder (OCD)

Pregnancy

It's common for pregnant people to itch due to a rash that begins on the abdomen and spreads elsewhere, usually in the third trimester or shortly after giving birth. It will disappear on its own. Experts aren't sure what causes it, but it's more likely in a first pregnancy.

Itching during pregnancy can also be due to an uncommon liver condition called obstetric cholestasis. This condition requires medical treatment, so if you are itching during your pregnancy, see a healthcare provider.

Symptoms

Pruritic dermatitis is itself a symptom, rather than a disease or condition. You may have red or irritated skin, bumps, or rashes along with itching. Pruritic dermatitis is sometimes worse at night.

When to See a Healthcare Provider

With so many causes of itchy skin, it can often take a medical professional to diagnose what's causing it and recommend the appropriate treatment. If your itch doesn't go away after about two weeks, call a healthcare provider.

Treatment

Treatment for pruritic dermatitis depends on what's causing it. Some common treatments include:

Home care:

• Moisturizers
• Less frequent bathing or showering in tepid water
• Over-the-counter (OTC) antihistamines or topical cortisone creams
• OTC local anesthetic creams
• Avoiding triggers like rough fabrics and products with fragrances

Prescription treatment:

• Antihistamines
• Steroids (oral or cream)
• Antidepressants like tricyclics or selective serotonin reuptake inhibitors (SSRIs)
• Immunosuppressants
• Anticonvulsants like Neurontin (gabapentin)

Summary

Pruritic dermatitis is itchy skin that does not go away. You may have scaly or dry skin, bumps, or rashes along with the itching. There are many causes of itchy skin, including irritation, allergies, skin conditions, some health conditions, and mental health conditions.

If your skin is itching, try moisturizers, cool compresses, and over-the-counter pills or creams for itching. If the itching continues to bother you, call a healthcare provider who can diagnose what's causing it and, if necessary, prescribe medications to help ease the discomfort.

A Word From Verywell

Pruritic dermatitis can affect your quality of life. If itching is wrecking your sleep or if scratching is making a mess of your skin, see if you can determine what's triggering it.

If you can't address it on your own, call a healthcare provider. It may seem like itching is just something you should live with, but it's worth the time to get to the bottom of it.