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I sometimes have a "ghost" itch in the middle of my back in a place that I can not reach. I'm using a long-handled comb to give it a good scratch. No obvious cause – no rash, no irritation or redness, no skin disorder diagnosed. It's annoying, but it does not disturb my life.
Unfortunately, this is not the case for all those who itch. About 15% of the population suffers from chronic itching, according to Brian Kim, co-director of the Center for the Study of Itching at the University of Washington's School of Medicine. "It's a very big problem," says Kim. "Studies have shown that its impact on quality of life is equivalent to chronic pain. Many of my patients who have both had a preference for pain with itching. The itching tends to be more exasperating.
Thomas M. Keahey, a dermatologist in Rockville, Maryland, says that itching is the main complaint of about 20% of his new patients. In addition, his elderly patients frequently raise the issue during their annual skin cancer screenings. Most of the time, their problems are minor, but "sometimes it's a request for serious help," he says.
There are hundreds of reasons people get itchy. These range from dry skin to psoriasis, including contact dermatitis (rough clothing, pet dander, soaps, laundry detergents and fragrances – known as eczema).
as well as more familiar affections such as insect bites or poison ivy. .
Some people enter hives after exposure to an external stimulus, such as cold air or the sun. "Can you imagine going out with itchy hives by walking outside in the cold or sunlight, or following a" healthy "workout?" Said Keahey.
There are also unexpected causes, some serious ones. These include diabetes, kidney disease and some cancers.
"One thing that can surprise people is that having a bad neck or bad back can cause itching caused by nerve damage from the spinal cord," Kim says. "Another thing that people may not know, is that in rare cases, cancer, especially lymphoma and leukemia, can cause itching."
Generalized itching caused by blockage of the bile ducts may be a sign of pancreatic cancer, for example. In cutaneous T-cell lymphoma, a type of non-Hodgkin's lymphoma, the cancer starts in white blood cells and attacks the skin, causing an itchy rash 'often confused with mild forms of eczema Says Keahey. In addition, about one-third of patients with end-stage renal disease experience itching "due to an accumulation of toxins, not well defined," says Keahey.
Researchers are studying the itch-itch cycle, trying to unravel the mysteries of what makes people itch, then scratch – and continue to scratch. Scratching causes damage to the skin, which causes inflammation, says Kim. "This increased inflammation, as with many rashes, causes more itching," he says. "So it's a vicious cycle of" itching-scratching "."
Kim and others think that the immune system plays a role. "We may think that our immune responses end in our immune system," says Kim. "But the itch-scratch cycle engages the immune system with the whole body and interacts with behavior and the environment."
Recent research in mice suggests that there is a link between itching and food allergies, which also constitute an immune response. According to studies, in animals, scratching the skin resulted in an increase in the number of activated mast cells (immune cells involved in allergic reactions) in the small intestine, indicating a possible relationship between allergies and atopic dermatitis, type of eczema. by scientists from the Boston Children's Hospital.
The brain can also be involved. In another study on mice, researchers from the Chinese Academy of Sciences have shown that a DIY with a small subset of neurons in a region of the brain that processes sensory information, including including pain, could cause or stop scratching in mice, suggesting that these neurons are connected to the itch. -crash cycle.
Experts believe that the cycle in animals has evolved over time as a protective behavior.
"The itch sensation plays a key role in detecting harmful substances, especially those that have become attached to the skin," said one of the Chinese Yan-Gang Sun researchers. "As the itching leads to scraping behavior, this allows the animal to get rid of harmful substances."
If the itching lasts more than a month, it is probably time to consult a doctor. Most people are reluctant to do it for a minor itch and use over-the-counter remedies, which are too weak to have an effect, says Keahey.
"When the itch begins to affect the quality of life – such as sleep – or it's associated with a disfiguring rash, people start to enter the dermatologist's office," he says.
According to Kim, there are many treatments, but the best ones depend on the nature of the itch: "Moisturizers help dry skin the best. While if you suffer from eczema, some anti-inflammatories have better anti-itch properties than others.
As for my "ghost" itch, both Keahey (who is my dermatologist) and Kim think I probably have a fairly common condition called paresthetic notalgia, which looks like an itch but really involves the nerves.
"We think that the nerves that transmit the sensations of the back are damaged or dysfunctional, which causes itching," says Kim. "You're right, it's a phantom itch because there is no primary stimulation in the skin. Rather, the nerve itself is missed. This is precisely why the classic "scratchback" was invented.
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