Chronic Pruritus: Practical Ways to Manage Long-Term Itching

Do you have itching that won’t quit for weeks or months? That’s chronic pruritus — persistent itch lasting longer than six weeks. It’s not a single disease but a symptom with many causes. This page gives clear, useful steps you can try now and explains when you need medical tests or specialist care.

Common causes

Start by thinking whether the skin looks normal or shows rashes. If the skin is clearly inflamed or scaly, common causes include eczema, psoriasis, or contact dermatitis. If the skin looks normal, itching can come from systemic issues (liver disease, kidney disease, thyroid problems), neurological causes (nerve damage), or psychiatric factors (stress or anxiety). Some medicines cause itch as a side effect. Older adults can get chronic itch with no obvious cause, so testing helps rule out hidden issues.

Practical treatment and care

Basic skin care helps a lot. Use a gentle, fragrance-free cleanser and pat your skin dry. Apply a thick moisturizer right after showering to lock in moisture. Lukewarm showers are better than hot ones. Wear breathable fabrics like cotton and avoid scratchy wool. Keep nails short and use cold compresses or a menthol cream for quick relief when you feel the urge to scratch.

Over-the-counter options can help: plain emollients, 1% hydrocortisone for small inflamed spots, and oral non-sedating antihistamines during the day or sedating ones at night if itch wakes you up. For stubborn cases, doctors may prescribe topical steroids, calcineurin inhibitors, or systemic medicines such as gabapentin, pregabalin, low-dose antidepressants, or newer targeted drugs for specific conditions. Phototherapy (narrowband UVB) is another option when other treatments fail.

Diagnosis matters. A doctor will take your history, check your skin, and often order basic blood tests — CBC, liver and kidney panels, thyroid tests, and glucose. Depending on results, they may test for hepatitis, iron status, or refer you for a skin biopsy or neurology consult. Finding the cause guides the right treatment and prevents unnecessary use of medicines that won’t help.

When should you see a doctor now? Seek help if the itch is severe, wakes you at night, causes skin damage from scratching, or comes with weight loss, fever, jaundice, or swollen lymph nodes. If multiple over-the-counter measures don’t help within a few weeks, a dermatologist can offer targeted treatments and tests.

Living with chronic itch is frustrating, but many people get meaningful relief by combining good skin care, trigger avoidance, and the right medical treatment. If you want, I can list specific moisturizers, safe OTC options, or questions to bring to your doctor.