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Nothing is more frustrating than trying not to scratch your itchy skin, particularly if you have eczema. Try these expert-approved strategies to break the itch-scratch cycle.
“Don’t scratch” is probably one of the best—and worst—pieces of advice an eczema patient can receive. The skin condition, which is caused by an immune reaction that results in dry, red, cracked patches of skin, is made worse by itching. Your nails damage the skin barrier, which then ramps up inflammatory molecules that exacerbate the itch, explains Jonathan Silverberg, M.D., Ph.D., associate professor of dermatology at George Washington University. What’s more, chronic scratching may make you more susceptible to infections, since it's easier for bacteria to invade the cracked skin.
Your best way to reduce the itch is to see your doctor for treatments (prescription or over-the-counter) that address the underlying cause. Although it may not be possible to stop itching once and for all, here are eight strategies that may help you keep your hands off.
Jeffrey S. Fromowitz, M.D., a dermatologist in Florida, recommends holding an ice cube or cool compress on the itchy area. “The cold stimulus interrupts the body’s feeling of itchiness and can help break the itch-scratch cycle,” he says.
One way to control the itch is by using a psychological tool called “habit reversal.” With habit reversal, you recognize the habit, think about times you’re most likely to scratch, then consciously do something different when the itch arises. For example, if you notice that you often scratch while you watch TV, have something to keep your hands busy during that time, such as a stress-relief ball, coloring book or fidget spinner.
Not everyone has the same eczema triggers, but a few common ones include heat or cold; certain fabrics like wool; allergens like dust or pet dander; and scented skincare products or detergents. Silverberg notes that it’s important to recognize these triggers so you can avoid them—or in instances where you can’t, then preemptively treat them.
One way to control the itch is by using a psychological tool called "habit reversal."
Stress and anxiety are eczema triggers for many people. Knowing that certain situations tend to leave you feeling fried and frenzied (and developing a keep-calm plan for such times) can help keep the condition under control. A few tried-and-true strategies: meditation, yoga, sleep and exercise.
Hot water might feel good in the moment, but it can ultimately worsen eczema by releasing itch-inducing compounds, says Fromowitz. Instead, use lukewarm water, which is less likely to exacerbate symptoms.
Stick with a mild, unscented soap, as perfumed products can irritate. After you towel off, apply a liberal amount of moisturizer to hydrate and repair the skin’s barrier.
The repetitive act of applying a nice lotion before bed can be soothing for your skin—and mind, says Silverberg. Try not to become frustrated if the sensation to scratch is distracting when you’re trying to doze off. “That frustration can aggravate the itch and make it even harder to fall asleep,” Silverberg says.
Keep nails as short and smooth as possible.
Although some people with eczema wear gloves to prevent themselves from scratching, Silverberg points out that this might have the reverse effect, since gloves can make hands sweaty (which can make skin feel itchier). A better option: Keep nails as short and smooth as possible. “If you do scratch, you won’t create quite as much damage,” Silverberg says.
Still struggling with persistent itch? You may want to consider light therapy (also called phototherapy), which uses ultraviolet light to penetrate the outer layers of skin in order to minimize inflammatory cells (and thus calm itching).
“It’s incredibly safe, but the downside is that it’s time-consuming,” says Emma Guttman-Yassky, M.D., Ph.D., director of the Center for Excellence in Eczema at the Icahn School of Medicine at Mount Sinai in New York. “Patients have to go two to three times per week for several months, and you start to see results after four weeks.”
For patients who have difficult-to-treat eczema, Guttman-Yassky recommends phototherapy as part of a combination treatment plan alongside moisturizers and topical steroids, in order to clear up the condition and hopefully ease itching.
