What is the itch-scratch cycle?
The eczema on your skin is itchy. You scratch. It itches again. You scratch again. The cycle seems unending. What doctors now realize is when you scratch skin impacted by eczema, you perpetuate the itch and worsen the condition.
This is called the itch-scratch cycle. Here’s how it happens: When you scratch, you break down the outer layer of skin, allowing allergens, irritants and bacteria to enter. Your immune system responds by sending signals to the surface of the skin, causing more inflammation, redness … and more itching. This increases your risk of infection.
Near-constant scratching can also affect quality of life and impact sleep, especially in children.
What are common triggers for itching with eczema?
Common triggers for itching with eczema include:
- sweating
- heat
- hot water
- exposure to allergens and irritant
- dust
- dry skin
- Wool fibers
- soaps and detergents
- stress
How do you break the itch-scratch cycle of eczema?
‘Just stop scratching’ is easier said than done. It may even cause unnecessary stress, worsening symptoms. Here are strategies and treatments to help relieve or minimize itch in patients with atopic dermatitis.
Frequent moisturization
Frequent moisturization can not only soothe the skin but also reduce the itch.
Medication
Medications to relieve the itch of eczema include:
- topical corticosteroids
- topical calcineurin inhibitors
- immunomodulators.
Talk with your doctor about using these medications for your AD.
Antihistamines
Sedative antihistamines can help during sleep; non-sedating ones are available as well and may help relieve itching in some patients. Be sure to confirm the correct antihistamine dosage when administering it to a child.
Keep fingernails short
Keep fingernails cut very short – especially for infants and young children. Put eczema mittens on a baby’s hands; your baby still may try to scratch, but not with fingernails.
Wear loose-fitting clothes
Loose fitting clothes can keep the pressure off the skin.
Distraction
Keep yourself busy and your hands occupied so you don’t focus on itching. For children, distract them with games.
Cooling
Cooling can relieve itching. Keep cool packs stored in the refrigerator and place one on itchy areas as needed. Apply a cool compress to the skin or take a cool shower or bath.
If you prefer a bath, stir in colloidal oatmeal, apple cider vinegar or a half-cup of baking powder and bathe for 10 minutes.
Bathing and Moisturizing
- Remember to pat yourself dry and use a moisturizer within 3 minutes of bathing.
- It may be helpful to keep moisturizers or topical medications cool in the refrigerator as well.
- For temporary relief, rub the skin with vinegar water (one tablespoon of vinegar to one quart of water).
Scratch with care
If you must scratch, try stroking the itchy area using the top side of the hand instead of your fingernails.
© 2021 Allergy and Asthma Network
Last updated : 2/6/2023