Itch-Scratch Cycle

Reducing the Itch-Scratch Cycle

Atopic dermatitis (AD) causes a significant itch, which naturally motivates the behavior of scratching. However, scratching can cause complications: scratching further damages the skin barrier, leading to a worsening of symptoms, thickened patches of skin (called lichenification), and increasing the risk of infection. In addition, scratching at night can cause disruption to sleep, as people with AD may wake repeatedly during the night to scratch due to the excessive itchiness. The repeated waking and loss of sleep is one of the most distressing impacts of AD on children living with the condition, as well as their family members.1-4

Itch-Scratch Cycle

The exact disease processes that cause itch in AD are not completely understood, but doctors know that the “itch-scratch cycle” (the skin feels itchy, which leads to scratching, which then causes the skin to feel even more itchy) perpetuates the disease. One of the recommendations for good skin care is to avoid scratching. Although it can be frustrating to hear “Just stop scratching,” as if that advice would solve the condition, there are techniques and therapies that can help someone reduce or avoid scratching.1,2

Itch-Scratch Cycle
Itch-Scratch Cycle

Avoidance of itch triggers

One of the first and most simple strategies that can be used to avoid scratching is to avoid agents and environments that trigger itch.

The most common triggers of itch include:

Itchiness induced by sweating is the most common trigger of itch in people with AD. To avoid this trigger, people with AD can wear light, breathable clothing, as well as avoiding hot environments.1


Frequent moisturization with emollients will help to relieve or minimize itch in many patients with AD.