The Vicious Cycle Of Stress And Itch
To make matters worse, itching isnt just triggered by stress it is also associated with increased anxiety, depression, and other mood disorders. And, in turn, stress and anxiety exacerbate itch, leading to a vicious cycle that worsens psoriasis and impacts quality of life.
Indeed, for many people, the itch of psoriasis which can be especially severe at night, disrupting sleep has a bigger impact on their quality of life than the patches of thick raised skin covered with silvery scales that represent the visible aspect of the disease.
Treating your psoriasis is the best way to reduce itching, and there are a host of treatments, ranging from topical creams and photo therapy to targeted biologics, that can help though lack of access to treatment due to the pandemic can still be an issue.
The goal in treating psoriatic itch is to inhibit the itch-scratch cycle. Biologic drugs like etanercept , adalimumab , infliximab , and ustekinumab , are better for itch than topical treatments because they have a central effect in the brain that reduces itch activation and improves mood.
Eczema: Red Itchy Irritated Skin
Like psoriasis, eczema is a chronic skin condition that often causes intense itching. Scratching causes redness and inflammation of the skin, leading to a worsening of the eczema. Scratching can also cause a secondary bacterial infection. The most common type of eczema is caused by a reaction to irritants like detergents, soaps, or household cleansers. So if you have eczema, you should be careful to use mild soap and regularly moisturize your sensitive skin. Your doctor may prescribe a steroid cream or other medications if eczema is severe.
What Causes The Itch
When you have psoriasis, a problem with your immune system causes your body to produce too many skin cells, and it does so at a rate of production thats too rapid.
The dead cells move quickly to the outer layer of your skin and build up, forming red patches covered in flaky, silver scales. The skin also turns red and inflamed.
Even though the word psoriasis comes from the Greek word for itch, in the past, doctors didnt consider itching a main symptom of the condition. Instead, they would determine the severity of the disease based on the number of scaly patches a person had.
Today, the medical profession is increasingly recognizing itch as a major symptom of psoriasis.
The itching is caused by psoriasis scales, flakiness, and inflamed skin. However, its also possible to itch in areas of your body that arent covered by psoriasis scales.
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When To Contact A Medical Professional
Contact your provider if you have symptoms of psoriasis or if your skin irritation continues despite treatment.
Tell your provider if you have joint pain or fever with your psoriasis attacks.
If you have symptoms of arthritis, talk to your dermatologist or rheumatologist.
Go to the emergency room or call the local emergency number if you have a severe outbreak that covers all or most of your body.
Itching Or Burning Numbness Or Tingling And Skin Bumps
- Medical Author: Melissa Conrad Stöppler, MD
Reviewed on 10/15/2020
Skin bumps associated with itching or tingling can be present in conditions such as lice infestation, chickenpox, or other skin conditions. An allergic reaction that produces hives can also be the source of these symptoms. If your symptoms do not improve or become worse, contact your doctor for advice and prompt treatment.
While the list below can be considered as a guide to educate yourself about these conditions, this is not a substitute for a diagnosis from a health care provider. There are many other medical conditions that also can be associated with your symptoms and signs. Here are a number of those from MedicineNet:
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Genital And Anal Psoriasis
Plaque psoriasis at the genitals is sometimes called genital psoriasis. A study from 2017 in the journal Dermatology & Therapy reported the prevalence and effect on quality of life of people with plaque psoriasis who had genital involvement. Researchers found that 70% of the study participants had genital involvement.
Among these study participants, 100% reported itch and discomfort, 95% reported redness, burning, and stinging, 85% reported pain, and 75% reported scaling. Many of the study participants reported that itch, stinging, and burning were the most bothersome symptoms.
Inverse psoriasis is a rare form of psoriasis that affects between 3% and 7% of people with psoriasis. It often affects the genital and anal areas at areas where the skin folds or creases.
It can cause ongoing discomfort to the upper thighs, pubis, the folds between the thighs and groin, the vulva, penis, anus, and buttocks. Inverse psoriasis causes dry, red, inflamed patches on the skin of these sensitive areas.
Upper thighs: Inverse psoriasis can cause red, inflamed patches on the upper thighs. This can be especially irritating when the thighs rub together with walking or running.
Pubis: The pubis, also called the pubic bone, is located just above the genitals. In this area, the skin is very sensitive. Itching and scratching can make this area even more inflamed and sore.
Why Does My Scalp Hurt Itch And Burn
Folliculitis is another skin condition that can cause scalp tingling. It occurs when the hair follicles become swollen and inflamed. Bacterial, viral, and fungal infections are among the most common causes. In addition to a burning or itchy scalp, folliculitis can cause pain, pimple-like red bumps, and skin lesions.
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What Are The Symptoms Of Genital Psoriasis
It can be hard to tell the difference between genital psoriasis and contact dermatitis or some types of infection. Even if you have psoriasis, its not a given that a genital rash is due to psoriasis. Learn more about the various causes of genital rash.
If your skin cracks, youre more susceptible to bacterial or fungal infections. Its possible to have both genital psoriasis and an infection at the same time, which may require a combination of treatments.
The skin around your genitals is delicate. If you develop a rash on or around your genitals, see a doctor for a diagnosis before you try to treat it.
Treating the condition sooner than later will give you a better chance of finding relief.
Do All Types Of Psoriasis Itch
Plaque psoriasis, a type that causes scaly, often gray-looking patches, is the most common type of psoriasis. It is also the most common cause of psoriatic itching, although other forms of psoriasis may also itch.
However, the severity of an itch may vary between one flare and the next. One psoriasis flare may only cause mild itching, while the following flare could result in severe itching sensations.
It is possible for one person to have multiple types of psoriasis at once and develop lesions that do not itch or only cause mild itching.
Many treatment options are available to help people who experience psoriatic itching.
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What Are Psoriasis Flare
One feature of psoriasis is that its recurring, often seasonally. Other times, the appearance or reappearance of your psoriasis symptoms can be unpredictable, with patterns or triggers changing over time. When your symptoms suddenly reappear or worsen, these are called flare-ups.
You may not have to suffer every time one occurs. Working with your doctor can help you make lifestyle choices to better manage flare-ups.
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Can A Diet Cure Psoriasis Naturally
- Avoiding environmental factors that trigger psoriasis, such as smoking, and stress, may help prevent or minimize flare-ups of psoriasis. Sun exposure may help in many cases of psoriasis and aggravate it in others.
- Alcohol is considered a risk factor for psoriasis, even moderate amounts of beer. People should minimize alcohol use if they have psoriasis. This is especially important if they are taking medications such as methotrexate or acitretin.
- Specific dietary restrictions or supplements other than a well-balanced and adequate diet are not important in the management of plaque psoriasis.
- Recently, some data has supported that an “anti-inflammatory” diet that is high in fruits and vegetables and low in saturated and trans fats may help manage psoriasis, although the value in preventing its onset is less certain.
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How To Manage The Pain
Psoriasis pain can stem from a few different sources. Psoriatic arthritis brings pain and swelling to joints youll probably notice the tenderness more when you apply any pressure to the spot and severe plaque outbreaks can trigger nerve endings in a number of uncomfortable ways. But there are also things you could be doing to diminish your pain.
Understanding And Managing Skin Pain With Psoriasis
People who have psoriasis pain use words such as, aching, burning, stabbing, throbbing, cramping, stinging, and more to describe skin pain. And when psoriasis flares become painful, you will want relief fast.
Having some remedies on hand can help you to soothe skin when you need relief. Heres what you need to know about skin pain and how to best manage its effects.
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What Are Bumps On Scalp That Itch And Hurt
Tinea capitis, or ringworm of the scalp, causes round, red, scaly bumps on the scalps surface. This is due to the mold-like fungus tinea , which infects the skin and quickly progresses if not properly controlled. Bumps are usually painful with incessant itchiness and may be filled with pus, according to MedlinePlus .
What Psoriasis Medications Can I Take
Systemic Medications
Biologics for Psoriasis
The following drugs are categorized under the term biologic because they are all proteins produced in the laboratory by industrial cell culture techniques and must be given either subcutaneously or intravenously. The frequency of treatment depends on the specific drug. All of these medications are very precise in that they block only one or two parts of the inflammatory reaction and are moderately immunosuppresive.
Biologics are expensive and do not cure psoriasis but as a group are quite effective and reasonably safe. If it is decided to start a patient on a biologic drug, the choice will depend on the particular physician’s expertise, as well as insurance coverage and payment issues.
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Block The Itch With Capsaicin
Capsaicin the source of heat in chili peppers, and an ingredient in certain creams and ointments helps relieve itch by blocking the nerve endings that transmit pain, explains Yosipovitch. German researchers found that over-the-counter creams with capsaicin helped reduce pain and inflammation from psoriasis lesions. Warning: You might feel a burning sensation where you apply the ointment, and it should not be applied to cracked or open skin.
What Are The Types Of Psoriasis
In children, common types of psoriasis include:
Plaque psoriasis. This is the most common type of psoriasis. It causes plaques and silvery scales, usually on the knees, elbows, lower back, and scalp. They can be itchy and painful and may crack and bleed.
Guttate psoriasis. This type often shows up after an illness, especially strep throat. It causes small red spots, usually on the trunk, arms, and legs. Spots also can appear on the face, scalp, and ears.
Inverse psoriasis. This causes smooth, raw-looking patches of red skin that feel sore. The patches develop in places where skin touches skin, such as the armpits, buttocks, upper eyelids, groin and genitals, or under a woman’s breasts.
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Why Am I Getting Painful Bumps On My Scalp
Categorically, painful bumps could be itchy, sore or inflamed. Certain scalp conditions may be associated with pain in scalp. These are mainly due to serious or chronic folliculitis, epidermal cysts, scalp psoriasis and inflamed acne. Tinea capitis is also a common and possible cause of spotty itchy ones.
What Are The Treatment Options
Though the underlying causes are different, treatment is generally similar, Dr. Fernandez says. You should see a dermatologist for any rash that doesnt go away with over-the-counter medicine, he says.
- Topical cortisone, especially if you have a mild case.
- Immunosuppressive drugs for more moderate to severe cases.
- or ultraviolet light treatment for severe cases.
Also, eczema can prompt a secondary infection so your doctor may use topical and systemic antibiotics to remove bacteria and calm the inflammation.
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Scalp Itch With Scaling/erythema
Scalp itch associated with interfollicular and perifollicular scales and/or erythema can be due to the following causes: seborrheic dermatitis, scalp psoriasis, contact dermatitis, early lichen planopilaris , tinea capitis, dermatomyositis, and xerosis secondary to atopic dermatitis or aging skin. Other less common causes of scalp conditions that may present with scalp itch and hyperkeratosis are pityriasis rubra pilaris, discoid lupus and Langerhans cell histiocytosis . Trichoscopy, direct sampling and cultures are useful tools for diagnosis. Histopathology can confirm diagnosis in doubtful cases.
Seborrheic Dermatitis
Seborrheic dermatitis, which affects approximately 16% of the adult population, is one of the most common causes of scalp itch. In a French study, 50% of affected patients complained of scalp itch. Other common symptoms included sensations of prickling, tightness, pain, and burning . Pruritus in seborrheic dermatitis typically disappears or decreases in severity after shampooing. The diagnosis of seborrheic dermatitis may be clinical when scalp itching is associated with flaking in seborrheic body parts such as mid-face and upper chest and back. However, it must be distinguished from psoriasis and contact dermatitis. On trichoscopy, seborrheic dermatitis and contact dermatitis present with arborizing vessels, whereas psoriasis presents with red dots at low magnification and twisted capillary loops at high magnification .
Psoriasis
Contact Dermatitis
Fig. 3
Triggers That Make Itchiness Worse
When you have an itch, the temptation is to scratch. Yet scratching can increase inflammation and make itching even worse. That creates a vicious pattern known as the itch-scratch cycle.
Scratching can also damage the skin, leading to the formation of even more itchy plaques and even infection.
Stress is another itching trigger. When youre under stress, youre more likely to have a psoriasis flare, which can set off another bout of itching.
Weather conditions can also influence itching. In particular, very dry conditions and warm weather have both been known to trigger or exacerbate itchiness.
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Causes And Risk Factors
Researchers dont know exactly what causes psoriasis or what causes it to spread to the anal or genital areas. They do know that genes and the immune system play a significant part in the development of psoriasis. Many family-based studies have found that about one-third of people with psoriasis have a first-degree relative with the condition.
In addition to genes, certain environmental factors can increase your risk of psoriasis. These include:
Make Sure Your Bedroom Is Conducive To Sleep
If you are having trouble sleeping due to psoriasis itching, the first thing you need to do is to make your room conducive to sleep. Your room should stay cool, but not cold to help soothe your psoriasis. To help you sleep better, make sure you turn off all the light sources, including your computer monitor. If you are sensitive to light or sound, consider wearing an eye mask and earplugs.
Choose a mattress that conforms to your body perfectly and provides adequate support. If you have psoriatic arthritis, a waterbed is highly recommended as it allows for more comfortable movement and helps keep your aching joints loose.
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When Was The Last Time You Felt Lonely
Maybe it was because you moved to a new city, lost a family member or close friend, or started a new job where you didnt know anyone.
If youre like three in four Americans, youve probably battled loneliness at some point. For most of us, a little loneliness is a normal part of life. However, constantly feeling lonely can be harmful to your physical and mental health.
Scalp Itch With Alopecic Patches
When assessing patients with alopecic patches who present with scalp itch, distinguishing between non-scarring and scarring alopecias is an important aspect of clinical evaluation. Non-scarring alopecias associated with scalp itch include alopecia areata and androgenetic alopecia. Patients with active alopecia areata often complain of mild itching or burning, which often precedes development of new patches. It may be caused by mast cell release of histamine and tryptase as well as lymphocytic infiltration with release of IL-31 . Patients with androgenetic alopecia often complain of scalp itch and frequently have concomitant seborrheic dermatitis.
In active telogen effluvium, patients complain of trichodynia rather than scalp itch. In a study of 109 patients, 24 patients with androgenetic alopecia, 47 with telogen effluvium, 20 with both conditions, and 18 with telogen effluvium in remission it was concluded that trichodynia is almost exclusive of active telogen effluvium. Trichodynia was significantly more prevalent in the patients with telogen effluvium and those with both telogen effluvium and androgenetic alopecia , compared to those who had only androgenetic alopecia without telogen effluvium or telogen effluvium in remission .
Table 1 summarizes epidemiology, symptoms, clinical manifestations, dermoscopic findings, and histological features of the most common scarring alopecias associated with itch .
Table 1
Fig. 7
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Tips For Managing Psoriasis Itching And Burning
Stress can trigger a psoriasis flare-up, as well as worsening the itching and burning. Finding ways to reduce and manage stress can help1. For example, meditation, relaxation techniques, and/or exercise can be helpful ways to deal with stress.
Some people find that a lukewarm or warm bath followed by a salicylic acid preparation and then the application of a thick lubricant is helpful in relieving the itch, at least temporarily. Hot baths can dry the skin and make itching worse7. Brief, cold showers can also provide some relief. Keeping lotion in the refrigerator so it is cold when used may have a soothing effect.