Eczema Itch/Scratch Cycle
Many people consider itching to be a minor nuisance, but rarely a serious problem. Eczema patients often know better.
With eczema, itching can be extremely intense and unrelenting. Clearly, itching should be treated for obvious reasons, as it is an unpleasant experience. If severe and regular enough, it can disturb sleep, break concentration, and be extremely draining on the patient.
There is another important reason that itching itself is problematic in eczema, called the itch-scratch cycle, and is a major reason why treatment should be prompt and aggressive to quickly stop itching.
What is the Itch/Scratch Cycle?
Itching naturally prompts scratching which may beneficial in removing mosquitoes or other irritants from our skin, but in the case of eczema or other chronic diseases that cause itching, scratching is clearly not beneficial.
While scratching provides temporary relief to itching, this relief is short lived. Intense scratching will damage the skin, which further irritates the sensitive skin and often causes a more intense itch later.
As scratching is often an impulsive and pleasurable act it can become an addictive behavior. Thus, a negative and self-reinforcing cycle called the itch scratch cycle can be formed. This cycle is problematic as it can worsen eczema rapidly, and break the skin, leaving the resulting wound open to bacterial infection.
Stopping the Cycle
Itching will need to be successfully controlled in order to stop scratching. While patients are advised to resist scratching, will power alone will often be insufficient to resist temptation as itching from eczema can be unrelenting.
Itching will often intensify during night time as there are less distractions to keep the mind occupied, especially just prior to sleep. If the itch is severe enough, patients can scratch unconsciously during sleep, which cannot be controlled by will.
- Control the itch using medication-in the case of eczema, corticosteroid creams are often used to control the initial flare.
- Other the counter antihistamines like Benadryl can help to contain itch quickly, but they can induce daytime sleepiness, so must be taken with care.
- Treatment should be started as early as possible before scratching makes the eczema more severe. Patients are advised to see a dermatologist at an early stage in a flare.
- If possible, resist the temptation to scratch. For infants, having them wear cotton mittens may help to avoid vigorous scratching with the nails which will damage the skin quickly.
- Coldness is a sensation that can numb itch temporarily. Applying an ice cube to the site of an itch can help to control itch temporarily.
- Cold baths or showers can cool your skin and reduce itching. The effect is temporary, but is preferred to scratching which damages the skin quickly.
- If you cannot resist scratching, try to pat the area, and don't use your nails.
- Don't try to control eczema yourself or try to fight itch with sheer will power. Visit a dermatologist, and have an appropriate treatment prescribed. The faster you seek appropriate treatment, the less damage your skin will take, and the faster your condition will clear.
- Moisturize on a regular basis to manage dry skin. Dryness caused by eczema is the main reason for prolonged itch.
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