Date: 10/20/2025

What Is the Itch–Scratch Cycle?

For people living with ichthyosis, itch (pruritus) can be one of the most distressing symptoms. The itch–scratch cycle describes a self-perpetuating loop where itching leads to scratching, and scratching damages the skin, which then causes more itching -  creating a difficult cycle to break.

 Why It Happens

Ichthyosis causes abnormal skin barrier function and dry, thickened skin, which can:

• Allow irritants and allergens to penetrate the skin more easily

• Cause skin cells to shed improperly, leading to buildup and tightness

• Trigger inflammation and nerve sensitivity that intensifies the feeling of itch

When the skin barrier is disrupted, nerve endings become overactive, sending stronger “itch” signals to the brain.

 Breaking the Cycle

While there is no one-size-fits-all approach, consistent skin care routines and targeted treatments can help manage itch and protect the skin.

1. Hydration & Moisture

• Apply emollients and ointments multiple times daily to keep skin hydrated.

• Use thick moisturizers (like petrolatum-based products or ceramide-rich creams).

• Apply right after bathing to lock in moisture.

2. Bathing & Cleansing

• Use lukewarm water and gentle, fragrance-free cleansers.

• Avoid hot water, which can dry and irritate the skin.

• Add bath oils or mild exfoliants if recommended by a clinician.

3. Anti-itch Strategies

• Cool compresses can calm itching sensations.

• Topical steroids or anti-inflammatory creams may help when prescribed.

• Oral antihistamines can reduce nighttime scratching for some individuals.

• Behavioral strategies, like keeping nails short or using cotton gloves at night, can minimize skin injury.

The Importance of Consistent Care

Managing itch in ichthyosis isn’t just about comfort — it’s about protecting skin integrity and reducing inflammation that can worsen the condition.
Breaking the itch–scratch cycle can:

• Prevent infection

• Improve sleep and quality of life

• Support healing and smoother skin texture

Remember

Each person’s experience with ichthyosis is unique. What works for one may not work for another. Partner with a dermatologist familiar with ichthyosis to find the right combination of treatments and routines for you.

Source: FIRST | Foundation for Ichthyosis & Related Skin Types
www.firstskinfoundation.org