Itch Relief For Healing Burn Scars - Phoenix Society For Burn Survivors

Bug bites, rashes, dry skin—most people can identify with the relief that comes from scratching a bothersome itch. Most can also relate to the annoying feeling when you just can’t reach that itchy area in the middle of your back. However, fewer people can identify with the problem of chronic or long-lasting itching. Much more than a nuisance, the long-term post-burn itch can be a very troubling issue that interferes with sleep, activities of daily living, and overall quality of life.

Itchy Burns Scars

Itching, also known as pruritus, is unfortunately quite common following burn injuries. Several studies have shown more than 90% of burn patients experience pruritus initially.1 While the percentage of individuals who report itching does decrease over time,2 a large number of people still continue to experience itching long after their initial injury. In one study, more than 40% of patients reported long-term itching for an average of 7 years following their burn.

Several factors that are associated with post-burn itching have been identified. These include a high percentage of total body surface area (TBSA) burns and a high percent of TBSA grafted.1 Certain characteristics of the wound, such as dry skin and raised or thick scars, are more associated with itching.

Furthermore, certain external factors, such as heat and sweating, have worsened itching.2 One study demonstrated a greater intensity of itching in skin-grafted wounds for up to 3 months, but this difference went away by 12 months.2Other factors, such as age and gender, are less clear, with different studies showing mixed results regarding their roles in itching.3,4

Why Does Itching Occur?

While we have learned a lot about why itching occurs, a complete understanding of post-burn itching is still lacking. A compound called histamine is one of the main factors involved in the sensation of itching. Histamine is released by mast cells, immune cells in the skin.

Mast cells can be activated to release histamine by several factors, including activity, heat, and manipulation of the wound, along with several other chemicals that are present in our bodies. Histamine activates histamine receptors, and the stimulus is then transmitted from particular nerve endings (C fibers) to the brain via specific pathways in the spinal cord.

Interestingly, the sensations of pain and itch share these same pathways. Whether you perceive pain or itching depends on the intensity of the initial stimulus. A superficial stimulus will be perceived as itching, while a deeper stimulus can be perceived as pain. Overall, many signals and pathways are involved in pruritus, and there is evidence that post-burn itch is unique in itself, which makes treating it quite complex.