Generalized Pruritus (Itching)

Generalized pruritus (i.e., generalized itching) is not an uncommon condition and can be quite maddening to the individual suffering from it. It may be associated with hives (i.e., urticaria) and/or angioedema (swelling). The itching is usually described as either intermittent or chronic itching in various parts of the body or it can be intermittent or chronic itching of the entire body. In some individuals, the itching only lasts for a couple of days. In other individuals however, the itching can last much longer. It is not atypical for the itching to lasts weeks, months, or in some cases, years. The severity of the itching can be anywhere from mild to very severe. Many pruritus sufferers complain that the itching is so bothersome that it affects their quality of life. Regardless of how severe the itching is, one should seek medical care from a board certified allergist, like the ones at Black & Kletz Allergy, if the itching has occurred for more than 6 weeks so that the cause of the itching can be explored and hopefully identified. Pruritus is also generally easier to treat if the cause of the itching has been identified.

The diagnosis of pruritus is based solely on what the individual tells the allergist during a comprehensive history and physical examination. It is however important for the allergist to try to identify a cause of the itching as there are many known causes of pruritus. If the itching has been present for less than 6 weeks, the pruritus is said to be “acute.” Most of the time with acute pruritus, no testing is needed and the patient is treated with medications to alleviate the itching. In instances of “chronic” pruritus, where the itching has been present for more than 6 weeks, allergy tests and/or blood tests may be indicated in order to try to find the cause of the itching.

Some of the more common causes of pruritus may include food allergies, medication allergies, iron deficiency anemia, hepatitis B, hepatitis C, thyroid disease, chronic lymphocytic leukemia (CLL), diabetes mellitus, lung cancer, uremia (i.e., kidney damage), xerosis (i.e., dry skin), and pregnancy. It is important that a cause be identified so that either the allergen is avoided or treatment can be directed at the underlying systemic condition responsible for the itching.

The treatment of pruritus is always aimed at treating the underlying condition responsible for the itching. For example, if an individual is found to have hypothyroidism as the cause for the itching, it is prudent to treat the thyroid disease and the itching should go away. If no identifiable cause can be detected; the treatment then is aimed at alleviating the itching itself. There are a variety of medications that can be utilized in order to treat the itching. Some of these medications may include antihistamines [e.g., Benadryl (diphenhydramine), Atarax (hydroxyzine), Claritin (loratadine), Allergra (fexofenadine), Zyrtec (cetirizine), Xyzal (levocetirizine), Clarinex (desloratadine)], H2 blockers [e.g., Pepcid (famotidine), Tagamet (cimetidine)], and leukotriene antagonists [e.g., Singulair (monteleukast)]. Rarely, oral corticosteroids may be used for refractory cases. Topical ointments and/or creams have also been used with some success in certain patients.  The length of time that a patient needs to be treated varies greatly from individual to individual.  In the majority of cases, medications may only be needed for 1 or 2 weeks, but can be necessary is some patients for several years.  Other treatments such as UV light treatments have been used with varying degrees of success.

The board certified allergy specialists at Black & Kletz Allergy have 3 convenient locations with on-site parking located in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. The Washington, DC and McLean, VA offices are Metro accessible and we offer a free shuttle that runs between the McLean, VA office and the Spring Hill metro station on the silver line. The allergy doctors at Black & Kletz Allergy are extremely knowledgeable regarding generalized pruritus as well as other skin disorders such as hives, eczema (i.e., atopic dermatitis), and swelling episodes. We diagnose and treat both pediatric and adult patients. In addition, we treat patients with environmental allergies, medication allergies, insect sting allergies, asthma, sinus disease, eosinophilic conditions, and immunological disorders. To schedule an appointment, please call any of our offices or you may click Request an Appointment and we will respond within 24 hours by the next business day. We have been servicing the greater Washington, DC area for more than 5 decades and we look forward to providing you with first-rate state-of-the-art allergy care in a welcoming and professional environment.