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Itching and Mental Health

Introduction - Itching and mental health are closely related.

  • Studies have shown that patients scoring high on a depression scale also score higher for itch intensity as compared to patients scoring lower on the same scale. However, the reasoning and significance behind such a relationship remain little-known and complex.

  • This post offers an insight into:

1) The relationship between itching and mental health from dermatological and psychological perspectives

2) Preventive measures to be taken to ease itching.

Anxiety, Stress and Itch

  • Anxiety may trigger itch, and the itching sensation may then trigger anxiety, this creates a vicious cycle

  • When anxious, stress kicks in and becomes excessive - this means that when our bodies experience hormonal fluctuations or inconsistencies in our nervous systems as a result of anxiety, this spurs unpleasant sensory symptoms such as skin burning and itching.

  • Depending on the context of the sensation, some itches persist, while some may not. The itch may or may not then occur with anxiety simultaneously.

  • For those without chronic skin conditions, high stress scenarios or severe mental conditions may lead to chronic itchiness.

    • Studies reveal that students without pre-existing skin conditions often demonstrate more symptoms of itching when they are under high stress levels

  • For those with chronic skin conditions, psychological stress and anxiety can often aggravate their symptoms or flare-ups, which may lead to more severe infections or discolored, broken or bleeding skin

  • Itching also often occurs concurrently with other symptoms of a particular disorder. Here are some of the most common symptoms of anxiety:

    • Nervousness or restlessness

    • Rapid heart beating

    • Difficulty in focusing

    • State of panic or feeling in danger

    • Twitching of muscles

    • Sweating, which exacerbates the severity of rashes

    • Insomnia

Is there a clinical term for such an itch?

  • As itches can be of medical concern when they culminate into chronic skin problems, dermatologists have categorized the roots that itches stem from into four main categories:

  1. Skin inflammation or skin damage

    1. Most common form of itch

  2. Neurogenic itch

    1. Generated from the central nervous system, such itches affect other organs other than the skin. Originating from cancer, liver/ kidney failure or even anemia

  3. Psychogenic itch

    1. Itch triggered by a psychological disorder

  4. Neuropathic itch

    1. Itch triggered from damage to sensory neurons. Origins include sclerosis (stiffening of a tissue or anatomical feature), diabetic neuropathy (nerve damage from diabetes) and shingles (rash consisting of blisters caused by varicella zoster virus to one side of face and body)

Out of these four categories, only psychogenic itches are directly related to mental health disorders.

Psychogenic Itch

  • Itch caused by a psychological disorder

  • May also be associated with psychological abnormalities

  • Common disorders include depression, obsessive compulsive disorder, anxiety, psychosis, substance abuse

  • Excessive urges to scratch or pick at normal skin

  • Approximately 2% of patients at dermatology clinics are diagnosed with psychogenic itch

  • There is no definite treatment; research on such treatment is still held in progress or under evaluation

Diagnosis and Treatment

  • Identifying the roots and origins of itching is important, especially when one does not know whether it is directly related to a mental health disorder

  • Conducting dermatological and psychological tests simultaneously:

    • Doctors may cooperate with dermatologists in conducting additional testing on patients' skin conditions, such as undergoing medical tests or observing other problematic conditions.

    • Mental health specialists may be able to help identify any symptoms of anxiety or depression.

  • Once diagnosis has been confirmed, treatment commences.

  • Treatment is dependent on the neurological/ physical causes of itchiness or the mental health disorder, as well as the underlying itching/skin conditions

  • In some cases, patients may need to consult both psychologists and dermatologists for suitable treatment

  • Skin conditions

    • Soothing creams or ointments and medications (such as corticosteroids or antidepressants) may be able to ease itching

    • On a regular basis, patients can use moisturizers, humidifiers and protect their bodies from hot surroundings that may stimulate itchiness.

    • To prevent scratching, gloves or covers can be worn. Fingernails can also be trimmed to alleviate the effects of scratching

  • Mental health conditions

    • Therapists or specialists can offer behavioral therapy, such as behavior modification therapy, or light therapy sessions

    • This is to lessen the impact of disorders such as anxiety, keep itching under control and change thought patterns.

    • Regular exercises, acupuncture, meditation, a healthy diet and sufficient sleep also help to reduce symptoms of stress, which then reduces symptoms of itching

Seek Help

  • Always consult a doctor if itchiness or feelings of stress, depression and anxiety begin to affect your daily life.

  • Inform your doctor about how your symptoms have progressed or changed throughout diagnosis and treatment.

  • Also let your doctor know if you have been diagnosed with other medical conditions

  • If you happen to have severe skin conditions, it is recommended that you consult a dermatologist, too.



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