Skin itching in a child

Skin itching in a child can be caused by a variety of reasons. The most common provocateur is atopic dermatitis, somewhat less often - urticaria, Duhring's dermatitis herpetiformis, 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 should not be ignored or waited for the problem to "go away by itself". We recommend that you carefully read the article and draw the right conclusions about what to do when children itch.

Epidemiology

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

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

Causes of the itchy skin

A weak immune system, an abundance of allergens, viruses, fungi, bacteria - all of these 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 the help will be incomplete or even ineffective if you do not eliminate the original cause of the uncomfortable condition, so it is very important to detect it in time, before the disease worsened.

The following diseases and conditions can cause itchy discomfort:

• 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 compulsive desire to scratch, in such a situation, there may be rashes in the form of blisters, swelling of the skin, redness. Atopic dermatitis, according to statistics, is found in one out of ten children, and this is quite a lot. But not in all cases, babies show the whole symptom complex at once: often itching and rashes are the only initial signs of the problem.
• Allergies are most often detected in childhood. Skin itching and rashes can indicate poor tolerance to food, medicines, hypersensitivity to pollen or dust, wool, chemicals and detergents, etc. The rash can be different - localized or focal, or may not be present at all. The rash in this case is different - local or focal, or may not exist at all. The worst case scenario is anaphylactic shock, which can lead to extremely negative consequences, so at the first sign of it, you should immediately call for "emergency help". [1]
• Medication rash is a painful reaction of the human immune system to the intake of certain medications, and often such medications are antibiotics. Itching after antibiotics in a child almost always has an allergic origin and can manifest focally, or throughout the body. With repeated intake of antibiotics, itching may increase, rash appears, swelling, up to anaphylactic reaction. But this is not always the case: in some children, itching is the only manifestation of such an immune reaction. [2]
• Scarlatina 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 in scarlatina in a child is expressed moderately, and only in severe and moderately severe course can bother quite intensely. By the end of the acute period of the disease, the rash dries up, but peeling and itching may still 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: the acute viral infection is transmitted by airborne droplets and is provoked by a specific virus belonging to the family Herpesviridae. Chickenpox most often affects children aged 4-5 years, but older children can also get the disease. [4]
• Insect bites have experienced each of us, so it is considered that itching from mosquitoes in a child - this is, on the one hand, a normal phenomenon. But often enough trivial bites grow into a full-blown allergic reaction, and even into an inflammatory process (for example, if the child scratched the bite site and brought infection). Therefore, insect bites - not only mosquitoes, but also wasps, bees, gnats, bedbugs, ticks - should not be ignored. They need to be treated, and even go to the doctors. By the way, predominantly night itching in children often has to do with the presence of such insects as bed bugs, ticks or lice (fleas).
• Severe itching in a child can be caused by squeezing a certain part of the body with clothes, shoes, restraining and fixing bandages (including plaster). Often bother begins to bother the place overstretched with an elastic band or shoelace. Itching under a plaster cast in a child occurs as a result of impaired local blood circulation in the tissues, or due to increased dryness of the skin caused by constant wearing of the bandage. Less often the cause is contact dermatitis - a peculiar skin reaction to prolonged irritation of the skin components of the cast (for example, calcium sulfate). If the sensations under the cast become unbearable, it is necessary to visit a doctor: it is not uncommon for skin and allergic diseases to develop under the bandage, requiring prompt medical attention and intervention.
• Pinworms often become the cause of itching in the anal area. The activity of these parasites is activated at night, when they go out and are engaged in the deposition of eggs in the specified zone. To clarify the diagnosis, you should take a stool analysis for worm eggs, as well as a scraping, which will help to accurately determine the cause of discomfort. Such diagnosis is necessary, because the symptom of perianal itching can be associated not only with the presence of pinworms, but also with the formation of microcracks of the anus - for example, due to prolonged constipation in the baby. [5]
• Diathesis is not a disease, as many believe, but only a tendency of the child's body to develop allergic and inflammatory processes. If you eliminate the cause of this propensity, then the itching will disappear by itself. Therefore, all efforts should be directed to the search for the allergen - most often it "hides" behind the use of certain foods. [6]
• Urticaria is the appearance of itchy reddish or pinkish rashes, like the blisters that usually accompany nettle burns. The rashes may appear and disappear on their own within one or two hours. Hives can be caused by cold or sun exposure, or by an allergen entering the body directly. [7]
• Measles is a dangerous viral pathology, one of the frequent causes of death among young children. Itching in measles in children is not the main symptom, as it is usually not severe and does not require the use of antipruritic drugs, but in some cases - for example, with fever - discomfort may increase. [8]

Risk factors

The intensity of itching in a child can vary, from a small scratching, to the strongest discomfort, disturbing 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 it is about such pathologies as diabetes, thyroid disorders, electrolyte imbalance, dysfunction of the digestive or nervous system. Hypersensitivity to certain medications, foods, etc. Is also not excluded.

In addition to the underlying cause, it should be noted the presence of provoking factors that directly or indirectly affect itchy manifestations. Such factors include:

• Dry skin (associated with dehydration or cold weather);
• increased water hardness, use of "adult" bathing products, improperly selected clothing and bedding (e.g., synthetics);
• immature nervous system, instability of mental-emotional state (excessive excitability, phobias, neuroses, etc.);
• irrational diet, scanty and monotonous food;
• improper use of medications, self-medication;
• non-observance of hygiene rules, or on the contrary, excessive observance.

The determination of the provoking factor is the responsibility of the attending physician. Self-treatment can only worsen the problem and prevent the rapid relief of the baby's condition.

Pathogenesis

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

Systemic causes of pediatric pruritus include:

• hypersensitivity of the body;
• hormonal changes during puberty;
• reactions to medications (antibiotics, ethanol, etc.);
• certain therapies (physiotherapy);
• Parasitic invasions (onchocerciasis, echinococcosis, trichinellosis);
• infectious pathologies (chicken pox, 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 sun, stress itching.

Allergic itching in children is particularly common. An important role in its pathogenesis is played by mast cells: their number increases, certain inflammatory mediators are released (e.g., histamine, tryptase, proteoglycans, eicosanoids, etc.). Mast cells provoke itching due to mediators and FRN, which promotes hyperplastic changes in nerve fibers. Inactivating agents are agents with antihistamine activity, glucocorticoid hormones, beta-adrenoreceptor antagonists.

Nervous itching in children is associated with overstimulation of the immune system: there is a malfunction in which the immune system attacks its own cells in response to stress. The balance between defense and aggression mechanisms is disturbed. The skin's sensory receptors are activated and send signals to the spinal cord and then to the brain. As a consequence, depending on the degree of activation of the nerve endings, itchy or even painful sensations occur.

Symptoms of the itchy skin

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

If the desire to scratch is the only symptom present, its first signs may be expressed in increased motor activity of the baby, constant restlessness, irritability, tearfulness, capriciousness. The baby can rub clothes, scratch limbs and body, rub against objects, cry without 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 can indicate the development of serious pathologies that require the earliest possible medical intervention.

If itchy small vesicles with cloudy contents are found on the skin, prone to grouping, which occasionally open to form ulcers and crusts, then dermatitis herpetiformis can be suspected. Usually manifests such itching on the elbows of the child, as well as in the face or coccyx area. Dermatitis herpetiformis is of viral origin and is highly contagious.

A reddish rash and itching in a child, arising sharply, most likely have an allergic nature: the rashes look like small spots, bumps or blisters. Such a reaction is a consequence of taking certain medications, vitamins, the use of certain foods, or direct contact with allergens. Unpleasant symptoms appear in any area on the body, and itchy elements in children are very often scratched and take a long time to heal.

It is extremely rare for an allergic process to combine such symptoms as rash, itching and fever in a child. The presence of fever in 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 signs. The course of infectious pathology can be sterile, manifested only by an increase in temperature.

Food allergy on 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, conduct a diagnosis and determine the cause of the problem. It is quite possible that such a cause is chickenpox, rubella - common viral diseases affecting mainly children.

Redness and itching in a child can be a consequence of allergic, inflammatory processes: externally, rashes have the appearance of reddish spots, elevations or blisters, with localization on the face or buttocks, or in other, atypical areas of the body. When scratching such elements are quickly covered with crusts, itching does not disappear, and even intensifies.

If a child has itching and flaking, seborrhea or mycosis may be suspected. A close examination of the skin may be enough to make an accurate diagnosis. With mycosis, there is not only flaking, but also skin detachment, the formation of small blisters and areas of irritation. With seborrhea there is dry skin, itching in the child is intense and accompanied by redness, crusting in the area of the eyebrows, eyelids, navel and so on.

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

Detected in the child pimples and itching - this is a reason to go to a dermatologist or parasitologist: if the help of another narrow specialist is required, the doctor will give a referral for additional medical consultation.

Forms

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

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

Often doctors describe the problem according to its localization:

• skin itching - indicates the presence of psychiatric, dermatologic, endocrine problems, as well as the presence of allergies;
• anal itching - is often a sign of rectal pathology, worm infestation;
• genital, inguinal itching - indicates gynecologic, andrologic, urologic, parasitic and dermatologic problems.

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

Localization of itching

Itching in a child all over the body with rashes on the skin requires additional diagnosis, since there is no single cause of such a phenomenon. The cause may be as an allergic process, and infectious (bacterial, fungal or viral) diseases, systemic pathologies (for example, intoxication or liver disease). Allergies in childhood are particularly common, due to imperfect immune defense and a variety of 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 zone in a child can bother both boys and girls. In addition, there are signs of restlessness, irritability, as well as local symptoms such as burning, discharge, unpleasant odor. Causes may include poor hygiene (insufficient genital hygiene, or excessive hygienic activity), anal fissures, allergic processes, pubic lice, candidiasis, etc. The causes of itching can be a violation of hygiene rules (insufficient genital hygiene, or excessive hygienic activity). Periodic itching in the groin in children can indicate hypersensitivity of the skin to certain materials and substances - for example, if the discomfort occurs when wearing synthetic underwear, or when using certain detergents.

Vaginal itching in children can indicate various pathologies, such as:

• candida, fungal infection;
• inflammatory processes in the vagina;
• worm infestations;
• tumor processes;
• endocrine pathologies (e.g., diabetes mellitus).

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

If the child has discharge and itching - this is a reason to contact a doctor, and it should be done as soon as possible. With discharge of curd character can be suspected fungal lesions, and bloody discharge often hides tumor processes. And the appearance of such symptoms during active puberty indicates a strong hormonal changes in the body. Consultation with a doctor is necessary in any of the above situations.

Itching in a child on the hands, palms - these are frequent symptoms that accompany liver disease. When bile circulation is disturbed, the content of bile acids in the bloodstream increases. These acids exhibit a toxic effect relative to 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 a malfunction of the insulin apparatus, but also by impaired metabolism, blood circulation and trophic processes in the tissues.

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

Itching on the feet of a child provokes not only a fungal infection, but also a violation of blood circulation in the extremities. Fungal lesions are manifested by severe discomfort between the toes, as well as in the foot area. Nail plates are modified and layered, sometimes there is an unpleasant odor. Blood circulation disorders are observed as a consequence of other diseases - for example, liver or kidney dysfunction, diabetes mellitus, vascular pathologies, infectious and endocrine disorders.

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

An itchy tummy in a child is most often caused by an allergic reaction. Such a reaction can develop to anything - even to milk formula or any complementary food. In small children, signs of allergies are first detected on the stomach and in the face (cheeks, forehead). When diagnosing young children should be considered and such a malfunction as sweating, which is characterized by the appearance of a small rash on the abdomen, back, buttock area. In sweating itching is not strongly expressed, but in some children 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, which can be provoked by several reasons. To address in this situation it is necessary either to a pediatrician, or to a parasitologist or a pediatric proctologist. It should be taken into account that itching from worms in a child is the most common case, the provocateurs of which are pinworms - intestinal parasites, the peculiarity of which is the nighttime laying of eggs in the area of the anus. It is with this is associated with the appearance of uncomfortable sensations, to get rid of which it is required to undergo antihelminthic treatment and strictly adhere to hygienic rules. Parasite infestation is often accompanied by other symptoms - for example, dizziness, lack of appetite, headaches, digestive disorders. In addition, there are often signs of anemia - pallor of the skin, the appearance of circles under the eyes, sleep disorders.

Back itching in children is an equally common phenomenon associated with such pathologic conditions:

• allergic reaction, atopic dermatitis;
• neuro-allergic processes;
• Scabies, in which discomfort increases in the evening and at night;
• dermatitis, folliculitis, impetigo;
• xeroderma (hereditary pathology);
• Seborrhea (impaired sebum production);
• red squamous lichen planus;
• psoriasis.

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

Itching of the head and face in a child is a characteristic symptom of pediculosis (lice infestation). If you carefully examine the scalp, you can see bite marks, scratches from combing, and even parasitic eggs called nits. In this situation, the baby's discomfort is due to the fact that the lice bite the skin, releasing their own secretion into the wound, causing a rather strong itching sensation.

Itching on the cheeks of a child is most often a consequence of food or contact allergies, but sometimes indicates a cold or solar reaction, which develops when the skin is sensitive to temperature changes or ultraviolet rays. In young children, the problem can be associated with dysbacteriosis, as malfunctions of the digestive system in babies are often reflected in the skin of the face, thighs and buttocks. Sometimes it is enough to completely eliminate discomfort to organize the diet, restore the balance of intestinal microflora.

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

If there is an excessive accumulation of wax secretion in the ear canal, itching in the ears of a child occurs. This itching is persistent and may be accompanied by a slight decrease in hearing function. Other probable causes are sometimes:

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

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, not always itching is accompanied by the appearance of 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, there is discharge or bothers pain, it is necessary to immediately show the baby to a medical specialist. It is possible that complex drug therapy will be required.

Complications and consequences

Constant intense itching in a child can lead to more than just restlessness and irritability. Most children scratch the affected areas, resulting in the formation of scabs and bloody wound surfaces. In turn, the wounds can penetrate opportunistic and pathogenic microorganisms, which is fraught with tissue infection, the development of purulent infection. As a result, complications such as pyoderma (purulent inflammation of the skin), fungal diseases, abscesses, phlegmons, etc. Can occur.

In most cases, the affected area becomes red, swollen, the inflammatory process spreads to healthy areas, purulent discharge appears.

To avoid unpleasant consequences, treatment should be started in a timely manner, under the supervision of a medical specialist.

Diagnostics of the itchy skin

Diagnostic measures in the detection of itching in a child are reduced to finding out the root cause of the problem.

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

In general, diagnosis usually involves the following steps:

• external examination of the skin, lymph nodes;
• blood tests (general, biochemical, determination of blood glucose), general urine analysis;
• If pathologic foci and elements are found on the skin, then instrumental diagnosis in the form of dermatoscopy, scrapings, biopsies are performed;
• ultrasound examination of organs located in the abdominal cavity.

If the itching in the child bothers in the area of the anus, then, in addition to visual inspection, it will be necessary to take a stool test for parasite eggs and protozoan microorganisms. In addition, a small patient is prescribed a coprogram, and if necessary - rectomanoscopy, colonoscopy.

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

Differential diagnosis

Differential diagnosis of pruritus in a child is usually made with such diseases as atopic dermatitis, scabies, seborrheic dermatitis, allergic contact dermatitis, ichthyosis, psoriasis, some immunodeficiency conditions (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: this cause in most cases is simply underestimated and not taken into account. First of all, the search for causes is based on diseases such as scabies, allergies, dermatitis, fungal lesions. Stress itching usually passes after taking sedatives, but you should not try to diagnose the infant independently, offering him one or another medicine. This approach will not only harm the child's health, but also complicate the subsequent diagnosis by the doctor.

Treatment of the itchy skin

Classical treatment of skin itching in children consists in eliminating the causes of discomfort. For example, in the case of allergies, the potential allergen should be found and neutralized, and in the case of stress, its source should be eliminated.

With a slight itching well help sedatives, which are prescribed by a pediatrician in an individual order. In addition, in almost all cases, antihistamines are used, for which the relief of itching is one of the therapeutic areas.

There is no need to try to eliminate the problem on your own. It is not uncommon for parents to immediately run to the pharmacy for antihistamines, not realizing that the cause is not always an allergic process. In many patients, the "culprit" becomes an infection, systemic diseases (for example, liver disease) or parasitic lesions. Therefore, it is better not to waste time and seek help from doctors. The doctor will prescribe a suitable treatment as soon as the root cause is identified.

It should be understood that not always the doctor is not always able to determine the provoking factor immediately, during the initial consultation. It is likely to have to undergo a number of diagnostic measures with the baby - to take blood and urine tests, stool analysis for intestinal parasite eggs, perianal scraping, etc. If an allergic process is suspected, the doctor will send the baby for provocation tests, or for blood tests for allergens. If an infectious pathology is suspected, skin cultures may be performed.

Prevention

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

• timely referral to a doctor for treatment of digestive disorders, endocrine disorders;
• timely detection and treatment of skin infections;
• prevention of parasitic lesions, observance of hygienic rules, regular washing of hands, as well as vegetables, fruits and greens, consumption of only heat-treated products of animal origin;
• regular preventive visits to the doctor;
• in the presence of allergies, suppression of contact with allergens, dietary intake, organization of hypoallergenic stay of the child in the home;
• prevention of stressful situations, ensuring that the child has a sound and healthy sleep, if necessary - counseling with a psychologist;
• switching to a healthy diet, drinking enough fluids;
• Prevent dehydration by using skin moisturizers (e.g., 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 itching sensations in children is determined immediately. Unfortunately, quite often the cause is not detected and eliminated at all, so the symptom acquires a wave-like recurrent form. In this case, in 60% of cases, itching in a child over the years is completely eliminated, while in other children may persist and periodically recur (such a course is characteristic of allergic processes).