Generalized Itching (Pruritus)

What is it?

Generalized itching, (also called “generalized pruritus”), is a condition where a person has diffuse itching of their skin usually without a rash, although one can be present.  It is a relatively common disorder as about 20-25% of the general public experiences this type of itching at least once in their lifetime.  The itching can vary from a mild itch to a severe, extremely bothersome itch which can disrupt a person’s quality of life.  If the itching has been present for less than or equal to 6 weeks, it is referred to as “acute.”  If the duration is greater than 6 weeks, it is referred to as “chronic.”  There are many causes of generalized itching, but in the majority of cases, no identifiable cause is found.  In chronic cases, when there is no cause found and other causes are ruled out, the condition is referred to as “Idiopathic Chronic Pruritus.”

What are some of the causes?
Diffuse itching can be a manifestation of an allergy, a skin disorder, a side effect of a medication, an infectious agent or infestation, a psychological issue, or an underlying systemic disease.  Such systemic diseases may include liver disease, kidney problems, thyroid disease, connective tissue disorders, neurologic disease, blood disorders, and malignancy, as well as other causes such as pregnancy.

How is the diagnosis made?
It is very important that a detailed history is taken from the patient.  Many things can be ascertained from the patient by the physician that may be responsible for the cause of their itching.  The board certified allergists at Black & Kletz Allergy see this disorder with great frequency and are able to ask the correct questions in order to elicit clues to discovering the cause of the itching.  The next step is for the allergist to examine the patient thoroughly in order to help identify signs that may aid in the search for a cause of the annoying itching.  After the history and physical examination are completed, there are numerous laboratory tests that are done which may include any one or more of the following:  blood tests, urinalysis, X-rays, skin biopsy, allergy skin tests, patch tests, and/or stool sample.

What is the treatment?
If an underlying systemic disease is found, therapy should be aimed in treating this disease.  In most cases, the itching subsides when the systemic disease is treated.  If no cause can be found, there are various treatments that can be used.  Most of these treatments involve medications that will diminish, if not completely relieve the patient’s itching.  A multitude of medications and combination of medications have been successful in alleviating generalized itching.  Oral medications are usually used, but topical creams and/or ointments also have been used with some success in certain patients.  The length of time that a patient needs to be treated varies greatly from individual to individual.  Medication(s) may only be necessary for 1 or 2 weeks, but can be necessary is some patients for years.  Most patients tend to only need the medications for weeks to months, however.  Other treatments such as UV light treatments have been used with varying degrees of success.

What should you do?
If you have generalized itching, we at Black & Kletz Allergy would be happy to help you find the cause.  Even if a cause is not identified after a thorough evaluation, our board certified allergists have the expertise to help reduce or preferably eliminate your itching.  Please call us at any one of our 3 locations in the Washington, DC, Northern Virginia, and Maryland metropolitan area.  We have offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.  Alternatively, you can click Request an Appointment and we will contact you within 24 hours of the next business day to schedule an appointment for you.  We look forward in serving your allergy needs in a friendly professional environment.