Having itchy skin might be seen as a mild irritation rather than a life-altering condition but research published earlier this year showed that those with chronic pain have a similar reduction in quality of life as those with chronic pruritis.
The study, published in summer in the Archives of Dermatology was a cross-sectional analysis of patients with chronically itchy skin and those with other chronic conditions such as persistent pain syndromes.
Recognising Suffering fron Skin Disease
Chronic pruritis can be an extremely complex condition, where patients experience subjective symptoms that cannot be objectively assessed and which often effect how they lead their lives and their enjoyment of life. Skin conditions, whilst often dismissed as being unimportant or not as serious as other health issues, frequently lead patients to feel depressed. This is further exacerbated by a reluctance to recognise suffering caused by the condition, especially where a cause cannot be found or where patients report subjective symptoms unverifiable by physicians.
Depression itself can make physical symptoms feel worse, as well as affecting how well a patient is able to care for themselves. Maintaining a prescribed drug regimen, or keeping on top of personal hygiene may be a struggle for some patients suffering from depression and this can adversely affect the health of the skin, in some cases leading to infection and further itchiness.
A Poorly Understood Condition
Unlike many pain syndromes and conditions causing a reduction in the quality of life for a patient, chronic itchy skin has not been studied in much depth and so there is a poor understanding of pruritis and how it affects people.
Conditions such as eczema, allergic dermatitis, psoriasis, acne, rosacea, and dry skin can all cause the skin to be itchy, whether intermittently or for a prolonged period of time if the skin problem is not able to be brought under control or well-managed through natural lifestyle interventions for healthy skin, removal of irritants, dietary protocols, or pharmaceutical interventions.
The study carried out in Atlanta included patients seen at the Emory Dermatology Clinic, Emory Spine Center, and Emory Center for Pain Management. Those suffering from chronic pruritis were included if they had experienced symptoms lasting six weeks or more and seventy-three patients were involved in this group during the study, along with one hundred and thirty-eight patients with chronic pain.
The researchers asked patients how much of their life expectancy they would be willing to give up in order to live without pain or pruritis, with utility scores ranging from 0 (death) to 1 (perfect health).
A Need to Improve Support
Sufferers of itchy skin had a mean utility score of 0.87 compared to 0.77 (with ranges of plus or minus 0.27 and 0.31 respectively). These results demonstrated to the researchers that chronically itchy skin was viewed as a serious issue for patients, with many willing to live shorter lives if only to be free of the condition.
The more severe the symptoms were the higher the reduction in quality of life, and the same was true for patients who were single. This lack of support network for patients is a clear indicator that more can, and needs to be done to help patients cope with their condition, along with better education for families so that they can continue to help patients with chronically itchy skin.
Seema P. Kini, MD, MSCR; Laura K. DeLong, MD, MPH; Emir Veledar, PhD; Anne Marie McKenzie-Brown, MD;Michael Schaufele, MD; Suephy C. Chen, MD, MS. The Impact of Pruritus on Quality of Life: The Skin Equivalent of Pain, Arch Dermatol. Published online June 16, 2011. doi:10.1001/archdermatol.2011.178.