Skin

Itching 

Itching is a common symptom for patients with long term conditions and can affect any area of your body. It may affect the whole of your body or just one particular area. Itching may be due to several factors, such as dry skin, medication (including painkillers), jaundice, liver or kidney problems. 

Tips for dealing with itchy skin 

• If your skin is dry use a simple moisturiser, such as aqueous cream, twice a day. A combination of aqueous cream and menthol can be helpful. If you store the cream in the fridge it will feel cool and soothing when applied. 
• If hot water makes the itching worse, take cool or lukewarm baths or showers. Try adding an emollient (moisturising solution) such as Oilatum® to bath water and use aqueous cream instead of soap. A little baking soda added to bath water can also help. After bathing, apply emollients or aqueous cream while your skin is still damp. 
• Protect your skin from the damage caused by scratching. Keep your nails clean and short and rub rather than scratch the itchy area. 
• Avoid things that may irritate the skin or make itching worse, such as biological washing powders, scented soaps, bubble baths and products containing lanolin. 
• Keep cool by wearing light, natural fibres such as cotton, and by keeping the atmosphere around you cool but not too dry. Avoid alcohol and hot spicy foods and drinks. 
• Use other activities to try to distract you from the itching. Relaxation techniques may help you cope. 
• Sometimes acupuncture or transcutaneous electrical nerve stimulation (TENS) can reduce itching. The aim of TENS is to stimulate the nerves reaching the brain, and so block out the sensation of itching. Acupuncture and TENS treatments are given at some NHS hospitals, and we can also offer Acupuncture. 

Itching can be difficult to control, but there are medicines that may help. If a medicine is the cause, an alternative drug may be prescribed. For some liver problems there are specific medicines that can control itching. Your doctor can discuss with you possible solutions. 

Some drugs that may be helpful include: 

• Antihistamine tablets or lotion 
• A short course of steroid cream or tablets 
• Anti-inflammatory drugs, cimetidine, aspirin and thalidomide 
• Drugs that affect blood pressure, such as propranolol 
• Drugs that act on the nervous system, including anaesthetics, antidepressants, anti-epileptic drugs, sedatives and some types of painkiller 
• An anti-sickness drug called ondansetron. 

Pressure Sores 

A pressure sore (also called a bedsore or pressure ulcer) is damage to the skin and the tissue underneath. It can be caused by the weight of the body pressing down on the skin. Friction from clothing or skin being dragged when you’re moved by others can also cause sores. If your mobility has been restricted by your illness or its treatment, you’re at a higher risk of developing a pressure sore. You’re also at a higher risk if you’ve lost a lot of weight or aren’t managing to eat and drink well. Some drugs can also increase your risk, including chemotherapy drugs, steroids and anti-inflammatory drugs. Inspect your skin, particularly bony areas like elbows and ankles. For areas that are difficult to see, like shoulder blades or the base of your spine, use a mirror or ask a friend to help. Look out for reddened or dark patches on these areas, or any blisters or breaks in the skin. Let your nurse know about them straight away. 

Preventing pressure sores 

• If you spend a lot of time sitting or lying in bed, change your position regularly – preferably every half an hour. Wear loose, cotton bedclothes and use pillows to support yourself in comfortable positions. 
• When possible, standing up for a short time or taking a short walk is the best way to relieve pressure. A physiotherapist can supply you with a walking aid to help with this, if needed. 
• Your district nurse will be able to assess whether you need a pressure-relieving mattress or cushion and arrange these for you. It’s still important to change position regularly when using these. A bed cradle can help keep the weight of bedclothes off your legs and feet. 
• Tell your doctor or a district nurse if you think you have early signs of a pressure sore. They can give you help and advice to make sure that your skin heals properly and to prevent infection from developing.  There are also organisations that can provide equipment to keep you comfortable. 
• Treat dry skin using the tips given above. 

Increased Sweating 

Sweating is one of the ways our body keeps our temperature normal, but when people are unwell, they can have episodes of increased sweating. When this is severe it can be very uncomfortable and affect activities like sleeping. There are different causes, including certain medicines. Your doctor will be able to advise you on the best treatment, depending on the cause. There are also things you can do to help: 

• Wear layers of light cotton clothing that can be taken off or put on easily. 
• Keep rooms cool and well-aired – a fan can be helpful. 
• Keep a sponge or flannel and some cool water by your bed for night sweats and have a change of night clothes available. 
• Use light cotton bedding and put a large cotton towel on the bed underneath you. This will absorb any sweat and can be removed easily, rather than having to change all the bedclothes. 
• Avoid things that may trigger sweats – for example, some people find sweats are made worse by alcohol or spicy food. 
• Your body loses fluid through sweating, so try to drink more to prevent dehydration. 

Some people will have night sweats caused by the menopause or as a side effect of hormonal treatment. 

If you have an urgent enquiry for our medical and nursing teams (which may be for help and advice) please phone 01892 820515.  This phone number is answered 24 hours a day, 7 days a week.