It demands relief, yet it doesn’t hurt. Making it feel better may actually make it worse. And its reason for being is often a total mystery. No wonder itching—or as science calls it, pruritus—still has medical experts scratching their heads. Around one in ten people suffers from chronic itchiness. For them, and the rest of us, the best defense against the torture depends on its cause. And there are many! Consider:

A neurological issue.
When nerves become damaged or compressed through injury or aging, they can respond by sending the brain an incessant “scratch me!” message, says Arianne S. Kourosh, MD, assistant professor of dermatology at Harvard Medical School. This can affect any body part, but most commonly occurs on the arms, middle of the back, or scalp.

The fix: Antiepileptic drugs and antidepressants have been found to reduce itchiness, as has Botox, which can interfere with a nerve’s ability to relay the scratch signal. Physical therapy, tai chi, yoga, and acupuncture may also help, theoretically by decompressing or reducing the activity of the affected nerve, says Sarina Elmariah, MD, PhD, a dermatologist at Massachusetts General Hospital who studies pruritus.

During bouts of internal inflammation brought on by allergies, autoimmune glitches, or a reaction to medication (like statins, opiates, or even herbal supplements), the body releases defensive molecules that set off varied responses—including itchiness.

The fix: Cortisone creams or oral antihistamines can extinguish the flame of the itch; drugstore moisturizers and protectant skin creams can prevent it from reigniting. If your meds are to blame, a new prescription may be all you need.

Intense stress can influence nerve function, which can lead to pain or a relentless itch, Elmariah says. Stressed-out scratchers have been known to scrape their skin raw.

The fix: Treatment for this type of itch addresses both the mind and the body and can include biofeedback, meditation, or acupuncture, as well as cognitive-behavioral therapy and medication.

A range of unrelated conditions that affect the kidney, liver, thyroid, and blood all may trigger obsessive scratching. So can autoimmune disorders, diabetes, and skin cancer.

The fix: If you have one of these issues as well as an itch, see a derm, who may prescribe ointments or oral treatments. Elmariah also suggests yoga, meditation, or tai chi to reduce stress.

Insect bites.
When a mosquito gets you, your immune system releases chemicals, including histamine, that prompt redness, swelling, and itching.

The fix: If your bite stays puffy and inflamed for a prolonged period, you’re likely having a heightened allergic reaction. A cortisone cream or an over- the-counter antihistamine should help, says Kourosh. Constant scratching may delay healing, so try holding an ice cube or pack on your bite: Cold temps make it harder for the itch-triggering nerve to communicate with your brain (heat has the opposite effect)—plus, your scratch-happy fingers will stay safely occupied.


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