Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, August 15, 1995 TAG: 9508150022
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: MIKE OLIVER ORLANDO SENTINEL
DATELINE: LENGTH: Long
Everybody does it. It's the irritating yin and yang of daily living. To itch is to scratch. To stop itching is divine.
In reality, no one thinks much about itching until it becomes a problem from dry skin, poison ivy, an allergic reaction or some other more serious illness.
There's also a psychological component to itching. Just thinking about itching can make you itch.
See?
OK, now, stop scratching and read on to find out why we itch and how to stop that itch, or, at least, to stop scratching that itch.
In the world of scientific study, itching is not high on the list, said Robert LaMotte, a Yale University neuroscientist who actually does study itching, among other things.
LaMotte said there are two sets of receptors that reside on our skin's nerve endings. Called nociceptors, they serve as the body's injury detectors. They let you know that something - like a hot stove - is injuring your body.
Both sets of receptors respond to pain, but only one set responds to stimulation that produces an itch. The theory goes, LaMotte said, that if only the itch receptors are active, then you will itch. Otherwise, it's pain you'll feel.
Scratching is a natural reaction to itching. But it's probably not the best course of action for a solution.
``The problem with scratching is that it can cause the release of chemicals that can exacerbate the itching,'' LaMotte said.
Histamine is one of those chemicals released by the skin. Scientists say histamine acts on the itch receptors in your skin, initiating the itch.
For example, when a mosquito bites your arm, the mosquito's irritating saliva triggers the release of histamine. The histamine tickles your skin's itch receptors, which rush this message to your brain: scratch.
This leads us to the corollary of our original premise: If to itch is to scratch, then to scratch is to itch.
Or, as Dr. Rick Fried, a Pennsylvania dermatologist-psychologist, posits: ``Itching begets itching.''
``An itch can take on a life of its own,'' said Fried, one of the few itch specialists in the country who is a medical doctor and a clinical psychologist. ``One of the things we see all the time with itchy patients is people prefer pain to itch, which is why they will claw their skin to pieces and leave scars.''
There are dozens and dozens of causes for itching, but all of them can be made worse by anxiety, Fried said.
Some itches are relatively easy to diagnose: fungal infections such as jock itch or athlete's foot; poison ivy or poison sumac; skin conditions such as eczema, acne or psoriasis; insect bites or scabies (where mites burrow under the skin).
Other causes are harder to pinpoint: environmental factors such as exposure to chemicals at work or allergies of various kinds.
For many people, self-diagnosis and treatment is no big problem: You go camping. You pitch your sleeping bag in a bed of leafy vegetation. You break out in itchy welts.
``Oh, so that's what poison ivy looks like,'' you exclaim. You buy calamine lotion and try not to scratch for a week or so.
Sometimes, it's a matter of matching the right ointment with the right itch, and that may require a doctor's guidance. There is a host of treatments out there ranging from topical creams and lotions to oral antihistamines, antibiotics and steroids. Some require prescriptions.
Dry skin, one of the most common causes of itching, is treated with moisturizers.
``It's often a creative combination that works,'' Fried said.
In treating your itch, it's important to learn some alternatives to scratching: wrapping ice cubes in a washcloth and pressing them to the skin; slapping instead of scratching - anything to avoid digging fingernails under the skin, dermatologists say.
Fried estimates that there is no clear-cut explanation for about 50 percent of the people he sees for chronic itching. There's even a psychological disorder, called delusions of parasitosis, in which the patient is falsely convinced that his skin is infested with bugs.
Persistent, unexplained itching for more than several days shouldn't be taken lightly. Itching is sometimes a symptom of serious illness, such as liver disease, kidney disease, Hodgkin's disease, AIDS, diabetes or cancer.
Fried recently saw a woman who came in because of itching, and it turned out she had lung cancer. Itching was her only symptom.
Making a diagnosis may not always be so dramatic, but it can often improve one's quality of life.
Dale Fiveash, a 40-year-old dialysis patient from Apopka, Fla., suffered for eight months with recurring bumps on his legs that itched like crazy.
``I tried everything I could find - calamine, Benadryl, allergy tablets, oatmeal baths,'' Fiveash said.
Nothing worked.
He went to see Orlando dermatologist Michael Gutierrez, who recognized a condition peculiar to some dialysis patients. The treatment involves exposure to ultraviolet light. This treatment has significantly reduced the frequency and intensity of the outbreaks, Fiveash said.
``I was at the point where I didn't think I could take it anymore,'' Fiveash said. ``These treatments have really helped improve my life.''
Those seeking to further satisfy their itch for knowledge on itching might want to pick up the Journal of the American Academy of Dermatology. There, Oregon dermatologist Susan Denman presents a comprehensive review of pruritus (that's the scientific word for itching).
She concludes the 14-page analysis of everything itchy with:
``Pruritus is best understood as a primary sensory modality carried on unyelinated C fibers in the spinothalamic tract and modulated by central factors, including cortical influences.''
If you didn't quite get that, here's the bottom line:
An itch itches.
by CNB