The Relationship Between Nerve Damage and Itching

You may have experienced itching from a minor healing wound in the past; in this case, it is a sign that the damaged skin is healing. However, when it comes to more severe burns, you may experience a more chronic itching that can be difficult to soothe. One type of itching, called neuropathic itch, is itching directly related to nerve damage.  

Neuropathic itch can be distressing, both physically and mentally. This article will discuss everything you need to know about neuropathic itch and how it may affect you after a burn injury.  

What is Neuropathic Itch?  

Researchers aren't exactly sure what causes neuropathic itch to develop. Neuropathic itch occurs because of nerve damage underneath the skin. The prevailing theory is that lesions on neurons lead to this type of discomfort.  

Neuropathic itch is one presentation of neuropathic pain. Neuropathic pain can cause discomfort that presents many ways, such as: 

• A sensation of burning or freezing

• Tingling or "electric shock" feeling

• Pain

• Numbness

• Prickling

• Increased or decreased sensitivity

• A sense of wetness or crawling skin

Neuropathic itch can sometimes cause the itch, but it is not the only way neuropathic pain can present. Often, there is a combination of both dry skin and potentially a neuropathic component. If the itch is caused by dry skin, this is often easy to tell. If adding moisture doesn’t work, then you may be presented with a neuropathic itch.

Itching can profoundly affect our quality of life and, further, create reverse effects if the scratching causes wounds to reopen. If you're experiencing itch, you most certainly will want to contact your medical provider to ask for recommendations for relief.

The Relationship Between Burn Injuries and Itchy Skin   

While most of the body's itching sensation is caused by a histamine reaction to outside agents, burn scars aren't the same. Most of the time, itching may be a normal part of the healing process. But in the case of neuropathic itch, it is due to the result of abnormal nerve signals resulting from the trauma caused by the injury. 

The body knows something is wrong at the burn's site. But it doesn't learn how to communicate that to the brain. So it miscommunicates internal itch — damage to the neurons — as external itch. This leads to these sensations that we have detailed above.  

How To Relieve Burn Scar Itching

Since neuropathic itch isn't only a matter of actual irritation in the skin itself, it can be challenging to get relief. Topical creams and antihistamine ointments won't always provide relief since they don't reach the source of the discomfort, the nerves. This, in turn, may lead to emotional distress because you quite literally can't scratch the itch.

The good news is that there are some options for relief. These range from minimally invasive options such as massage or rubbing lotion into the skin more invasive options for unrelieved itching that may include surgery or laser treatments.

Controlling Your Environment

The first step to understanding your itch is understanding how your environment affects it. If you're in a hot, humid climate, consider how this may be causing the itch. Try finding yourself a cooler, drier environment to understand if this is bringing relief. If you're located in a drier climate, consider if adding a thick moisturizer to your routine helps.

While immediate cooling of the skin may seem like a good idea, it can be very damaging. Using cooling with ice packs can decrease circulation, and could even result in a cold-induced burn injury. Overall, prolonged use of hot or cold applications can lead to further skin damage or graft loss.

If controlling your environment doesn't work, there are other options that you can explore with a medical professional.

Here Are Other Options For Neuropathic Itch Relief After A Burn Injury You May Explore:

• Moisturizing itch lotion (not scented lotion, which contains alcohol) do not have to be specifically formulated for itch. There is some form of alcohol in most of these products but scented lotions have a higher alcohol content.

• Pressure garments: Pressure garments reduce blood flow to burn scars, thus reducing sensation. It is best to have a pressure garment fitted by a professional at a burn center for the best effectiveness.

• Scar Massage & Stretching: Massaging and stretching for scars can help desensitize and soften skin. Stretching several times a day, combined with moisturizing before stretching, can help increase mobility by breaking up scar tissue and make you more comfortable. Massage can also help prevent scars from becoming raised (known as hypertrophic scars) and also may help prevent them from sticking to underlying tissues and muscles.

• Topical anesthetics: Topical application of an anesthetic ointment may reduce the itching.

• Oral medication: Some oral anti-itching medicines, such as Zyrtec, Benadryl, or a prescription for Atarax (similar to Benadryl) to provide relief. While they may provide temporary relief, they may cause some bothersome side effects, such as sedation. Your doctor may also prescribe a medication such as gabapentin, also used for those with seizures. In addition, some doctors may prescribe anti-nausea and anti-depression medication options. It is important to note that while some anti-itch medication is available over the counter, always consult your doctor before taking any medications.

• Surgery: In severe cases, patients may need to receive surgery to reduce scar tissue and find relief from the neuropathic itch.

• Laser treatments: Laser treatments may be another practical option for severe, chronic neuropathic itch.

Interested in learning more about burns and itching? Check out other resources here.

Will Burn Itch Go Away?  

Ultimately, there is no way to answer this question. We recommend reaching out to your provider and letting them know what you're experiencing to find the best treatment method. They'll likely provide you with one or more of the above methods to try and alleviate your itch.