Skin itching in a child

Skin itching in a child can be due to many reasons. The most common provocateur is atopic dermatitis, somewhat less often - urticaria, Dühring's herpetiform dermatitis, eczema, mastocytosis, as well as various infectious and autoimmune diseases. As you can see, itchy discomfort is not as harmless a symptom as it seems at first glance. Therefore, it cannot be ignored or waited until the problem “goes away on its own”. We recommend that you carefully read the article and draw the right conclusions about what to do with children's itching.

Epidemiology

Itching in children is becoming more and more common. So, over the past thirty years, frequent visits to the doctor on this matter have been recorded: about 17-18% of preschool children and up to 20% of adolescents and primary school students are treated. The reasons for this surge have not yet been determined. Meanwhile, this trend is observed not throughout the world, but only in the countries of Western Europe, South and North America, and practically throughout the entire territory of the post-Soviet space.

Statistics also state that itching problems in children appear in 80% of cases if the parents are prone to allergic manifestations or have any chronic skin diseases. A pathological symptom affects up to 60% of children in whom one of the parents is prone to allergies.

Causes of the itchy skin in a child

Weak immunity, an abundance of allergens, viruses, fungi, bacteria - all this can cause itching in a child, from mild to intense and debilitating. Of course, any parent wants to help the baby as soon as possible. But help will be incomplete or even ineffective if the initial cause of the uncomfortable state is not eliminated, so it is very important to detect it in a timely manner, before the disease worsens.

The causes of itchy discomfort can be the following diseases and conditions:

• Insufficient or, conversely, excessive compliance with hygiene rules can lead to the development of atopic dermatitis - a disease that occurs in the presence of certain irritating factors. In addition to the obsessive desire to scratch, in a similar situation, rashes in the form of bubbles, swelling of the skin, and redness can be observed. Atopic dermatitis, according to statistics, is found in one in ten children, and this is quite a lot. But not in all cases, the whole symptom complex manifests itself in babies at once: often itching and rashes become the only initial sign of a problem.
• Allergies are most often detected in childhood. Skin itching and rashes may indicate poor tolerance to foods, medicines, the presence of hypersensitivity to pollen or dust, wool, chemicals and detergents, etc. The rash can be different - local or focal, or may be absent altogether. The worst case scenario is anaphylactic shock, which can turn into extremely negative consequences, so at the first sign of it, you should immediately call for "emergency care".[1]
• A drug rash is a painful reaction of a person's immune system to taking certain medications, and antibiotics often become such medications. Itching after antibiotics in a child almost always has an allergic origin and can manifest itself focally, or throughout the body. With repeated use of the antibiotic, itching may increase, a rash, swelling, up to an anaphylactic reaction appear. But this is not always the case: in some children, itching becomes the only manifestation of such an immune response.[2]
• Scarlet fever is a disease characterized by the appearance of a characteristic scarlet rash, which is a specific reaction of the body to the release of erythrotoxin. Itching with scarlet fever in a child is moderately expressed, and only with severe and moderate course can it disturb quite intensively. By the end of the acute period of the disease, the rash dries up, but peeling and itching may be present for some time.[3]
• Chickenpox is an extremely unpleasant disease, classified as a childhood infection. Itching with chickenpox in children is especially painful: an acute viral infection is transmitted by airborne droplets and is provoked by a specific virus belonging to the Herpesviridae family. Chickenpox often affects children 4-5 years old, but older children can also get sick.[4]
• Each of us experienced insect bites, so it is believed that itching from mosquitoes in a child is, on the one hand, a normal phenomenon. But quite often, banal bites develop into a full-fledged allergic reaction, and even into an inflammatory process (for example, if a child combed the bite site and brought an infection). Therefore, bites of insects - not only mosquitoes, but also wasps, bees, midges, bedbugs, ticks - should not be ignored. They need to be treated, and even see a doctor. By the way, predominantly nocturnal itching in children is often related to the presence of insects such as bed bugs, mites or lice (fleas).
• Severe itching in a child can be caused by squeezing a certain part of the body with clothes, shoes, holding and fixing bandages (including plaster casts). Often, a place tied with an elastic band or lace begins to disturb. Itching under a cast in a child occurs as a result of a violation of local blood circulation in the tissues, or due to increased dryness of the skin caused by the constant wearing of a bandage. Less commonly, contact dermatitis becomes the cause - this is a kind of skin reaction to prolonged skin irritation with gypsum components (for example, calcium sulfate). If the sensations under the cast become unbearable, then you should definitely visit a doctor: there are frequent cases of skin and allergic diseases developing under the bandage, requiring prompt medical attention and intervention.
• Pinworms often cause itching in the anus. The activity of these parasites is activated at night, when they go outside and lay eggs in the specified area. To clarify the diagnosis, you should take a stool test for worm eggs, as well as scraping, which will help to accurately determine the cause of the discomfort. Such a diagnosis is necessary, since the symptom of perianal itching can be associated not only with the presence of pinworms, but also with the formation of microcracks in the anus - for example, due to prolonged constipation in a baby.[5]
• Diathesis is not a disease, as many believe, but just a tendency of the child's body to develop allergic and inflammatory processes. If the cause of such a tendency is eliminated, then the itching will disappear by itself. Therefore, all efforts must be directed to the search for an allergen - most often it “hides” behind the use of certain foods.[6]
• Urticaria is the appearance of itchy rashes of a reddish or pinkish tint, like blisters, which usually accompany nettle burns. Rashes may appear and disappear on their own within one or two hours. The cause of hives can be cold or sun exposure, or an allergen directly into the body.[7]
• Measles is a dangerous viral pathology, one of the most common causes of death among young children. Itching with measles in children is not the main symptom, since it is usually not very pronounced and does not require the use of antipruritic agents, however, in some cases - for example, against the background of fever - discomfort may increase.[8]

Risk factors

The intensity of itching in a child can vary, from a slight scratching to severe discomfort that disturbs the well-being and sleep of the baby. In most cases, the pathological sensation is associated with allergic processes in the child's body, but in about every third case we are talking about pathologies such as diabetes, thyroid disorder, electrolyte imbalance, dysfunction of the digestive or nervous system. Also, hypersensitivity to certain medicines, food, etc. Is not excluded.

In addition to the basic cause, the presence of provoking factors that directly or indirectly affect itching manifestations should also be noted. These factors include:

• dry skin (associated with dehydration or the cold season);
• increased water hardness, the use of "adult" bathing products, improperly selected clothes and bedding (for example, synthetics);
• immature nervous system, instability of the mental and emotional state (excessive excitability, phobias, neuroses, etc.);
• irrational nutrition, poor and monotonous food;
• improper use of medicines, self-medication;
• non-compliance with hygiene rules, or vice versa, excessive compliance.

Determination of the provoking factor is in the competence of the attending physician. Self-medication can only worsen the problem that has arisen and prevent the baby from getting relief as soon as possible.

Pathogenesis

Quite often, an itchy problem in children is associated with atopic dermatitis, or appears against the background of other systemic disorders. In most cases, the symptom occurs paroxysmal - for example, it bothers you only during sleep.

Systemic causes of children's itching are:

• hypersensitivity of the body;
• hormonal changes during puberty;
• reactions to medicines (antibiotics, ethanol, etc.);
• some types of therapy (physiotherapy);
• parasitic invasions (onchocerciasis, echinococcosis, trichinosis);
• infectious pathologies (chickenpox, roseola);
• liver or kidney disease (obstruction, cholestasis);
• hematological pathologies (leukemia, anemia, erythremia);
• endocrine diseases, neurological disorders, intoxication.

There are also variants of the problem such as solar, stress itch.

Allergic itching in a child is especially common. An important role in the pathogenesis of its occurrence is played by mast cells: their number increases, certain inflammatory mediators are released (for example, histamine, tryptase, proteoglycans, eicosanoids, etc.). Mast cells provoke itching due to mediators and NGF, which promotes hyperplastic changes in nerve fibers. Inactivating agents are agents with antihistamine activity, glucocorticoid hormones, beta-adrenergic antagonists.

Nervous itching in children is associated with an overstrain of the immune system: a failure occurs in which the immune system attacks its own cells in response to stress. The balance between the mechanisms of defense and aggression is disturbed. Sensory receptors in the skin are activated and send a signal to the spinal cord and then to the brain. As a result, depending on the degree of activation of the nerve endings, itching or even pain occurs.

Symptoms of the itchy skin in a child

Children's itching is often found in conjunction with other painful symptoms - for example, sometimes it is redness and peeling, dry skin, swelling, crusting, rashes, as well as general malaise, fever, headache, etc.

If the desire to scratch is the only symptom present, then its first signs can be expressed in increased motor activity of the infant, constant anxiety, irritability, tearfulness, capriciousness. The baby can fiddle with clothes, scratch the limbs and body, rub against objects, cry for no reason. Often there is a change in appetite, mood instability, insomnia.

Itching in a child without a rash occurs with allergies (at the initial stage of the disease process), as well as with infectious and other diseases, including parasitic lesions. Therefore, this symptom should not be ignored, because it may indicate the development of serious pathologies that require the earliest possible medical intervention.

If itchy small vesicular elements with cloudy contents are found on the skin, prone to grouping, which from time to time open, forming ulcers and crusts, then dermatitis herpetiformis can be suspected. Usually such itching appears on the elbows of the child, as well as in the face or tailbone. Dermatitis herpetiformis is of viral origin and is highly contagious.

A reddish rash and itching in a child that occurs abruptly are most likely allergic in nature: the rashes look like small spots, bumps or vesicles. Such a reaction is a consequence of taking certain medications, vitamins, eating certain foods, or direct contact with allergens. Unpleasant symptoms appear in any area on the body, while itchy elements in children are very often combed and heal for a long time.

It is extremely rare for an allergic process to combine symptoms such as rash, itching and fever in a child. The presence of temperature with allergies is the exception rather than the rule. If such a symptomatic triad is observed, then in most cases it is a concomitant infectious disease. Infections are not always accompanied by cough, runny nose and other relevant symptoms. The course of infectious pathology is erased, manifested only by an increase in temperature.

Food allergies against the background of intoxication can also be accompanied by hyperthermia. However, “guessing” the diagnosis is pointless and dangerous: it is better to visit a doctor, diagnose and determine the cause of the problem. It is possible that such a cause is chicken pox, rubella - common viral diseases that affect mainly children.

Redness and itching in a child are the result of allergic, inflammatory processes: outwardly, the rashes look like reddish spots, elevations or vesicles, localized on the face or buttocks, or in other, atypical areas of the body. When combing, such elements are quickly covered with crusts, while the itching does not disappear, and even intensifies.

If a child has itching and peeling, then seborrhea or mycosis can be suspected. To make an accurate diagnosis, a careful examination of the skin is enough. With mycosis, there is not only peeling, but also detachment of the skin, the formation of small bubbles and areas of irritation. With seborrhea, there is dry skin, the child's itching is intense and is accompanied by redness, the formation of crusts in the area of \u200b\u200bthe eyebrows, eyelids, navel, etc.

Night itching of the skin in a child associated with an insect bite requires a careful examination of the skin in the morning: for example, after bug bites, characteristic red itchy bumps can be found, and with flea bites, small pinkish elements are located in close proximity to each other (as the insect moves along skin cover).

Acne and itching found in a child is a reason to contact a dermatologist or parasitologist: if you need the help of another narrow specialist, the doctor will give a referral for additional medical advice.

Forms

There is no generally accepted medical classification of itching in a child. This is mainly due to the fact that itching discomfort in itself is not a disease: it is only one of the symptoms indicating any disturbances in the body, among which hypersensitivity reactions are especially common.

In medical terminology, a symptom can be divided into allergic or non-allergic, local or focal, minor and intense.

Doctors often describe the problem according to its localization:

• skin itching - indicates the presence of problems of a psychiatric, dermatological, endocrine nature, as well as the presence of allergies;
• anal itching - often a sign of rectal pathology, helminthic invasion;
• genital, inguinal itching - indicates gynecological, andrological, urological, parasitic and dermatological problems.

As a rule, itching in the intimate area of a child, itching of the extremities or anus requires different approaches to treatment, therefore, the doctor always focuses on the issue of localization of the lesion.

Localization of itching

Itching in a child all over the body with skin rashes requires additional diagnosis, since there is no single reason for this phenomenon. The cause can be both an allergic process and infectious (bacterial, fungal or viral) diseases, systemic pathologies (for example, intoxication or liver disease). Allergies in childhood are especially common, due to imperfect immune protection and many provoking factors (both external and internal). Therefore, when an itchy rash appears all over the body, the doctor, first of all, must exclude an allergic reaction.

Itching in the intimate area of a child can disturb both boys and girls. Additionally, there are signs of anxiety, irritability, as well as local symptoms such as burning, discharge, and an unpleasant odor. The reasons may be a violation of hygiene rules (insufficient hygiene of the genital organs, or excessive hygienic activity), anal fissures, allergic processes, pubic lice, candidiasis, etc. Periodic itching in the groin in children can indicate skin hypersensitivity to certain materials and substances - for example if discomfort occurs when putting on synthetic underwear, or when using certain detergents.

Itching of the vagina in children can indicate various pathologies, for example:

• candidiasis, fungal infection;
• inflammatory processes in the vagina;
• helminthic invasions;
• tumor processes;
• endocrine pathologies (for example, diabetes mellitus).

Sometimes itching of the genitals in a child is caused by banal factors: lack or insufficiency of personal hygiene, wearing synthetic or tight underwear, which becomes a favorable environment for the spread of pathogenic microorganisms. Many underestimate these factors, but they can provoke not only the appearance of itching, but also an unpleasant odor, and even inflammatory processes.

If a child has discharge and itching, this is a reason to see a doctor, and this should be done as soon as possible. With secretions of a curdled nature, it is possible to suspect a fungal infection, and tumor processes are often hidden behind bloody secretions. And the appearance of such symptoms during active puberty indicates strong hormonal changes in the body. A doctor's consultation is necessary in any of the above situations.

Itching in a child on the hands, palms is a common symptom that accompanies liver disease. When bile circulation is disturbed, the content of bile acids in the bloodstream increases. These acids exhibit a toxic effect on the receptor network of the skin. As a result, the baby experiences itchy sensations. Another common root cause is diabetes mellitus: this disease is characterized not only by the failure of the insulin apparatus, but also by metabolic disorders, blood circulation and trophic processes in tissues.

Itching between the fingers of the child's hands, as well as in other skin folds (in the armpits, in the groin) often becomes a sign of scabies - a parasitic pathology that develops when a scabies mite is damaged. Why does the skin itch during scabies? The fact is that the female parasite, before laying eggs, makes whole labyrinths of passages in the skin layers. The skin, of course, is damaged, the mites crawl in their own passages, which gives such an unpleasant sensation.

Itching on the legs of a child provokes not only a fungal infection, but also a violation of blood circulation in the limbs. Fungal infection is manifested by severe discomfort between the fingers, as well as in the foot area. The nail plates are modified and exfoliate, sometimes an unpleasant odor appears. Violation of blood circulation is observed as a result of other diseases - for example, impaired liver or kidney function, diabetes mellitus, vascular pathologies, infectious and endocrine disorders.

Only a doctor will be able to answer the question of whether the itching of the feet, heels in a child is associated with an infection, or the root cause should be sought among systemic diseases. You should not ignore a visit to the doctor, since the cause of discomfort is not always harmless.

Itching of the abdomen in a child most often appears due to an allergic reaction. Such a reaction can develop on anything - even formula milk or any complementary food product. In young children, signs of allergy are primarily found on the abdomen and in the face (on the cheeks, on the forehead). When making a diagnosis, young children should also consider such a problem as prickly heat, which is characterized by the appearance of a small rash on the abdomen, back, and gluteal area. With prickly heat, itching is not very pronounced, but in some children it is one of the basic symptoms (especially with prolonged wearing of a wet diaper).

Itching in the anus in a child is an unfavorable sign that can be provoked by several reasons. In this situation, it is necessary to contact either a pediatrician, or a parasitologist or a pediatric proctologist. It should be noted that itching from worms in a child is the most common case, the provocateurs of which are pinworms - intestinal parasites, a feature of which is the night laying of eggs in the anus. It is with this that the appearance of uncomfortable sensations is connected, for getting rid of which it is necessary to undergo anthelmintic treatment and strictly adhere to hygiene rules. Parasitic infestation is often accompanied by other symptoms, such as dizziness, lack of appetite, headaches, and digestive disorders. In addition, signs of anemia are often found - pallor of the skin, the appearance of circles under the eyes, sleep disturbances.

Itching of the back in children is an equally common phenomenon associated with such pathological conditions:

• allergic reaction, atopic dermatitis;
• neuro-allergic processes;
• scabies, in which the discomfort increases in the evening and at night;
• dermatitis, folliculitis, impetigo;
• xeroderma (hereditary pathology);
• seborrhea (impaired production of sebaceous secretion);
• lichen planus;
• psoriasis.

If the interscapular region is especially itchy, then it is possible to suspect thyroid dysfunction, diabetes, and liver pathologies. Itching on the neck of a child occurs after insect bites, after exposure to ultraviolet radiation, or occurs as a result of prolonged friction of the skin on the collar of clothing, which especially often occurs with owners of sensitive skin.

Itching of the head, face in a child is a characteristic symptom of pediculosis (lice infestation). If you carefully examine the scalp, you can see bite marks, scratch marks, and even parasitic eggs called nits. In this situation, the discomfort in the baby occurs due to the fact that the lice bite the skin, releasing their own secret into the wound, which causes quite strong itchy sensations.

Itching on the cheeks of a child is most often the result of a food or contact allergy, but sometimes it also indicates a cold or solar reaction that develops when the skin is sensitive to temperature changes or to ultraviolet rays. In young children, the problem can be associated with dysbacteriosis, since problems with the digestive system in babies often affect the condition of the skin of the face, thighs and buttocks. Sometimes, to completely eliminate discomfort, it is enough to streamline nutrition, restore the balance of intestinal microflora.

Itchy eyes in a child becomes the first sign of incipient conjunctivitis, or a fungal infection of the conjunctiva. In many children, this is how an allergic reaction begins to manifest itself - for example, if the allergen is pollen, animal dander or house dust. Usually, itchy sensations are followed by redness of the eyes, swelling and even pain, cramps and burning.

With excessive accumulation of sulfur secretion in the auditory canal, itching occurs in the ears of a child. Such itching is persistent and may be accompanied by a slight decrease in auditory function. Other likely causes are sometimes:

• allergic processes;
• otomycosis, fungal lesions of the skin;
• diabetes;
• the presence of a foreign body, an insect in the ear canal;
• erysipelas of the auditory canal.

Itching and burning sensations can manifest themselves in any area of the body, and they arise for a variety of reasons. As it becomes clear, itching is not always accompanied by a rash, just as a rash can appear in a child without fever and itching. In any case, if there is an itchy moment, as well as peeling, inflammation of the skin, discharge or pain is present, you should immediately show the baby to a medical specialist. You may need complex drug therapy.

Complications and consequences

Constant intense itching in a child can lead not only to his anxiety and irritability. Most children scratch the affected areas, resulting in scratching and bloody wound surfaces. In turn, opportunistic and pathogenic microorganisms can penetrate into the wounds, which is fraught with tissue infection, the development of a purulent infection. As a result, complications such as pyoderma (purulent inflammation of the skin), fungal diseases, abscesses, phlegmon, etc. Can occur.

In most cases, the affected area turns red, swells, the inflammatory process spreads to healthy areas, and purulent discharge appears.

In order to prevent unpleasant consequences, treatment should be started in a timely manner, under the supervision of a medical specialist.

Diagnostics of the itchy skin in a child

Diagnostic measures for detecting itching in a child come down to finding out the root causes of the problem.

If there are other skin manifestations against the background of itching, then you need to contact a dermatologist, with a mandatory consultation of a therapist. This approach will allow you to assess the health of the skin and exclude the presence of common pathologies. If necessary, these specialists will assist in consultations with a hematologist, allergist, etc.

In general, diagnosis usually includes the following steps:

• external examination of the skin, lymph nodes;
• blood tests (general, biochemical, determination of glucose in the blood), general urinalysis;
• if pathological foci and elements are found on the skin, then instrumental diagnostics is carried out in the form of dermatoscopy, scrapings, biopsies;
• ultrasound examination of organs located in the abdominal cavity.

If the itching in a child is disturbing in the area of the anus, then, in addition to a visual examination, it will be necessary to test the feces for eggs of parasites and protozoa. In addition, a coprogram is prescribed for a small patient, and if necessary, sigmoidoscopy, colonoscopy.

If itching is found in intimate places, the doctor will visually examine the genitals, take a smear for microflora with culture and sensitivity to antibiotics, a smear for the presence of atypical cells. Also, general clinical blood and urine tests, coprogram and feces for parasite eggs become mandatory.

Differential diagnosis

Differential diagnosis of itching in a child is usually carried out with diseases such as atopic dermatitis, scabies, seborrheic dermatitis, allergic contact dermatitis, ichthyosis, psoriasis, some immunodeficiency states (hyperimmunoglobulinemia E syndrome, Wiskott-Aldrich syndrome).

It should be taken into account that itching in a child can occur as a result of stressful situations: in most cases this reason is simply underestimated and not taken into account. First of all, the search for causes is based on diseases such as scabies, allergies, dermatitis, and fungal infections. Stress pruritus usually resolves after taking sedatives, but you should not try to diagnose the infant yourself by offering him certain medications. Such an approach will not only harm children's health, but also make it difficult for a doctor to make a subsequent diagnosis.

Treatment of the itchy skin in a child

The classic treatment for itching in children  is to eliminate the causes of discomfort. For example, in case of allergies, a potential allergen should be found and neutralized, and in case of stress, its source should be eliminated.

With a slight scratching, sedatives, which the pediatrician prescribes individually, help well. In addition, in almost all cases, antihistamines are used, for which the removal of itching is one of the therapeutic areas.

You don't have to try to fix the problem yourself. It is not uncommon for parents to immediately run to the pharmacy for antihistamines, not attaching importance to the fact that the allergic process is far from always the cause. In many patients, the culprit is an infection, systemic disease (such as liver disease), or parasitic infections. Therefore, it is better not to waste time and seek help from doctors. The doctor will prescribe the appropriate treatment once the underlying cause has been identified.

It must be understood that it is not always possible for a doctor to determine the provoking factor immediately, during the initial consultation. You will probably have to go through a series of diagnostic measures with the baby - take blood and urine tests, a fecal test for eggs of intestinal parasites, perianal scraping, etc. If an allergic process is suspected, the doctor will send the baby for provocative tests, or for a blood test for the presence of allergens. If an infectious pathology is suspected, it is possible to carry out crops from the skin.

Prevention

Itching in a child is a consequence of any pathology, and not an independent disease. Therefore, the main point of prevention is the prevention of the causes of itching. Here is what is meant by this:

• timely appeal to the doctor about the treatment of digestive disorders, endocrine disorders;
• timely detection and treatment of skin infections;
• prevention of parasitic lesions, compliance with hygiene rules, regular washing of hands, as well as vegetables, fruits and herbs, use only heat-treated products of animal origin;
• regular preventive visits to the doctor;
• in the presence of allergies, the suppression of contact with allergens, adherence to dietary nutrition, the organization of a hypoallergenic stay of the child in everyday life;
• prevention of stressful situations, providing the child with a sound and healthy sleep, if necessary - consulting a psychologist;
• switching to a healthy diet, drinking enough fluids;
• prevention of dehydration, the use of skin moisturizers (for example, special baby creams);
• if necessary, taking vitamin and mineral complexes that improve metabolic processes in the child's body).

Forecast

Only in half of the cases, the cause of the appearance of itchy sensations in children is determined immediately. Unfortunately, quite often the cause cannot be detected and eliminated at all, so the symptom acquires a wave-like recurrent form. At the same time, in 60% of cases, itching in a child is completely stopped over the years, while in other children it may persist and periodically recur (such a course is typical for allergic processes).