A new study published in the British Journal of Dermatology has revealed that people with chronic pruritus are twice as likely to experience fatigue compared to the general population. The research found that 41% of individuals with long-term itchiness reported fatigue, while only 22% of the control group experienced this symptom.
Chronic itch is defined as an itch lasting longer than six weeks and affects one in six adults, with a higher prevalence among the elderly. It can be a symptom of inflammatory skin conditions such as eczema, psoriasis, and hives, as well as internal diseases such as liver disease, end-stage kidney disease, and blood malignancies. In approximately 8% of cases, the cause of the itch remains unknown.
Symptoms of itching have a reported association with worsened QoL across various psychological and social domains, including fewer periods of rest and reduced sleep quality. Itch is thought to contribute to sleep disruption due to nocturnal itch-scratch cycles, since people with chronic itch often report that the itch intensifies at night, making it difficult to fall asleep or causing them to wake up with the need to scratch.
Dr. Gil Yosipovitch, Director of the Miami Itch Center at the University of Miami Miller School of Medicine and lead author of the study, explained the findings in a press release:
“We know that itch is amplified at night and that this contributes to sleeplessness, which over time can become fatigue,” he said. “This research puts a number on the extent to which itch contributes to rates of fatigue. People with chronic itch are twice as likely to have fatigue compared to the general population. We know from previous research that this has a significant impact on people’s quality of life.”
The researchers analyzed data from 114,015 adult patients in the U.S. National Institutes of Health (NIH) All of Us Research Program. They identified individuals experiencing chronic itch and reviewed how many of them had also developed fatigue, comparing them to a control group without itch but with similar characteristics.
Dr. Yosipovitch highlighted another study finding, noting that “68 per cent of adults over 85 [years] have fatigue. We know that changes to the immune system and skin physiology, which contribute to dry skin and immune dysregulation, mean older adults are much more likely to develop chronic itch. Future studies could explore whether itch is an important factor in these high rates of fatigue amongst the elderly.”
Dr. Paula Geanau of the British Association of Dermatologists emphasized the impact of persistent itch, stating, “Persistent itch is easy to underestimate. Research shows that it is comparable to chronic pain. Sleep is just one of many areas of life that itch can devastate. Fatigue contributes to underperformance at work and school, can leave people without energy to do the things they love, affects our mental wellbeing and can damage relationships.”