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Generalized itchy conditions usually affect adults, such as the elderly itching, winter itching, summer itching or pregnant itching. The itching tends to occur intermittently, in various intensities, and be worse at night or during sleep. Because of repeatedly scratching, skin damages such as scratching marks, bleeding marks, darkening, hardening and thickening, cracking, oozing and even infection can often be found on the body. Doctors will suggest undergo detail physical examination and laboratory tests to find out the underlying causes, and once a cause has identified, the itchy symptom can then be treated successfully. For some individuals who only have an itchy symptom, no obvious skin change and cannot identify a cause, they can still be managed by itch-relief methods.
Skin itching due to internal diseases should manage the underlying causes first, for example lowering the blood sugar in diabetes, so as to relive the symptom completely.
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Traditional Chinese medicine (TCM) has a rich experience in managing skin problems. Skin itchiness is commonly categorized as wind-related problems. From a TCM holistic view, itch development has internal and external origins. Internal factors such as loose striae, damp-heat accumulation, blood deficiency, organ weakness, or meridian disharmonies make the skin become vulnerable and lay a foundation for itch development. When external factors such as weather changes, environmental irritations, improper diet or emotional distress get a chance to further stimulate the skin, skin itching will be triggered. It is claimed that the internal factors are usually associated with blood and qi (vital energy) disturbances, or disharmony between the defense(wei) and nutrient(ying), while the external factors are usually associated with wind irritations. When the external factors are dominant, the itchy conditions are likely to be acute; when the internal factors are dominant, conditions may be lingering and difficult to heal.
TCM treatment for itchy skin focuses on restoring a total balance, and the remedies aim to free blood and qi circulations, remove local irritations, expel toxic wastes out of body, and promote tissue repairing and organ recovery, so as to achieve a comprehensive therapeutic result. Based on individual conditions or syndrome differentiation, physicians will design a unique treatment plan for each patient. TCM external remedies are well enough to relieve simple and mild itchy conditions, while for severe and stubborn cases, it is necessary to treat by a combination of oral and external remedies.
It should be noted that skin itchiness caused by internal diseases such as diabetes is likely to be relapse, and difficult to control, the only way for a long-term relief is to treat the underlying problems, such as lowering blood sugar in the case.
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| Ledebouriella root |
Cicada slough |
Schizonepeta herb |
Herbal prescriptions for itchy skin
Below are common disharmony patterns of generalized itchiness and the anti-itch remedies.
Wind cold attack body surface
Skin itching tends to occur on exposed body parts, which can easily trigger or aggravate by cold temperatures or climatic changes. Individuals usually feel worse at night, especially when taking off their clothing to bed. Other accompanied symptoms include dry skin, aversion to cold, slight fever, the tongue is pale, and the pulse is floating and tense. The remedy should aim to disperse wind and cold, harmonize internal and external body.
Sample of prescription: modified Half Ephedra and Half Cassia Twig Decoction (ma gui ge ban tang)
Wind heat accumulate in skin
Skin itching tends to occur in summer or autumn season, high temperatures or low humidity usually trigger or aggravate the situation. Other accompanied symptoms may be a feverish sensation, slight aversion to wind and cold, thirst, sweating, hard stools, yellowish urine, a red tongue with yellow or dry coating, and the pulse is floating and rapid. The remedy should aim to disperse wind, clear heat and cold, harmonize internal and external body.
Sample of prescription: modified Honeysuckle and Forsythia Powder (yin qiao san)
Toxic dampness accumulate in skin
Itching that mostly affects the anus, scrotum or private part of female. Very often individuals feel hard to resist scratching, and so the local area appears scratching marks, redness, and even thickening and hardening after a long period of time. Rubbing or certain foods can trigger or aggravate the situation. Other accompanied symptoms may be sweating, bad breath, a bitter taste in mouth, smelly vaginal discharges in women, a red tongue with yellow greasy coating, and the pulse is rolling and rapid. The remedy should aim to clear heat, eliminate dampness and stop itching.
Sample of prescription: modified Gentian Liver-Purging Decoction (long dan xie gan tang)
Over-heated blood and abundant wind
Severe generalized itching with a burning feeling, and may have bleeding marks on the skin. Individuals usually feel worse when hot but alleviated when cool. Other accompanied symptoms may include a feverish sensation, irritability, dryness in the throat and mouth. The tongue is red with yellow dry coating, and the pulse is rapid. Individuals are mostly young adults, and likely to develop in spring and summer seasons. The remedy should aim to clear heat, cool blood, disperse wind and stop itching.
Sample of prescription: modified Wind Dispersing Powder (xiao feng san)
Blood deficiency lead to wind and dryness accumulation
Individuals are mostly elderly or weak, flare up frequently and likely to be affected in winter and then alleviated in summer. Skin itching tends to occur from one area to another, worsen at night and disturb sleep. The overall body looks dry and scaly with plenty of scratching marks. Other accompanied symptoms may include fatigue, general weakness, constipation, pale complexion, a pale tongue, and thready and forceless pulse. The remedy should aim to nourish blood, lubricate skin, disperse wind and stop itching.
Sample of prescription: modified Angelica Root Drink (dang gui yin zi)
Liver stagnation and blood deficiency
Skin itching usually triggers by emotional distress. Individuals tend to have a depressed mood, sallow complexion, sighing, irritability, a bitter taste in mouth, pale lips and nails, irregular or missed periods in women. The tongue is pale or darkened, and the pulse is thready and hesitant. The remedy should aim to soothe liver, release stagnation, nourish blood and disperse wind.
Sample of prescription: modified Free and Easy Wanderer Plus (jia wei xiao yao san)
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| Rehmannia root |
Angelica root |
White peony root |
Pregnancy and skin itching
Pregnant women are likely to experience itching, especially in the second and third trimesters. The problem is mostly affected the trunk and lower limbs, aggravates with time, and then quickly goes away after delivery. Some preexisting skin conditions such as eczema, hives or dermatitis can also worsen during the time, pregnant women should first consider the common causes of skin itching before direct linking with pregnancy.
From a TCM perspective, pregnant women tend to develop a yin deficient disharmony, because plenty of essence and blood are absorbed by the fetus and less blood flows to the body surface to nourish the skin. Moreover, development of the fetus can disturb the normal body functioning of the mother, for example affecting fluid distribution function of the triple burner, and leading to damp-heat accumulating on the skin. TCM treatment usually involves activating blood, and physicians are careful in selecting herbs for the pregnant patients, so as to avoid the unnecessary adverse effects to harm their sensitive body and the fetus too.
Below are common disharmony patterns of itching during pregnancy.
Blood deficiency lead to wind and dryness accumulation
Generalized itchiness appears in the middle and late stage of pregnancy. The skin looks dry and scaly, there may also have dizziness, insomnia or dream-disturbed sleep, palpitations, mental fatigue, pale tongue and lips, and a weak pulse. The remedy should aim to nourish blood and stop itching.
Sample of prescription: modified Nourish Blood and Conquer Wind Decoction (yang xue sheng feng tang)
Excess wind and heat with blood dryness
The skin is dry and very itchy, and may also have bleeding marks or a painful feeling. Individuals feel worse in windy and hot environments. Other accompanied symptoms include thirst, yellow and scanty urine, hard stools, a red tongue with yellow coating, and the pulse is floating and rapid. The remedy should aim to disperse wind, clear heat and stop itching.
Sample of prescription: modified Wind Dispersing Powder (xiao feng san)
Stagnated heat in liver and gall-bladder
Generalized itchiness appears in the middle and late stage of pregnancy. The women may have mild yellowish tinged skin, and feel distention and soreness in the rid sides. Other accompanied symptoms include irritability, agitation, insomnia, mouth dryness, or a bitter taste in the mouth. A red tongue with yellow coating, and the pulse is taut and rapid. The remedy should aim to clean liver and purge gall bladder.
Sample of prescription: modified Decoction for Clearing the Liver and Relieving Stagnation (qing gan jie yu tang)
To sum up, the use of anti-itchy herbs is under the guidelines of TCM theories, and will be selected and combined from person to person. Even for patients with similar skin conditions, their herbal prescriptions may be totally different, due to personal experiences of physicians and clinical staging of each patient. In the prescriptions, the herbs can target on different aspects of the body so as to create a comprehensive healing process, such as anti-septic, anti-inflammatory, anti-histamine, calming and lubricating, which are not just for symptom relief but also help eradicate root causes.
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