What to do when it becomes uncomfortable

How does itching arise?

Itching, medically called pruritus, results from complex processes involving both the skin and the nervous system. As a barrier to the environment, the skin reacts to external influences such as pollutants or mechanical stimuli by releasing signalling substances like histamine. This molecule activates certain nerve fibres in the skin that are responsible for the perception of itch. Other substances, such as serotonin or compounds released by poisons, temperature changes or electric shocks, can also trigger this reaction.

Chronic itch often arises from hypersensitivity of the nerve fibres, so that even minor stimuli send strong signals to the brain. Scratching temporarily masks the itch signal with pain signals, which leads to relief. At the same time, mechanical irritation of the skin releases new signalling substances that intensify the itch again and start a vicious cycle. Not only can skin damage result, but mental well‑being also suffers, especially due to sleep loss and exhaustion.

Symptoms: how does itching present?

Itching presents with a variety of symptoms that can affect both the skin and emotional well‑being. Redness, swelling or blisters often occur and may be accompanied by dry, scaly or cracked skin. Hives, itchy nodules or skin thickening are also typical symptoms. Constant scratching often leads to abrasions, bleeding or crusting, which further irritate the skin and can increase itching. In severe cases scars, discolouration or ulcers may develop.

Chronic itch often goes beyond purely physical complaints and becomes a significant burden. Affected people frequently suffer from sleep disturbances because itching tends to be stronger at night. Fatigue, mood swings and psychological strain can follow. Many feel uncomfortable in social situations because of visible skin changes or their scratching behaviour, which can lead to shame, isolation and, in some cases, anxiety or depression.

Furthermore, scratching can damage the skin so severely that the original diseases or triggers of the itch are no longer recognisable. If bacteria colonise the injured skin areas, infections can occur and worsen the condition. The vicious circle of itch, scratching and renewed skin irritation thus becomes increasingly difficult to break.

Where on the body can itching occur?

Itching can theoretically occur at any body site, with exact localisation depending on individual factors such as age, skincare, underlying diseases and lifestyle. Some body regions are particularly commonly affected. On the hands and arms, itching often appears on the palms, the flexor sides of the arms, around the elbows and in the armpits. Feet and legs are also affected, especially the soles, calves, the backs of the knees and shins, and occasionally the thighs.

On the face, itching often affects the eyelids, the scalp and the area around the ears. The neck and nape, particularly the hairline, are also sensitive. The trunk can be affected too, especially the abdomen, the back, along the spine and around the shoulder blades. Under and on the breasts itching may occur with or without a rash. The genital area is also commonly affected: in women the labia, the vaginal entrance or the vagina may itch; in men the testicles and penis can be involved. The buttocks and the anus are also regions at higher risk for itch.

Certain diseases can lead to a specific localisation of the itch. In atopic dermatitis, itch and eczema typically occur in the folds of the arms and legs, the neck and nape, and the face. Psoriasis commonly affects the elbows, knees, palms, soles and scalp. Under psychological stress many sufferers report particularly strong scalp itching.

What can cause itching?

Itching can have many causes, ranging from skin disorders to internal diseases. Often the cause lies in a disorder or disease of the skin itself. Dry skin, a damaged skin barrier or inflammatory conditions such as atopic dermatitis, hives (urticaria), psoriasis or infections can lead to itching. External factors like low air humidity in winter or the use of harsh cleaning products can also dry out the skin and promote itch.

Quite often itching is a symptom whose cause lies within the body. Liver, gallbladder or kidney diseases, metabolic disorders such as diabetes, neurological diseases or even tumours can play a role. In liver and biliary diseases the so‑called cholestatic itch often occurs, which is particularly noticeable in the evening and at night, frequently on the hands and soles.

Aging processes can also favour itching, since with time the skin loses water‑retention capacity and sebum production, becoming more prone to dryness. In kidney insufficiency, metabolic products accumulate in the body and can cause skin irritations, particularly in dialysis patients.

Other specific triggers include, for example, eczemas caused by dry skin or frequent washing, or psoriasis, which presents with itchy, scaly areas. In rare cases itching can also be due to a parasitic infection such as scabies, an intolerance to skincare products or even more serious conditions like Hodgkin lymphoma. A careful analysis of the affected skin areas and consideration of accompanying symptoms help to identify the cause and initiate suitable treatment.

Can the psyche trigger itching?

Yes, the psyche can indeed trigger itching, especially when psychological stress is involved. Stress has a direct effect on the skin because it triggers certain physiological responses in the body. Stress hormones such as cortisol influence the skin barrier and make it more susceptible to irritation. These bodily changes can then lead to itching and, in some cases, rashes.

Moreover, emotional strain such as anxiety, grief or work stress can exacerbate symptoms of existing skin conditions like eczema or atopic dermatitis. It is important to recognise stress not only as a physical burden but also as a psychological one and to cope with it using appropriate methods. Relaxation techniques such as meditation, regular exercise or talking to a psychologist can help restore mental balance and thus break the cycle of itch and stress.

What really helps against itching: effective tips

• Place an ice pack or a cold drink can on the itchy skin to relieve the itch. Make sure to put a cloth between the skin and the ice to avoid skin damage.
• Store menthol or peppermint creams in the refrigerator to enhance the cooling effect and effectively relieve itching.
• Pharmacies sell ointments with antihistamines that relieve itching through their cooling effect. If there are skin injuries, however, consult a specialist.
• For insect bites or small wheals, heat can relieve the itch. Use special devices from the pharmacy to warm the skin for a few seconds to about 50 degrees.
• Take a cold shower to calm the itch and then moisturise the skin well to replenish moisture. Avoid hot water and shower only with lukewarm water to avoid further irritating the skin.
• Apply cool, moist compresses, for example with black tea, to the itchy skin. This soothes the itch and calms the skin.
• A bath in salt water or with special bath additives can not only relieve the itch but also help you relax.
• Place raw potato slices on the affected areas. This simple home remedy can help reduce itching.
• Use home remedies such as oatmeal baths, aloe vera or coconut oil to relieve the itch. Baking soda, apple cider vinegar and honey can also help with skin irritations and inflammations.
• Choose clothing made of breathable materials such as cotton, which do not further irritate the skin or worsen the itch.
• Find out the cause of the itch and avoid common triggers such as spicy food, allergens or frequent washing of the skin.
• Keep your fingernails short to reduce the risk of unconscious scratching. Wear cotton gloves at night to reduce scratching.
• Keep the bedroom cool so that heat and sweat do not worsen the itch.
• Frequent or long baths and sauna visits can dry out the skin and increase the itch. Limit the duration of such activities.
• If the itch worsens or does not go away, see a doctor who can help you with specific creams or medications.

Itching is a common symptom that can have various causes and significantly impair quality of life. Careful skin care and avoiding possible triggers are essential steps towards relief.