Itching (pruritus) in children

What is it about ?

Pruritus is a tickling, itchy sensation that makes you want to scratch. Your child may be itchy in one place or all over his body.

Itching in children can have a variety of causes and can appear with or without skin lesions. Skin damage can also be caused by scratching.

Causes of pruritus in children

• Atopic eczema : itchy rash, mainly in the skin folds, face, neck and eyelids. Over time, the skin can also become thicker and rougher. Atopic eczema is often associated with asthma, hay fever and food allergies. Atopic eczema often begins in childhood. Usually, the disease affects several members of the family.
• Urticaria : raised spots (papules), small or very large, which appear quickly and are accompanied by itching. They appear and disappear, from one place to another, and can develop over a large part of the body. Acute hives (lasting less than 6 weeks) are most often associated with infections.
• Scabies : raised plaques (papules) and blisters which itch especially in the evening and at night. When analyzing the palms of the hands and the soles of the feet, we can observe characteristic furrows.
• Lice head: Where lice bite, itchy bumps (nodules or papules) form. If you look closely, you can see the lice. Lice eggs (nits) stick strongly to the hair.
• Pinworm type worms : itching around the anus, especially during the night, and can disturb the sleep of the child.
• Bacterial infection in the anus: itching, intense redness and pain around the anus.
• Varicella : raised plaques and plaques that quickly turn into itchy vesicles. They appear, disappear and reappear elsewhere. Chickenpox is often accompanied by fever.

Allergies

In summer, itching can be a symptom of hypersensitivity to light. A allergy due, for example, to citrus fruits, strawberries and cocoa, can sometimes trigger, in its mildest form, only itching. A pollen allergy is sometimes accompanied by itching in the ears.

The itchy skin disease called mastocytosis occasionally occurs in children and goes away on their own.

How is the diagnosis made?

The doctor makes the diagnosis based on the appearance of the skin and the location of the pruritus (localized or generalized itching).

What can you do ?

Try to prevent your child from scratching at the lesions, as this can cause an infection. Make sure your child always has their fingernails trimmed as flush as possible. There are also anti-eczema onesies or mittens to prevent it from scratching.

• You can treat the dry skin with a moisturizer or ointment, on sale in pharmacies. Limit baths, as they dry out the skin even more. Use fragrance-free, hypo-allergenic skincare products and shower oil instead of soap.
• You can relieve a hot, itchy skin by applying a cold compress or mint cream.
• You can effectively treat head lice washing the hair every 3 to 4 days for two weeks, and combing it afterwards with a lice comb. Do this until you no longer see any lice or nits on the comb.
• If your child has the scabies, you must wash clothes and sheets. The doctor will also prescribe treatment.

What can your doctor do?

Treatment depends on the cause of the itch.

• In case of dry skin, the doctor will suggest a moisturizing ointment. It should be applied once or twice a day to make the skin less dry and more supple.
• Basic treatment for atopic eczema is a moisturizing treatment combined with a low dose cortisone ointment or cream.
• In case urticaria, the doctor will prescribe an antihistamine.
• If the child has the scabies, it is necessary to apply a very specific cream all over the body.
• In case of lice, scabies or worms, it is often necessary to also treat the whole family or the children that your child sees daily (nursery, school).

Want to know more?

• Atopic eczema (image) – DermIS – Dermatology Information System
• Urticaria (image) – DermIS – Dermatology Information System
• Scabies – Papules and Blisters (image) – DermIS – Dermatology Information System
• Scabies – Furrows (image) – DermIS – Dermatology Information System
• Chickenpox (image) – DermIS – Dermatology Information System

• Dry skin: regular care – mongeneraliste.be – SSMG – Scientific Society of General Medicine
• Corticosteroids for the skin (low potency preparations) – CBIP – Belgian Center for Pharmacotherapeutic Information
• Antihistamines – CBIP – Belgian Center for Pharmacotherapeutic Information

Sources

• Foreign clinical practice guide ‘Pruritus in children’ (2000), updated on 11.05.2016 and adapted to the Belgian context on 02.11.2019 – ebpracticenet
• www.cbip.be