Thread by @shakiratgold

#dermatologyteaching
It's been some time hasn't it?
I'm choosing a topic that I have gotten up to three people ask me about it in the last one week.
Do you scratch your body after bathing? You may have what is called 'Bath related pruritus'. Pruritus just refers to itching😊

So some people for one reason or the other start to scratch like someone that has 'werepe' on their skin after bathing. Intense itching that happens about 5 minutes after bathing. Several causes have been ascribed to this. I'll talk about the common ones.

1) Aquagenic pruritus which is related to the water used in bathing. Some people scratch after they come in contact with the water. There are some itch mediators that are released causing the person to scratch. More common with hot/warm water but note that it can occur with any

For some...hard water also seems to play a role. So you might move from one area to another and perhaps the water in that environment is hard water
2) Sensitivity to the soap being used. Some people react to the soap especially when the pH is not compatible with the skin

All of you that keep using medicated and antiseptic soaps🙄. I don't know what you're cleaning. Is it a soak away?🙄🙄
3) Some react to the sponge that is used
4) Some people have really dry skin called xerosis cutis (xerosis means dry, cutis means skin)
There's another group

5) The ones that may have a systemic disease. Like Chronic renal failure, chronic liver disease, hematological disease like polycythemia rubra vera (PRV), even some cancers can present with generalized itching. However except for PRV, most would have the itching without bathing

There may also be other symptoms of the disease noted such as anaemia in patients with kidney disease.
Note that in this discussion, I'm focusing on those causes NOT related to systemic diseases. I'm also focusing on itching WITHOUT any rash on the skin.

If there's a rash....that's another topic on it's own.
Note that it may not be easy to get the cause. Genetic and environmental factors are in play for this condition with several causes. How then do you manage?

1) Use hypoallergenic soaps that the pH is compatible with the skin. Stop putting antiseptics in your water. Your normal flora (bacteria) would get upset with you.
2) Try different temperature of water and see what works best for you. If you try cold and you itch more, switch.

3) Stop using 'ibile' sponge...aka hard sponge to bath. You're not a pit latrine🙄. You can use a very soft sponge or do away with sponge completely. You know some of us have hard hands. So please easy does it on the scrubbing.
4) Stop using your towel as a sponge.

You know the way some of us do the towel like as if we're trying to mop the the floor dry? (swish swish). No. Infact, let your body be damp before you moisturise. In other words, stop toweling the skin dry.
5) It is compulsory to moisturise your skin. COMPULSORY.

We all know the gender that says 'I don't 'rub' cream on my body?' 🙄
You better don't do that if you have bath related pruritus. Moisturise your skin liberally. And make sure you do it immediately after bathing while the skin is wet. And I don't mean with bleaching creams o🤷‍♀️

6) Resist the urge to scratch. There's something called the itch-scratch cycle. The more you scratch, the more it itches you. Try to resist it along with all these other things I've mentioned.
No pictures today because this doesn't come with a rash.

If you have any questions...I'll answer on the thread. Please don't try to send me DMs for consultation. I will not respond.
I may not answer now because it's the Nigerian association of dermatologists annual conference but rest assured that I will respond later. Merci