Skin itching with psoriasis: remedies and treatment

Psoriasis is a fairly common disease in which reddish scaly patches and plaques appear on the surface of the skin. In addition, one of the permanent symptoms is pruritus in psoriasis - it can have a different intensity, from minor discomfort to unbearable burning, and is often very disturbing for patients. Why does it itch? How to get rid of this symptom?

[1], [2], [3], [4]

Causes of the itching with psoriasis

Itching of the skin is always a consequence of any malfunctions inside the body - for example, intoxication. Thus the patient can feel, both easy unpleasant sensation, and a strong burning sensation.

The reasons for this condition can be:

• infection of the external inflammatory process;
• improper use of cosmetics, or use of unsuitable cosmetics;
• taking certain medications (often in the form of self-medication);
• adherence of endocrine diseases;
• nervous disorders;
• disturbances in metabolic processes;
• liver disease;
• allergic reactions.

It is unlikely that the patient will be able to establish the cause of itching in psoriasis. To do this, you need to see a doctor and go through a series of special studies.

[5], [6], [7]

Risk factors

Itching may appear or increase under the influence of several factors:

• at progression of pathological process (for example, at relapse);
• when using non-conforming medicines;
• with general chronic or acute poisoning;
• when exposed to a psychogenic factor;
• when attaching scabies or allergies;
• in the HIV-associated process;
• after eating some products;
• after contact with chemicals;
• under harmful production conditions;
• with a sharp change in climate;
• diseases of the digestive system;
• after consuming coffee, chocolate, alcohol, spicy food.

[8], [9], [10], [11], [12]

Pathogenesis

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

In patients with an easily excitable nervous system, pruritus may appear on the skin in the region of an earlier inflammatory process. Unpleasant sensations can be amplified if, in addition, the patient suffers from an endocrine or cardiovascular system.

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

[13], [14], [15], [16], [17], [18]

Epidemiology

According to statistics, about 4% of the world's population is affected by psoriasis. In this case, itching occurs in 80% of patients with psoriasis of the skin. This itch can have a different intensity.

Approximately in 20% of patients there is no sensation of itching at all, which at first can make it difficult to diagnose the disease.

[19], [20]

Symptoms

Itching is usually attributed to the classic symptoms of psoriasis, despite the fact that it is not present in all patients.

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

As additional symptoms, you can name:

• cracks and small bleeding in places of plaque damage;
• deterioration of the nail plates, appearance of dimples on them, color spots, stratification;
• spots and itching in the skin folds (for example, under the buttocks or under the mammary glands).

The first signs in the form of itching and burning can appear even before the detection of red peeling spots: so the body warns about the onset of the development of the inflammatory process in the skin layers.

[21], [22], [23]

Stages

Psoriasis is usually divided into several stages:

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

[24], [25], [26]

Forms

Itching in psoriasis can be common (throughout the body) or limited (only on one or two sections of the trunk).

A common itching often occurs in the so-called senile psoriasis, when the disease progresses and spreads massively through the body.

If the itching is present only on a separate area of the skin - for example, in the genital area or on the head, then talk about a limited version of the itch.

[27], [28]

Diagnostics of the itching with psoriasis

As a rule, the diagnosis of pruritus with psoriasis does not present difficulties for the dermatologist, since this disease is easily recognized by the characteristic clinical picture.

As a supplement, to clarify the diagnosis, tests can be assigned:

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

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

• cutaneous biopsy;
• radiography of joints;
• scraping of the skin with sowing on the microflora.

[29], [30]

Differential diagnosis

Differential diagnosis of pruritus in psoriasis is carried out:

• with helminthiases;
• with red planus weed;
• with syphilis;
• with parapsoriasis;
• with dermatitis and dermatophytosis.

[31], [32], [33], [34], [35], [36]

Treatment of the itching with psoriasis

The use of medications is considered the most effective treatment for psoriasis to eliminate itching. Choosing a treatment regimen and specific drugs, the doctor must take into account the age of the patient, the state of his health in general, the presence of contraindications to the reception of certain funds.

Assign in the form of intramuscular injection of 0.5% aminazine in an amount of 1 ml every evening, prednisolone 20 mg every day with a slow decrease in dosage.

External applied 10% diluted Validol, which is well soothes the skin.

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

One can not ignore the elementary care for the affected skin. Every day you need to apply moisturizers to itchy areas, especially after taking a bath or shower. This simple method smoothes out disorders of the water-fat layer of the skin, preventing its dehydration, thereby softening the manifestations of itching.

Tablets from itching in psoriasis are applied when feelings become really unbearable. Such remedies will help to eliminate the feeling of discomfort:

• Psorilom is a homeopathic remedy with minimal side effects. Psoril take 1 tablet three times a day sublingually, 30 minutes before meals. Contraindications to taking the drug are: children under 18 years of age, an increased likelihood of allergy, lactose intolerance.
• Suprastin is an antiallergic agent based on chloropyramine. Take it to eliminate itching in psoriasis, 1 tablet three times a day, with food. Be careful: Suprastin causes drowsiness, dizziness.
• Tavegil is an antiallergic agent with an active ingredient called clemastine. The drug takes 1 tablet every morning and evening, before meals, with a maximum daily dosage of 5-6 tablets. Reception Tavegila can be accompanied by drowsiness, fatigue, inhibition.
• Cetrin is an antiallergic and antipruritic agent based on cetirizine. The drug effectively removes itching in psoriasis, if taken 10 mg daily, once a day, washed down with water. Cetrin in some cases can cause headache and dry mouth: these phenomena occur after stopping the drug.

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

• Salicylic ointment is an inexpensive softening and protective skin for the skin, which has a distracting and antiseptic effect. As a rule, 2% ointment is used to relieve itching in psoriasis, 2-3 times a day. In rare cases, after application of the drug, itching may be intensified: in such cases, the ointment is canceled and replaced with another external agent.
• Zinc ointment is an external anti-inflammatory and adsorbing drug. It is applied 2-3 times a day daily, but not for a long time. Prolonged use of zinc ointment can cause dryness of the skin in places of application, which, in turn, can provoke an increase of itching in psoriasis.
• Calcipotriol is a drug based on a synthetic analogue of vitamin D. Ointment belongs to the class of the most safe external products for the removal of itching in psoriasis. Calcipotriol is applied a small 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 serves as an antiseptic and dermatotropic agent. Berestin is applied to the problem skin once a day for 20 minutes, after which it is washed off with warm water, and the skin is lubricated with a nutritious or softening cream. The course of treatment of pruritus with psoriasis by Berestin can last up to 1 month. Itching usually disappears completely after 2-3 treatments.
• Naphthalan Ointment is an ointment combination of purified naphthalan oil, paraffin and petrolatum (a product of oil oil dewaxing). Ointment softens itching in psoriasis, dissolves plaques. It is recommended to combine the drug with other external agents based on sulfur or birch tar.

Vitamins

Favorable effect on the body is provided by vitamins - they should be included in complex treatment, along with medicines and medical procedures.

The most attention should be given to such vitamins:

• Vitamin A - is involved in the processes of keratinization of the skin, in the restoration of tissues.
• Vitamin E - is an active antioxidant, regulates metabolism, takes part in the synthesis of cellular DNA.
• Vitamin D - is involved in the exchange of calcium and phosphorus, helps to repair the damaged epidermis.
• Vitamins of group B - improve the cellular metabolism, stabilize oxygen exchange in the skin, normalize the work of the nervous system.

Multivitamin preparations are prescribed taking into account individual characteristics. Well-suited as a supporting complexes such tools as Hexavit, Vitrum, Undevit.

It helps to eliminate the itching also calcium and sodium salts, which are used in the form of sodium thiosulfate and calcium chloride.

Physiotherapeutic treatment

Physiotherapeutic treatment of pruritus with psoriasis usually includes:

• ultraviolet irradiation (UVB and UVA);
• ultrasound;
• method of teleradenthenotherapy;
• application of beech rays;
• cryotherapy.

Additionally, auxiliary methods can be prescribed: electrosleep, segmental ultrasound, magnetotherapy.

Alternative treatment

With unbearable itching psoriatic plaques can be lubricated with their usual tincture of valerian root, which is bought in a pharmacy, or with an oil solution of menthol.

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

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

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

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

It is possible to use an ointment based on tar. For its preparation, take 5 g of birch tar, 20 g of lanolin, 70 g of cosmetic Vaseline and 5 g of zinc oxide.

Against the itch help warm tubs on the basis of needles: effective extract from juniper, young shoots of spruce and pine.

After taking a bath, the affected area should be lubricated with any moisturizer (preferably - a normal baby cream).

[37], [38]

Herbal Treatment

To alleviate the unpleasant itching of psoriasis, medicinal herbs with antipruritic effect are used. It is possible to use elecampane, dill, nettle, nettle leaves.

For the preparation of dill infusion take 2 tsp. Dill seed, pour 250 ml of boiling water, insist and filter. The medicine is taken 100 ml three times a day.

If there is no time to cook the infusion, you can grind the dill seed in a coffee grinder and eat the resulting powder on the tip of a teaspoon three times a day, washing down with warm water.

Such antipruritic action is infused with leaves of nettle, melissa, mint: they are brewed for 2 tbsp. L. For 250 ml of boiling water and drink three meals a day.

Against the itch, the burdock root, which should be boiled for 10 minutes (1 tablespoon per 500 ml of water), also helps. The broth is drunk for 100-150 ml to 4 times a day.

Homeopathy

Homeopathic treatment of pruritus consists of the use of the main remedy for psoriasis - psorinochel, which takes 10 drops every morning and after dinner. Treatment with psorinogel supplemented with the use of the drug hepel (1 tablet in the morning and in the afternoon), sulfur-heel (1-2 tablets in the morning and in the evening), shvef-heel (10 drops in the morning and in the evening).

Outer ointment traumel or psoriaten - a small layer, three times a day, slightly rubbing into the affected skin.

Conducted clinical trials confirmed that the proposed treatment can significantly reduce the buildup of flakes, eliminate flaking and itching, remove inflammation during the exacerbation of psoriasis.

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

Complications and consequences

Medical specialists determine the intensity of itching in psoriasis on a special 10-point scale. The strongest itch with psoriasis is estimated at 10 points (very strong, unbearable sensations) - while the affected areas of the skin can bleed.

Severe itching is usually accompanied by an irresistible desire to comb the problem area. Doing this is highly discouraged, as this can lead to the development of hypertrophy of nerve endings. Due to strong or permanent scratching, the skin becomes more sensitive, which leads to an even greater itching.

The brain in response to increased unpleasant sensations becomes more susceptible to external stimuli. The patient begins to form a syndrome of Kebern - a kind of phenomenon that is characterized by a false appearance of itching in places not affected by psoriasis: as a result of constant scratching of such places and they begin to form psoriatic plaques.

[39]

Prevention

Prophylaxis of pruritus with psoriasis can quickly heal skin damage and prevent further spread of the disease.

• It is necessary to ensure proper rest and sleep, which contribute to improving metabolic processes and stabilizing the hormonal balance.
• It is important to adhere to the rules of personal hygiene, using special means for irritated skin.
• Lingerie, clothes and shoes need to be selected according to the season. Preference should be given to products made from natural and "breathable" materials.
• After any contact with the skin with water, use a soft towel. In addition, it is recommended to apply moisturizing creams or vegetable oils to the itchy areas.
• Nervous stress and experience intensify the itching in psoriasis, therefore it is recommended to adjust the work of the nervous system. This can contribute to yoga, gymnastics, counseling therapist.

[40],

Forecast

The prognosis of curability can be considered favorable at an early stage of the disease. The main goal is to prevent relapses, which are usually accompanied by itching. For this, it is required to prevent or stop the inflammatory process, to detect and treat associated infectious diseases and helminthic invasions (which greatly affect immunity), to ensure tranquility of the nervous system, to lower the level of immune T cells in the bloodstream and tissue structures.

If everything is done correctly, then there is a long period of remission - the attenuation of the disease, during which the itching does not disturb psoriasis.