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What Causes Itching in a Burned Patient and How to Treat it (Part I)

Itching is the feeling or sensation that leads to the desire to scratch. Itching is a normal part of the healing process and most patients recovering from burn injuries experience itching at some point during their recovery. The itching sensation happens due to the activation of sensory neurons that have their peripheral nerve endings situated on the surface of the skin (Stein, 1983).

There prevalence of itching to happen post burn is high; it initially affects more than 90% of burned patients (Carrougher et al, 2013). When the skin is burned, the oil glands (Pilosebaceous glands) location in the skin will be damaged. These gland are responsible for secreting an oily material (sebum) that lubricates the skin and keep it moist. As a result of the lack of these glands in the healing and scar tissue, the skin will be dry leading to the sensation of itching that can be problematic and distressing to the patient.

The severity of itching varies from one patient to another; the frequency of itching and its intensity may not be related to the severity and size of the burned area. Itching may be so severe that it may interfere sleeping, eating, working, moving and the quality of life of the patient. Anything that increases the temperature of the body may lead to an increase in the itching sensation (due to an increase in the histamine release which is one of the mediators of itching) such as physical activities including sports and exercise.

Itching is usually worse at night due to decreased movement and pain making falling asleep more difficult. Itching may increase in areas where a skin graft is used to treat the burned area as well as in the donor area where the graft is taken from. Scratching due to continuous itching may lead to beading and opening of the healing areas which are fragile making it more liable for infection. The onset of scratching to the point of bleeding is usually linked to pruritus (chronic or long lasting itchiness) and specific personality type (Gauffin et al, 2015). Patient with thick scars, at a young age and with dry skin are more liable for post burn itching (Carrougher et al, 2013). Itching usually improves as the healing process proceeds and becomes less over time.

 

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.