Psychogenic pruritus
(Diseases)
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What is Psychogenic Pruritus?
This condition is known by several names, including neurodermatitis, psychogenic itch, or functional itch disorder. It is a medical condition characterized by persistent itching of the skin, where psychological factors play a significant role in triggering, aggravating, or intensifying the itch.
It is classified as a form of chronic pruritus, although the exact cause of the itch is not fully understood by psychiatrists or dermatologists. However, both psychological and pharmacological treatments are effective in reducing symptoms.
What Are the Symptoms of Psychogenic Pruritus?
- Itching is experienced as an urge to scratch and is often accompanied by visible scratches on body parts easily reached by the hands, such as the upper and lower limbs,abdomen, scalp, neck, face, and upper back.
- What Are the Causes of Psychogenic Pruritus?
- Itching may occur in individuals with dermatological diseases, but there are several psychological andneurological disorders associated with psychogenic pruritus, including:
– Central Nervous System Disorders: resulting from nerve cell damage.
– Psychiatric disorders, such as depression, anxiety, and obsessive-compulsive disorder.
– Somatoform dissociation: disorders affecting integrated functions like consciousness, memory, identity, or perception of the environment. Itching is also considered one of the associated symptoms.
- How Is Psychogenic Pruritus Diagnosed?
- The physician collects the medical history and then performs clinical, biological, and imaging assessments. Diagnosing psychogenic pruritus is complex and requires precise criteria to avoid misdiagnosis. These criteria include:
- Three Mandatory Criteria:
1. Localized or generalized itching.
- 2. Chronic itching lasting more than 6 weeks.
- 3. Lack of an identifiable physical cause for pruritus
- Three Out of Seven Additional Criteria Must Also Be Met:
- – Temporal relationship between the itch and life events with psychological impact.
- – Changes in itch intensity related to stress.
- – Night-time fluctuations in itch intensity.
- – Increased itch during rest or inactivity.
– Coexisting psychiatric disorders.
– Improvement of itch with psychiatric medications.
– Improvement of itch with psychological treatments.
- How Is Psychogenic Pruritus Treated?
- Treatment depends on the severity of the condition. It must be clarified during the initial consultation that the itch is not caused by a dermatological issue but may be linked to brain function. There are no specific clinical trials for treating psychogenic pruritus, but psychiatric medications can help relieve symptoms.
- Pharmacological Treatment:
Anxiolytics and antidepressants.
Antipsychotic medications.
- Anticonvulsants.
- Psychological Therapy: A three-levelapproach is proposed:
- Organic Level: Treating scratches andlesions caused by persistent itching.
Emotional Level: Providing emotionalsupport and behavioral therapy.
Cognitive Level:Improving the patient’s understanding of their condition and encouraging healthy attitudes toward skin cleansing and the use of alternatives to scratching.Cognitive Behavioral Therapy (CBT) can help break the itch-scratch cycle. Chronic itching may increase anxiety levels, as constant focus on the sensation of itching worsens psychological stress and reduces quality of life.
How Can Psychogenic Pruritus Be Prevented?
- There are no specific preventive methods, but general recommendations include:
- Avoiding irritating factors.
Skin dryness can be prevented through consistent use of moisturizers.
What Are the Complications of Psychogenic Pruritus?
With chronic itching, the skin may become thickened and hyperpigmented. Patients often use their nails for scratching, and some may resort to other tools, which can be painful and lead to infections.
Frequently Asked Questions:
Is Psychogenic Pruritus Contagious?
