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Itching: No Big Deal in Most Cases But ...

— Summer usually brings with it plenty of causes for itching, most of which are annoying but not indicative of serious health problems.

MedpageToday

Summer usually brings with it plenty of causes for itching, most of which are annoying but not indicative of serious health problems.

Sources of itch include the usual suspects -- mosquitoes, chiggers (a member of the mite family), and various irritant-bearing plants and vegetation. Additionally, summer can present more than the usual problems for individuals with chronic skin conditions -- such as psoriasis and atopic dermatitis -- according to Sam Friedlander, MD, of University Hospitals/Case Medical Center in Cleveland.

"Sun light and heat can irritate and induce flare-ups of eczema," Friedlander told 鶹ý. "The chlorine in swimming pools is another potential source of irritation for people who have chronic skin conditions. People can deal with sunlight by taking some of the same precautions that apply to skin cancer, such as avoiding long periods of direct sunlight and wearing clothes that cover the affected areas of the skin.

"Avoiding swimming pools is the best way to avoid chlorine irritation. People who choose to swim in chlorinated pools should try to limit the amount of time they spend in the water and take extra care in following their skin-care regimens that their physicians prescribe for them."

The most common complication of mosquito bites and itching caused by other types of insect bites is scratching. Continual scratching can predispose to infections, particularly if scrapes or scratches in the skin are not kept clean. Friedlander said topical agents can help minimize itching and scratching. Otherwise, keeping the insect-bite areas clean (especially if scratched) offers the best protection.

The one potentially serious consequence of mosquito bites is disease transmission. People concerned about mosquito-borne illness should check with the local public health department or their personal physicians to see whether they live in an at-risk area, said Friedlander.

Bed bugs, a type of parasite, have become increasingly common in developed countries, including the U.S. The reasons for the spread are unclear but could be a consequence of increasing travel outside the US, as well as increased trade with areas of the world that have a long history of the pests.

Bed bugs can hide almost anywhere: luggage, dirty clothes, shoes, gift and souvenir bags. Once introduced into a household, the bugs proliferate and spread rapidly, taking up residence in closets, under mattresses, in pillow cases, and a multitude of other places. Bed bug bites usually cause no more than annoying itching, said Friedlander. Rarely, allergic reactions have been reported.

According to the CDC, the best way to get rid of bed bugs is to contact a reputable exterminator.

Sometimes overlooked as a cause or itching is sunburn, or more specifically, the dead skin that occurs as a result of sunburn.

"I've had people come see me because of an 'allergic reaction,' only to discover that the itching was caused by peeling skin from a sunburn," said Friedlander. "It's more common than you might imagine."

"The best protection against this type of itching is to prevent sunburn," he added. "Wear protective clothing, avoid being in the sun during times of the day when the exposure is most intense, and, of course, use sunscreens."

Avoidance also is the best protection against exposure to irritant vegetation, such as poison ivy, poison oak, sumac, and others. The itching is caused by an oil on the surface of the plants, said Friedlander. If a person recognizes the exposure soon enough, it might be possible to avoid the irritation by washing the exposed areas of the skin.

Despite the widespread belief that exposure to poison ivy and the like can be transmitted from person to person, little evidence exists to support that.

"Most of the evidence I have seen indicates that you have to come in direct contact with the plant," said Friedlander. "Now it is possible to be exposed by contact with a pet, usually a dog, that has the oil on its coat. Also, if people don't know they have been exposed, they can spread it to other parts of their own body. I know of cases where people used the toilet without realizing they had been exposed, and they developed itching and burning in places where you really don't want itching or burning."

In two other situations, itch can indicate a more serious health problem: hives and liver disease. Hives indicates a systemic reaction, and an affected person should see a physician for evaluation of the problem. In the case of liver disease, the itching is almost always accompanied by jaundice, which mandates immediate medical attention, said Friedlander.

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    Charles Bankhead is senior editor for oncology and also covers urology, dermatology, and ophthalmology. He joined 鶹ý in 2007.