Itching is a health problem called pruritus in medicine and seen as a common symptom of many skin diseases. Itching that can be seen locally or throughout the body can occur for many different reasons. Itching is a condition that can affect daily life considerably. For this reason, the health problem causing itching should be determined and treatment should be started accordingly. Skin diseases and internal diseases are among the most common diseases that cause itching. In some cases, it can be seen as a simple and temporary symptom, but sometimes it can be a harbinger of serious diseases. Liver and kidney diseases, neuropathy, infections caused by bacteria, fungi and viruses, psychiatric diseases, dry skin and eczema are some of the causes of itching. In the type of itching called neural itching, it is caused by the dysfunction of the neurons that produce itching stimuli and detect itching. Although the treatment plan differs according to the individual, in most cases, there is no complete and definitive symptomatic treatment option.
What is nervous itching?
Neural itching, also known as neuropathic itching, is a health problem thought to be caused by any disorder of nerve conduction in neurons, which are nerve cells. It is thought to be caused by neuronal and glial damage in the nervous system, not the skin itself. However, the exact cause of nervous itching is not fully understood by dermatologists or neurologists. Pain is also very common in neuropathy patients. Although it is not a symptom as serious as pain, itching is very difficult to treat, especially if it is chronic, and it significantly reduces the quality of life. There is a hypersensitivity to stimuli in both neuropathic pain and itching. Conditions such as the patient’s medical history, the severity and type of itching have an important role in determining the treatment plan. Scientific research studies are still ongoing on neural itching, which has different opinions about its development mechanism and has not yet been fully detected.
What are the symptoms of nervous itching?
Itching can be seen as a symptom of many diseases and it is not possible for the person to understand which problem is caused by itching. Increasing at night; Itching with symptoms such as jaundice, abdominal pain and nausea increases the likelihood of liver diseases. Neural itching is caused by false sensations due to nerve damage, just like neuropathic pain. Nervous itching may drive the patient crazy and make it difficult for him to continue his work life and even his daily life. Itching concentrated in a single area is usually caused by skin diseases. Dermatological diseases such as eczema, dryness, allergies, infectious diseases, dermatitis cause such regional itching. Neural itching is usually seen in the form of itching affecting a large non-regional area on the back, hands, feet, legs and trunk. Likewise, itching due to skin diseases may include skin rash, redness, inflammation and change in skin appearance. However, these should not be confused with skin damage caused by physical intervention after itching. Itching problem may develop depending on psychological reasons and it is possible to confuse these itching with neuropathic itching. The most accurate diagnosis can be made as a result of the detailed medical history of the patient and medical screenings.
What are the causes of nervous itching?
Neural itching develops as a result of damage to nerve cells for various reasons. There may be different health problems that can cause this damage to neurons. The most common of these is diabetic neuropathy. Long-term high blood sugar in poorly controlled diabetic patients damages nerve cells and leads to diabetic neuropathy, one of the three most common complications of diabetes. Neuropathy concentrated in the hands and feet causes severe pain and itching. The ability of nerve cells to renew and reproduce is very limited. This is one of the reasons that make treatment difficult. Apart from diabetes, some other causes such as traumas, infections, metabolic problems, hereditary neurological diseases are among the factors that cause nervous itching. Genetic predisposition is a risk factor for neuropathy and nervous itching, as in many types of diseases. In particular, individuals with a family history of diabetes can undergo regular health screening to diagnose a possible development of diabetes at an early stage. Likewise, existing diabetes patients should comply with their treatment plans and pay attention to applying the recommended medical nutrition treatment. In this way, the damage that high blood sugar can cause on nerve cells can be prevented.
How is nervous itching diagnosed?
The diagnosis process of neuropathy, which causes nervous itching, usually begins when patients apply to healthcare institutions with pain and itching complaints. The medical history of the patient is learned in detail, accompanying diseases and family history of diseases are learned. Then a neurological examination is done. Common complaints of patients with suspected neuropathy include problems such as numbness in the hands and feet, tingling, chills, burning, weakness, and fatigue, in addition to itching and pain. Since there are different diseases that may cause these symptoms, discriminatory questions may be asked by the physician and additional diagnostic tests may be requested in order to rule out the possibilities for these. With neurological examination, skin structure, appearance, color changes, whether lower and upper extremity pulses can be taken, responses to stimuli, pain, temperature and position responses, muscle strength, reflex level are examined. Electromyography (EMG) test is applied to patients with suspected neuropathy as a result of this examination. With this test, neurological damage can be detected and neuropathy can be diagnosed. In nerve biopsy, which is another screening method, a sample piece taken from the nerve is examined under laboratory conditions. Nerve biopsy is a very rarely used screening method today. As a result of all examinations, the cause of itching and other symptoms can be determined and the treatment process can be started.
How to treat nervous itching?
Treatment for nervous itching is versatile and individualized. There is no definitive and permanent treatment method in reducing itching and pain. Generally, drug therapy is the preferred treatment option. Various surgical interventions may be required in patients with insufficient response to medication. In cases where drug therapy is applied, drug alternatives are generally applied by trial and error method. Pharmacological agents such as gabapentin, duloxetine, pregabalin, alpha lipoic acid are some of the commonly preferred drugs in nervous itching. Blood sugar regulation should be provided primarily in neuropathic itching caused by diabetes. If necessary, insulin treatment should be applied to newly diagnosed diabetic patients, a diet program suitable for the age and health status of the patient should be prepared by the dietician and the patient should be educated on this subject. After the blood glucose reaches the required value range, blood glucose should be checked by the patient at appropriate intervals with the help of finger measuring devices. In addition to these, different treatment options such as physical therapy, meditation, and pain therapy can be recommended by the physician if deemed necessary. Medications used to relieve symptoms related to nerve damage may cause side effects such as muscle weakness. In order to prevent this, applications such as physical therapy applications and exercises can be used.