Do you itch more when you are upset?

Cynthia Bailey, MD|February 11, 2013

dog emotions and scratching Over the years, I’ve observed that when a person is under emotional stress they often suffer more from their existing physical ailments. The ailments are not necessarily worse, but the suffering can be. As a dermatologist, I notice that patients tend to itch more from skin problems when their lives are in a difficult emotional place. 

There will be more signs of scratching, their itchy skin keeps them up more at night; I can see their anxiety building, causing more suffering overall.

It's part of what we call the “itch scratch cycle”; itching causes scratching, which causes anxiety and changes in the skin, then there’s more itching, scratching, and anxiety and it just keeps winding up.

We can name it, but we haven’t been entirely clear on the “chicken and an egg” aspect of the cycle; meaning, is it always that the itching causes the anxiety, or could the anxiety be fueling the itching? A new study in the British Journal of Dermatology suggests that a negative emotional state can make your itch worse. The authors have shown that your emotional state can influence your perception of itch. The authors used movie clips to induce a “negative” or “positive” emotional state in a group of healthy women (they watched Happy Feet for a “positive” emotional state and a violent scene from Irreversible to create a “negative” emotional state). At the same time they used laboratory methods to induce itch and pain on the subjects' skin. They demonstrated that subjects watching the violent film reported much higher scores for both pain and itch compared with those watching the positive film. We already have scientific evidence that pain perception is impacted by emotional state but this is the first scientific evidence connecting itch and emotional state. For me as a physician, it means that helping my patients improve their emotional well-being is an important part of treating their chronic itch. Because I’ve observed this connection between itch or pain (e.g. shingles) and emotional well-being/anxiety for years, I’ve routinely included lifestyle counseling in my treatment of skin problem that cause these symptoms. I like to think of emotional well-being as a “volume control” for pain and itch “signals” that are being sent in by the nerves - improving emotional well-being turns the "signal" volume down! What are some of the lifestyle changes I’ve found helpful for my patients with chronic itch or pain? If you are suffering from chronic itch or pain, aim for activities that help you de-stress, and say “no” more often to activities that have a “negative” impact on you emotionally. You have to figure out what this personally means to you, but in general, Activities that help to de-stress and to promote a sense of “well-being” include:

  • Spending time with friends and people who are easy to be with.
  • Exercising daily.
  • Spending quiet time in nature.
  • Getting a good night’s sleep every night.
  • Taking the time to eat healthy meals.
  • Taking time every day for a hydrating bath or shower followed by application of a really good skin moisturizer. (Well-hydrated skin sends fewer “signals.”  Click here for my dermatologist’s advice for how to do this well).
     
     
  • Meditating, practicing yoga, going to church, or whatever it is that helps to connect you to something deeply comforting.
  • In really difficult cases, I would recommend biofeedback (a form of therapy to help control the physiological experience of stress such as heart rate, blood pressure, and breath) and acupuncture.
  • For my patients with really complex emotional issues I recommend counseling to help ease their burden.

Stressful activities to consider limiting because they may create “negative” emotions include:

  • Spending time with people who are difficult to be with.
  • Pushing to get too much done.
  • Reading, watching, or listening to violent or emotionally upsetting media.
  • Spending too much time in stressful, jangling places.
  • Constantly putting yourself at the bottom of your list of priorities for the day.

I think these are good lifestyle recommendations to boost the sense of well-being for all of us. If you suffer from a skin problem with chronic itch or pain, it now becomes part of your treatment too. Do you have any other lifestyle ideas to improve emotional well-being to help treat chronic itch or pain? Reference: van Laarhoven AIM et al. Role of induced negative and positive emotions in sensitivity to itch and pain in women. Br J Dermatol 2012 Aug;167:262. Photo: Thanks and Gratitude to Nick Mitha

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