Skin itching in psoriasis: remedies and treatment

Psoriasis is a fairly common disease in which reddish flaky spots and plaques appear on the skin surface. In addition, one of the constant symptoms is itching in psoriasis - it can have varying intensity, from minor discomfort to unbearable burning, and often greatly disturbs patients. Why does itching appear? How to get rid of this symptom?

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Causes psoriasis itching

Itching of the skin is always a consequence of some problems inside the body - for example, intoxication. In this case, the patient may feel both a slight unpleasant sensation and a strong burning sensation.

The reasons for this condition may be:

• infection of the external inflammatory process;
• incorrect use of cosmetics or use of unsuitable cosmetics;
• taking certain medications (usually as self-medication);
• addition of endocrine diseases;
• nervous disorders;
• metabolic disorders;
• liver disease;
• allergic reactions.

It is unlikely that a patient will be able to independently determine the cause of itching in psoriasis. To do this, you need to see a doctor and undergo a series of special tests.

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Risk factors

Itching may appear or intensify under the influence of certain factors:

• when the pathological process progresses (for example, during a relapse);
• when using inappropriate medications;
• in case of general chronic or acute poisoning;
• when exposed to a psychogenic factor;
• when scabies or allergies occur;
• in HIV-associated process;
• after eating certain foods;
• after contact with chemicals;
• under harmful production conditions;
• in case of a sharp change in climate;
• for diseases of the digestive system;
• after drinking coffee, chocolate, alcohol, spicy food.

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Pathogenesis

The sensation of itching is a neuro-reflexive process. In the pathogenesis, disorders of the cerebral cortex function and neurophysiological factors play a special role.

In patients with an easily excitable nervous system, itching may appear on the skin in the area of a previously existing inflammatory process. Unpleasant sensations may intensify if, in addition, the patient suffers from an endocrine or cardiovascular disorder.

Itching in psoriasis can be primary (due to metabolic disorders, visceropathies, etc.) and secondary (due to changes in the structure of the skin in the affected areas).

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Epidemiology

According to statistics, psoriasis affects approximately 4% of the world's population. At the same time, itching occurs in 80% of patients with skin psoriasis. Such itching can have varying intensity.

Approximately 20% of patients do not experience itching at all, which can make it difficult to diagnose the disease at first.

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Symptoms

Itching is usually considered a classic symptom of psoriasis, although not all patients experience it.

Itching usually occurs with the onset of the exacerbation stage of the disease, when an acute inflammatory process begins with the appearance of convex elements on the skin - reddish plaques with a dense flaky surface. Most often, such plaques cover the bends of the elbows, knees, phalanges of the fingers.

Additional symptoms may include:

• cracks and small bleedings in areas of damaged plaques;
• deterioration of the condition of the nail plates, the appearance of pits, colored spots, and delamination;
• spots and itching in skin folds (for example, under the buttocks or under the breasts).

The first signs in the form of itching and burning may appear even before the red flaky spots are discovered: this is how the body warns about the beginning of the development of an inflammatory process in the skin layers.

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Stages

Psoriasis is usually divided into several stages:

• progress stage – characterized by the appearance of small rashes in the form of papules, which are most often accompanied by severe itching;
• stationary stage - it is characterized by a decrease in the intensity of itching, which is replaced by a slight burning sensation;
• regression stage – characterized by a weakening of the main symptoms of psoriasis and a significant reduction in itching.

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Forms

Itching in psoriasis can be widespread (all over the body) or localized (only in one or two areas of the body).

Widespread itching is often found in so-called senile psoriasis, when the disease progresses and spreads widely throughout the body.

If itching is present only on a specific area of skin – for example, in the genital area or on the head – then it is called a limited form of itching.

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Diagnostics psoriasis itching

As a rule, diagnosing itching in psoriasis does not present any difficulties for a dermatologist, since this disease is easily recognized by its characteristic clinical picture.

As an addition, to clarify the diagnosis, the following tests may be prescribed:

• general blood analysis and blood biochemistry, changes in which are observed only in advanced stages of psoriasis;
• a general urine analysis, which can indicate changes in the water-salt balance in the body;
• stool analysis for the presence of helminthiasis (helminths are often the cause of itchy skin).

Instrumental diagnostics can help to clarify some points in the diagnosis. For this purpose, the following studies are carried out:

• skin biopsy;
• X-ray of joints;
• skin scraping with microflora culture.

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Differential diagnosis

Differential diagnosis of itching in psoriasis is carried out:

• with helminthiasis;
• with lichen planus;
• with syphilis;
• with parapsoriasis;
• with dermatitis and dermatophytosis.

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Treatment psoriasis itching

The use of medications is considered the most effective treatment for psoriasis to eliminate itching. When choosing a treatment regimen and specific drugs, the doctor must take into account the patient's age, his general health condition, and the presence of contraindications to taking certain drugs.

Prescribed in the form of intramuscular injections of 0.5% aminazine in the amount of 1 ml every evening, prednisolone 20 mg every day with a slow reduction in dosage.

Externally, apply 10% diluted validol, which soothes the skin well.

How to relieve itching in psoriasis? Traditionally, 1-2% salicylic ointment is used in combination with local glucocorticosteroid drugs. However, it should not be forgotten that the use of strong hormonal drugs is a significant risk of developing side effects and complications. In particular, withdrawal syndrome may develop, which manifests itself as a new exacerbation of the disease.

Basic care of the affected skin should not be ignored. It is necessary to apply moisturizers to itchy areas every day, especially after taking a bath or shower. This simple technique smooths out the disorders of the water-fat layer of the skin, preventing its dehydration, thereby softening the manifestations of itching.

Psoriasis itching tablets are used when the sensations become truly unbearable. The following medications will help eliminate the feeling of discomfort:

• Psorilom is a homeopathic medicine with minimal side effects. Psorilom is taken 1 tablet three times a day sublingually, 30 minutes before meals. Contraindications to taking the medicine are: children under 18, increased risk of allergies, lactose intolerance.
• Suprastin is an antiallergic drug based on chloropyramine. It is taken to relieve itching in psoriasis, 1 tablet three times a day, with food. You should be careful: Suprastin causes drowsiness, dizziness.
• Tavegil is an antiallergic drug with the active ingredient clemastine. The drug is taken 1 tablet in the morning and evening, before meals, with a maximum daily dosage of 5-6 tablets. Taking Tavegil may be accompanied by drowsiness, fatigue, and lethargy.
• Cetrin is an antiallergic and antipruritic agent based on cetirizine. The drug effectively relieves itching in psoriasis if taken 10 mg daily, once a day, with water. Cetrin in some cases can cause headaches and dry mouth: such phenomena disappear after stopping taking the drug.

Ointments for itching in psoriasis are well absorbed, eliminate dry skin and reduce the intensity of the inflammatory reaction at the local level. Such ointments include the following drugs:

• Salicylic ointment is an inexpensive softening and protective preparation for the skin, which has a distracting and antiseptic effect. As a rule, to relieve itching in psoriasis, 2% ointment is used, 2-3 times a day. In rare cases, after applying the drug, itching may intensify: in such cases, the ointment is discontinued and replaced with another external agent.
• Zinc ointment is an external anti-inflammatory and adsorbent drug. It is applied 2-3 times a day, daily, but not for a long time. Long-term use of zinc ointment can cause dry skin in the areas of application, which, in turn, can provoke increased itching in psoriasis.
• Calcipotriol is a drug based on a synthetic analogue of vitamin D. The ointment belongs to the class of the safest external products for relieving itching in psoriasis. Calcipotriol is applied in a thin layer twice a day, for no more than one and a half to two months in a row.
• Berestin is a liquid oily ointment based on birch tar, which acts as an antiseptic and dermatotropic agent. Berestin is applied to problem skin once a day for 20 minutes, then washed off with warm water, and the skin is lubricated with a nourishing or softening cream. The course of treatment for itching in psoriasis with Berestin can last up to 1 month. Itching usually disappears completely after 2-3 applications of the drug.
• Naftalan ointment is an ointment combination of purified naftalan oil, paraffin and petrolatum (a product of dewaxing of petroleum oils). The ointment alleviates itching in psoriasis and dissolves plaques. It is recommended to combine the preparation with other external agents based on sulfur or birch tar.

Vitamins

Vitamins also have a beneficial effect on the body; they should be included in complex treatment, along with medications and medical procedures.

The greatest attention should be paid to the following vitamins:

• Vitamin A – participates in the processes of skin keratinization and tissue restoration.
• Vitamin E is an active antioxidant, regulates metabolism, and takes part in the synthesis of cellular DNA.
• Vitamin D – participates in the metabolism of calcium and phosphorus, helps restore damaged epidermis.
• B vitamins – improve cellular metabolism, stabilize oxygen exchange in the skin, and normalize the functioning of the nervous system.

Multivitamin preparations are prescribed taking into account individual characteristics. Such products as Hexavit, Vitrum, Undevit are well suited as supporting complexes.

Calcium and sodium salts, which are used in the form of sodium thiosulfate and calcium chloride, also help to relieve itching.

Physiotherapy treatment

Physical therapy treatment for itching in psoriasis typically includes:

• ultraviolet radiation (UVB and UVA);
• ultrasound;
• teleroentgenotherapy method;
• application of Buka rays;
• cryotherapy.

Additionally, auxiliary methods may be prescribed: electrosleep, segmental ultrasound, magnetic therapy.

Folk remedies

If the itching of psoriatic plaques is unbearable, you can lubricate them with a regular tincture of valerian root, which can be purchased at a pharmacy, or with an oil solution of menthol.

Itchy skin is well lubricated with almond oil or lemon balm tincture in alcohol (in a 1:5 ratio, kept for 15 days) in the morning and evening.

If the itching is localized in the genital area, then apply a mixture of oak bark infusion and glycerin:

• boil 200 g of bark in a glass of water for 20 minutes;
• The decoction is filtered and mixed with 100 ml of glycerin.

The mixture is applied to the affected areas 1-2 times a day.

It is possible to use a tar-based ointment. To prepare it, take 5 g of birch tar, 20 g of lanolin, 70 g of cosmetic petroleum jelly and 5 g of zinc oxide.

Warm baths with pine needles help against itching: juniper extract, young shoots of spruce and pine are effective.

After taking a bath, the affected areas should be lubricated with any moisturizing cream (preferably regular baby cream).

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Herbal treatment

To relieve the unpleasant itching associated with psoriasis, medicinal herbs with an antipruritic effect are used. It is possible to use elecampane, dill, deadnettle, and nettle leaves.

To prepare dill infusion, take 2 teaspoons of dill seed, pour 250 ml of boiling water, infuse and filter. The medicine is taken 100 ml three times a day.

If you don’t have time to prepare an infusion, you can grind dill seeds in a coffee grinder and eat the resulting powder on the tip of a teaspoon three times a day, washing it down with warm water.

Infusions of nettle, lemon balm, and mint leaves have a similar antipruritic effect: brew 2 tbsp. of them in 250 ml of boiling water and drink three times a day.

Burdock root, which should be boiled for 10 minutes (1 tbsp. per 500 ml of water), also helps well against itching. Drink 100-150 ml of the decoction up to 4 times a day.

Homeopathy

Homeopathic treatment of itching consists of the use of the main remedy for psoriasis - psorinoheel, which is taken 10 drops in the morning and after lunch. Treatment with psorinoheel is supplemented by taking the drug hepel (1 tablet in the morning and afternoon), sulfur-heel (1-2 tablets in the morning and evening), shvef-heel (10 drops in the morning and evening).

Externally, apply Traumeel or Psoriaten ointment in a thin layer, three times a day, lightly rubbing into the affected skin.

Conducted clinical trials have confirmed that the proposed treatment can significantly reduce the growth of scales, eliminate flaking and itching, and relieve inflammation during periods of exacerbation of psoriasis.

Homeopathic preparations are not toxic: in addition to their own effect, they can enhance the therapeutic effect of most non-hormonal psoriasis remedies. Therefore, the use of homeopathy along with standard psoriasis treatment is only welcomed.

Complications and consequences

Medical specialists determine the intensity of itching in psoriasis using a special 10-point scale. The most severe itching in psoriasis is estimated at 10 points (very strong, unbearable sensations) - in this case, the affected areas of the skin may bleed.

Severe itching is usually accompanied by an irresistible desire to scratch the problem area. It is highly inadvisable to do so, as it can lead to the development of hypertrophy of nerve endings. As a result of severe or constant scratching, the skin becomes more sensitive, which leads to even greater itching.

The brain, in response to increased unpleasant sensations, becomes more susceptible to external stimuli. The patient begins to develop Keburn syndrome - a peculiar phenomenon characterized by the false appearance of itching in places not affected by psoriasis: as a result of constant scratching of such places, psoriatic plaques begin to form on them.

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Prevention

Preventing itching in psoriasis allows skin lesions to heal faster and prevent further spread of the disease.

• It is necessary to ensure adequate rest and sleep, which contribute to the improvement of metabolic processes and the stabilization of hormonal balance.
• It is important to adhere to the rules of personal hygiene, using special products for irritated skin.
• Underwear, clothes and shoes should be selected according to the season. Preference should be given to products made from natural and "breathable" materials.
• After any contact of the skin with water, a soft towel should be used. In addition, it is recommended to apply moisturizing creams or vegetable oils to itchy areas.
• Nervous stress and anxiety increase itching in psoriasis, so it is recommended to improve the functioning of the nervous system. Yoga, gymnastics, and consultation with a psychotherapist can help with this.

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Forecast

The prognosis for cure can be considered favorable at an early stage of the disease. The main goal is to prevent relapses, which are usually accompanied by itching. This requires preventing or stopping the inflammatory process, detecting and treating concomitant infectious diseases and helminthic invasions (which significantly affect immunity), ensuring calmness of the nervous system, and lowering the level of immune T-cells in the bloodstream and tissue structures.

If everything is done correctly, then a long period of remission occurs - a fading of the disease, during which itching from psoriasis does not bother.