Itch-Scratch Cycle

How To Break The Eczema Itch-Scratch Cycle [Step-By-Step Guide].

Proton health eczema itch image depicting moisturiser
The eczema itch is pretty frustrating. It can come and go frequently, and at times become overwhelming. Here, we’ll explore the process in further detail and share evidence-based strategies to bring it under control. The good news is that if these techniques are used, they’ve been shown to cure chronic eczema in 90% of individuals. Read on to find out more!

The Eczema Itch

As individuals with eczema, we’re more likely to be caught up in intense itchy periods. Over many years, we become accustomed to the process and sometimes even forget that we’re scratching! But sadly, this itching can do a lot more underlying damage.

A group of researchers wanted to explore these effects. They did this by using a scratching tool on a group of patients with ‘normal’ skin, i.e. without eczema. Over several weeks, they consistently used the device on these participants and looked at their skin under a microscope. The results were staggering because their skin looked exactly like eczematous skin. 🤯

That’s right, even those without eczema end up with eczema-appearing skin if they scratch. So it turns out that scratching actually causes a lot of damage.

And it’s all do to with the itch-scratch cycle…

The Eczema Itch-Scratch Cycle

The itch-scratch cycle is a damaging process whereby dry skin from eczema increases the chance of itching. And, of course, when we then experience this itch, we begin to scratch. Scratching leads to further skin damage and dryness, so the process continues.

There are 4 steps involved in the Itch-Scratch cycle:

Step 1: Dry Skin - this is caused by eczema. Which leaves our skin less hydrated due to an issue with our skin barrier.

Step 2: Itch - if the skin is dry, it makes itching more likely. This is because we’re more likely to experience skin irritation, which brings on that itchy feeling.

Step 3: Scratching - because our brain sends us signals that we’re itchy, we end up scratching. This leads to further skin damage due to friction and shedding skin cells.

Step 4: Eczema - This skin damage leads to worsening eczema. In turn, our skin becomes even drier, and the process continues.

Notice how this process can become an infinite loop. Over time, this causes what is known as chronic eczema. This is the pigmentation of the skin resulting from constant scratching and can be challenging to overcome. Fortunately, there are evidence-based techniques to break and reverse these skin changes.

Breaking The Eczema Itch-Scratch Cycle

This process requires a coordinated strategy to tackle. Simply using emollients alone won’t tackle the process. Nor will forcing yourself to stop scratching because the evidence suggests that we even itch during our sleep. Instead, it’s essential to appreciate and tackle all four stages and use them together:

Stage 1 - Tackling Dryness

This involves applying emollients to act as a second skin. By reducing dryness, we’re preventing skin damage and helping to dampen the itch sensation.

Stage 2 - Reducing Itching

Flare-ups can leave our skin vulnerable to bugs. Which can cause infections and heighten the itch response. By using steroids, skin damage is reduced, and the urge to itch is considerably less.

Stage 3 - Habit Reversal

The itching sensation can become so great that we end up scratching. But, unfortunately, this is the stuff that does the real damage. So we can use habit-reversal techniques to help prevent itching.

One of these techniques is by using a competing response. The idea is to use a less harmful response to an itch. This helps break the habit of itching by doing something else, like clenching your fist or turning the ring on your finger.

Stage 4 - Eliminating Stress

The final stage to dampen the entire cycle is stress, which has been linked with itching. Techniques like mindfulness, relaxation therapy and muscle relaxation are great tools to boost mood and reduce the itch sensation.

The Proton Health programme provides a structured method to break this process. We begin by creating awareness by helping you track your itch in greater detail. We’ll then guide you through the above stages to conquer the cycle for good.

Further Tips

In addition to the four stages, there are other tips you can do to reduce the impact of the process.

  • Using anti-histamine medications that reduce the chemical histamine that leads to itching.
  • Using stress management techniques like mindfulness and cognitive behavioural therapy within the app. Our stress reduction toolkit includes various activities like meditation to help cope with stress and promote healing.
  • Avoiding your eczema triggers. This includes irritants such as soap or perfume, allergies (e.g. dust mites), and extremes of weather.
  • Using the guided intervention sessions within the Proton Health app. These use mindfulness and relaxation therapy to reduce the brain’s urges to itch.
  • Placing a cool material on itchy areas.
  • Tracking your skin and itch regularly. Simply observing your symptoms has been shown to reduce them via a process known as the Hawthorne effect.

Where Next?

The itch-scratch cycle is something that’s often formed over a long period. It’s essentially a habit created whenever we experience an itch. So equally, there’s a need to use different techniques to break this habit and reverse it with more healthy behaviours.

Keep an eye out for these sessions within the Proton Health programme for a structured process to break this cycle.

August 1, 2022
by 
Dr Noreen Akram
Proton Health Programme
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