Soothing the Itch - Q and A with Dermatology Nurse Paula Oliver

Having itchy skin might sound like nothing but it can have a massive impact on our quality of life. No one wants to spend half the night lying in bed - scratching. Apart from the general irritation and sleep disturbance, scratching can lead to skin damage. The upper layer of our skin is actually very sensitive and continual rubbing, picking and scratching can take chunks out of our main barrier to bacteria and infection. 

Known in dermatology as pruritus, the British Association of Dermatologists (BAD) estimates that itchy skin affects up to 9% of the population at any one time. 

Getting to the bottom of itching is important. With that in mind, nurse Paula Oliver has been answering our questions on how to soothe the itch.

How many times a day do I need to be moisturising my body? I suffer from dry, itchy, flaky skin- especially the tops of my arms, which can become bumpy as well.

The number of times you need to moisturise your skin and the correct application is a very individual thing. It sounds like your skin is quite dry, so think about the type of moisturiser you use; a cream is sometimes helpful in the morning as it’s less greasy so more cosmetically acceptable but perhaps at bedtime you could use something like a moisturising gel or ointment which are more oil-based and greasy. We often advise someone who has eczema or psoriasis to apply their moisturiser up to four times a day but we do appreciate that the routine of moisturising has to fit into your lifestyle.

I’ve got an itchy scalp. It doesn’t matter which shampoo I use. I understand it’s quite common as you age. Is there a cream to rub into the skin which doesn’t leave the hair looking greasy?

 Scalp pruritus (itchy scalp) is a common but miserable condition. Dandruff and seborrheic dermatitis are the most common causes. Once a week, try using a greasy moisturiser (or coconut/olive oil) and massaging it into the scalp. Then apply a shower cap and leave it on for a couple of hours before shampooing with a medicated shampoo. It’s a little messy but maybe worth a try when you have a quiet evening to see if it improves the itch.

Are there any foods that are good to eat or even help with dry itchy skin?

We would always recommend a healthy diet with plenty of fruit and vegetables and to ensure a good fluid intake of at least two litres a day. We do know that fatty types of fish like salmon containing omega-3 fatty acids can reduce inflammation and help to keep the skin moisturised but in general, a good varied diet is probably the best way forward.

I suffer from Keratosis Pilaris – it really affects my confidence. I use an expensive moisturising foundation to cover and moisturise. Is it better to use two separate creams (specific cream and covering foundation?) If so, what is best to relieve my symptoms?

Keratosis Pilaris is a very common, harmless skin condition where small bumps appear on the skin commonly on the upper arms, thighs, buttocks and cheeks. It can still clear up in adult life! I understand how it can make you feel, however, as I have spoken to many patients who really find the condition embarrassing. Unfortunately, we have no cure but we can help manage the symptoms by doing certain things. I wouldn’t suggest that you need to purchase expensive foundations to cover. It’s best to use mild or non-perfumed soaps when washing or a non-irritating cleanser. You can gently rub the skin with a washcloth or exfoliating mitt but only gently!

 I have what I think of as underlying itchiness all the time. If I scratch, I itch. Is there anything I could take or use to alleviate this?

It does sound like you have dry sensitive skin and perhaps mild eczema. With dry skin and eczema, it’s very common for people to find themselves in the ‘itch scratch cycle’. Sometimes the itch gets so bad that we scratch it until it bleeds…which can make the skin worse. I would recommend that you avoid any perfumed products on the skin when washing or moisturising. Use non-perfumed products and apply moisturiser regularly (at least twice a day). If you get the urge to scratch, reach for your moisturiser and apply it in downward strokes - don’t rub or massage it in as this can increase the itch. Wool or synthetic fabrics are best avoided - cotton clothing will potentially be more comfortable.

What is the reason for my dry itchy shins? In the winter, tights or any items of fitted clothing aggravates them more so floppy trousers are all I can wear.

As we age, our skin becomes drier. We don’t produce as many natural moisturising factors in the skin so we need to increase our moisturising regime. As we move into the autumn months, our home environment also changes; dry air combined with indoor heating and double-glazed windows can lead to skin dryness. I would suggest that come September time, increase the amount of times you moisturise your skin and avoid perfumed products which will lead to further dryness.

I get very itchy skin around my ankles and on the tops of my feet. I use E45 cream which helps a bit. I wondered if there is a better moisturiser?

As well as moisturising your skin in the morning with your cream, it may be worth trying a slightly greasier gel or ointment overnight.

What product would be best for dry itchy skin around my ears and the sides of my face?

Avoid using soap products in these areas and use a soap substitute for cleansing your skin; soap products can lead to further dryness and disrupt our natural skin barrier. You may find that using a cream formulation is more effective than a lotion which is more water-based with less lipid (fat) content.

My problem is an itchy scalp. I’ve never noticed it before and I am not sure what to do about it. I have changed my shampoo and moisturiser but still no help. Having spent half term with the grandchildren, I even checked for ‘nits’ any advice is appreciated

You did the correct thing in checking that you didn’t have any uninvited ‘guests’ in your hair following the visit from the grandchildren. It may be worth trying a special shampoo that you can buy over the counter for dry itchy scalps to see if this will calm things down.

I seem to have a permanent itchy back. There is nothing I can see on the skin except for some broken veins. I have invested in a back scratcher which brings temporary relief, and how on earth do I get cream to my back?

There is nothing worse than a relentless itch and in particular, one that you can’t get too. I am not sure if you have a bath or are able to use one but sometimes lying in a warm/tepid bath for ten minutes with a non-perfumed bath emollient can help (taking extreme care though not to slip at it makes the bath really slippery). If not, another top tip for applying moisturiser to your back is to purchase a small radiator paint roller from the hardware store. Put some of your moisturiser in a saucer or plate and use the roller to apply over your back.

I have tried a free sample of the itchy and dry lotion produced by Balneum and have found it so helpful for my dry and flaky skin. I had a hip replacement and between worry and loss of appetite, I lost a stone and a half and my skin has suffered. I also have varicose eczema and wondered if this is the best product to use on it. I have flare-ups but by the time I see my GP they have subsided.

The product you mentioned is suitable if your skin is prone to varicose eczema. It’s also important to wash your legs with a non-perfumed or non-soap product as these could lead to further dryness. Perhaps a couple of times per week at bedtime, you could try using a greasier ointment to moisturise your legs.


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Last revised: 19 August 2020
Next review: 19 August 2021