Itch poses ‘major challenge’ in aging adults, but must be addressed
Key takeaways:
- Adults aged older than 50 years are most likely to visit a dermatologist for itch.
- Rather than dismissing it as dry skin, dermatologists should look at the varied reasons itch can occur in this population.
ORLANDO — Itching in older patients should not be dismissed as simply dry skin, but rather approached as a complex problem involving numerous causes, according to a speaker at the American Academy of Dermatology Annual Meeting.
“Itch, or pruritus, is the most common concern that someone comes to a dermatologist for after the age of 50. For a really long time, we didn’t really have great schematics to understand why this was the case,” Daniel C. Butler, MD, associate professor of dermatology at The University of Arizona College of Medicine Tucson, told Healio. “Now because of the development of science behind our understanding of itch, we understand there’s all these systems that get influenced by time and, of course, age by proxy, and each one of those changes, in a way, influences and creates that symptom of itching.”
In fact, dermatologists often see patients with increased itch after patients turn 40 years old, leading Butler to speculate that changes in immunologic, idiopathic and microbiome systems begin as individuals age, creating itchy skin.
“There are a lot of players in the itch system in this schematic of aging skin,” Butler said during his presentation.
Treating this complex system can present difficulties, especially in older adult patients, as safety is paramount.
Beginning with topical treatments to stem the problem without systemic medications is the first line, but then treatments that target both the immune and neuropathic pathways of itch are important.
This can include methotrexate, calcineurin inhibitors, Janus kinase inhibitors or biologics, all of which target different systems that can cause itch.
No one treatment is going to cure itching in all aging adults, Butler continued in his presentation.
“Itching in older adult patients is a really challenging problem and it’s a growing problem. We are getting to a point with our understanding of what causes this itching and with treatments that we are able to attack this in a really sophisticated way,” Butler told Healio. “So, while it’s a major challenge, we are all now equipped with the ability to help these patients.”
For more information:
Daniel C. Butler, MD, can be reached at dcbutler@arizona.edu.