Post Wound Itch: Causes and Remedies

It is completely normal for skin to itch when it is healing, whether from a small scratch or a severe burn. This process, also called wound pruritus, is due to the release of chemicals during your body’s immune response against the injury. The skin around the wound also undergoes a variety of immune processes, so it is very common to experience itchy skin at the wound site, though it is important not to scratch it, as that can slow down the healing process.¹ This article will tell you a bit more about the underlying causes of this post-wound pruritus, as well as give you some remedies to help you resist scratching. 

Causes of post-wound itch

Inflammatory response

The skin contains nerve endings called C-fibres, which look similar to pain fibres but instead provoke an itching sensation. During the healing of a wound, these nerve fibres react and signal the spinal cord and brain that the skin is being stimulated. The brain interprets this signal as an itch.

In addition, these nerve fibres are especially sensitive to substances released during wound healing that cause you to itch (known as mediators called pruritogens), such as histamine.^2,15 When the skin is injured, immune cells will release these itch-mediators as part of their inflammatory process, causing itch signalling. Additionally, cytokines such as interleukin, growth factors and cysteine get released by these immune cells, which have also been linked to an itchy feeling.³ This inflammatory process is completely normal during wound recovery, as it is vital for the removal of any germs and harmful substances at the injury site. 

Healing process

Collagen is a protein that plays a very important role during the healing process of a wound, including the formation of clots to stop any bleeding, scar formation, and skin regeneration.⁴ Collagen initiates new skin growth by forming a scab on the wound. This process stimulates the nerve endings under the skin, signalling it to the brain as an itching sensation. In addition, scabs are usually dry, further causing itch.³ 

Foreign bodies

You may think of using wound dressings or wound-care products to encourage the healing process and avoid itching. Wound dressings are great at keeping injuries moist, which benefits healing. There are different wound dressings with different properties, but they all create a barrier that prevents scratching. Wound care products can also be used to accelerate the healing process. However, both may cause skin irritation and increased itching. They could also cause an allergic reaction on the skin, triggering itch.⁵ Itching is also completely normal when a wound is stitched or glued up, as the body still goes through all the usual healing processes.

Infections 

If itching becomes more severe or is accompanied by other symptoms such as pus and swelling, this may be a sign of infection. For example, some molecules from a bacterial infection can interact with specific proteins that release itch mediators.² 

Fungal infections can also play a role in the delay of wound healing. Indeed, open wounds and ulcers may get invaded by fungi, eventually leading to infection. This causes your skin to look red, swollen and rashy and makes the affected area very itchy.⁶ 

In addition, any type of infection causes inflammation. As mentioned above, inflammation leads to immune cell responses which release pruritogens and cause itch. 

How long does a post-wound itch last?

Post-wound itch can last between a couple of days to months, depending on the time it takes for the wound to heal. This can vary with many factors, including the size, severity and location of the wound. In general, the inflammatory response peaks 1 to 2 days after the injury occurred. This stage of healing does not usually take longer than one week. 

Next, the scab formation stage occurs, which lasts one to three weeks. Lastly, your skin gets regenerated, and a scar is formed, a process that can take weeks to months to complete. Itching may or may not be experienced throughout all stages and generally disappears completely once the wound is healed.

Remedies for post-wound itch

Itching is a normal part of the healing process, but it is important to resist this sensation, as scratching the healing wound will only slow down the process. Additionally, it can lead to complications like infections and reopened wounds. Luckily, there are several remedies to help deal with post-wound itch, which are outlined below.

Over-the-counter and prescribed treatments

Several over-the-counter remedies help combat itchiness. Anti-itch creams often contain hydrocortisone, which is great at inhibiting inflammatory responses and, thus, itching. The stronger versions of these creams, called corticosteroid creams, are often prescribed to treat skin conditions like eczema. If the over-the-counter hydrocortisone does not help, a doctor may prescribe this stronger version. Both types should not be used for longer than a couple of weeks, as they can lead to addiction and skin thinning. Lastly, you should seek permission from a healthcare professional before applying any type of cortisone cream to your face.⁷ 

Instead of cortisone-based creams, antihistamines can also be used. You may also use oral antihistamines in the form of pills, though these often cause side effects such as drowsiness and headaches. Antihistamines block the effect of histamines on the body, thus reducing itch.⁸ 

Lastly, immunosuppressant drugs may be prescribed if no other treatment works. However, this only happens in more severe cases or patients with an autoimmune disease. Immunosuppressants modulate the body’s immune response, which helps suppress itch. The drugs can come with several side effects and require regular administration to work.⁸ 

Natural remedies

On top of over-the-counter and prescription medicines, several natural remedies may help suppress itch:

• Aloe vera has both cooling and anti-inflammatory properties, which help reduce itch and soothe damaged skin. Aloe vera gel is easy to find and is very effective in reducing itch and pain.⁹ 
• Calendula oil is retracted from marigold flowers and has anti-inflammatory properties. Additionally, the oil is believed to combat fungal and bacterial growth, which prevents infection. Thus, Calendula oil may help in the healing and anti-itching of wounds¹⁰  
• Applying a cold compress or an ice pack against itchy skin can help soothe the latter and temporarily reduce itch¹¹  

Lifestyle adjustments  

As mentioned, applying something cold to your itchy skin has a soothing effect. Accordingly, try to avoid taking hot showers or exposing the wound to hot water, as this can irritate the skin further and increase itchiness. 

Next, avoid wearing tight-fitted clothing and opt for more loose-fitting and soft clothes instead. This helps avoid irritation or reinjuring of the wound and prevents moisture or sweat build-up in the affected area, instead keeping the wound clean.  

Make sure to keep your wound clean and moisturised. Simply cleaning the injury with warm water and mild, non-irritating soap is great at removing any dirt or germs that may be present in the wound. Next, using antibacterial sprays or creams can help neutralise the bacteria and avoid infection. Applying a bandage or plaster is great at first to block any germs or dirt from entering the wound, but make sure to let the wound breathe once a scab is formed. 

Lastly, moisturising the skin surrounding your injury with a mild, non-irritating or scented lotion can help reduce itchiness. It can also help prevent scabs from cracking or splitting, which could re-expose the wound to harmful compounds.¹² 

Prevention strategies

Proper wound care

Cleaning and disinfecting the wound is very important to avoid infection and encourage the healing process. On top of this, plasters and bandages can act as a protective layer for the wound. This provides protection not only against bacteria or dirt but also prevents you from scratching the wound. Some wound dressings have specific properties, like antibiotic or collagen synthesis-promoting ones, which can help with healing.

It is vital to ensure you are not allergic to any products used. Not only does this increase itchiness, but it can also cause the formation of a rash or blisters, often accompanied by a burning sensation. Additionally, make sure that any products used are fragrance-free, mild, and appropriate for sensitive skin to avoid irritation.¹³ 

Minimise scratching

One simple but straightforward way to reduce scratching is to trim your nails. Additionally, you could use distraction techniques to take your mind off of the itch. For example, applying pressure on the skin surrounding the wound may help relieve the itchy sensation, as it tricks the nerves into thinking you have scratched it. Distracting yourself by keeping busy may also help you forget about the itch and prevent scratching.

When to consult a healthcare professional

Itching is a completely normal part of your body’s healing process. However, there are a few warning signs that you should look out for that may indicate a more severe issue or need for professional help:

• The itch lasts over a month and feels severe
• An old, previously healed wound starts itching intensely again
• Signs of infection: redness/soreness, skin feels hot/swollen, pus, open wound or stitches fall out, you experience fevers or feel unwell, unpleasant smell coming from the wound, excessive bleeding¹⁴ 
• You experience an allergic reaction to treatment
• You have underlying medical conditions 

In any of these cases, it is important to seek professional help from your healthcare provider. They will help evaluate your symptoms, assess what the underlying issue may be and help treat the latter effectively. 

Summary

Post-wound itch, or pruritus, is a natural factor in the skin’s healing process. The sensation is caused by the stimulation of specific nerve endings by cytokines, histamine and other mediators released by the body’s immune cells. 

Several remedies can be used to help with pruritus, including over-the-counter and prescription creams and pills, and more natural treatments. In addition, you can make several simple modifications in your daily life to help with itch and prevent scratching. 

In general, it is important to keep the wound clean and disinfected to avoid infection. You should also make sure you are not allergic to any products used as treatment. If you experience symptoms of infection or allergy, or the itch is persistent and intense, it is important to consult a healthcare professional to seek proper treatment.