The Neurobiology of Itching

Posted by Alex in Medicine on June 26, 2008 at 11:49 am


Throughout most of medical history, doctors thought that itch was a mild form of pain - then in 1987, scientists found out that it’s a completely separate form of sensation. Still, itching can be extremely aggravating, especially if the feeling won’t quit.

Here’s a fascinating though a bit long article at the New Yorker by Atul Gawande about itching. It talks about a woman called "M." who suffered a persistent scalp itch that, of course, led to constant scratching, and a man called "H." who suffered from itching and pain in his arm after a spinal cord surgery.

“Scratching is one of the sweetest gratifications of nature, and as ready at hand as any,” Montaigne wrote. “But repentance follows too annoyingly close at its heels.” For M., certainly, it did: the itching was so torturous, and the area so numb, that her scratching began to go through the skin. At a later office visit, her doctor found a silver-dollar-size patch of scalp where skin had been replaced by scab. M. tried bandaging her head, wearing caps to bed. But her fingernails would always find a way to her flesh, especially while she slept.

One morning, after she was awakened by her bedside alarm, she sat up and, she recalled, “this fluid came down my face, this greenish liquid.” She pressed a square of gauze to her head and went to see her doctor again. M. showed the doctor the fluid on the dressing. The doctor looked closely at the wound. She shined a light on it and in M.’s eyes. Then she walked out of the room and called an ambulance. Only in the Emergency Department at Massachusetts General Hospital, after the doctors started swarming, and one told her she needed surgery now, did M. learn what had happened. She had scratched through her skull during the night—and all the way into her brain.

(Okay, that may be a stretch - but the rest of the article is very good)

Link (Photo: Gerald Slota) - via Ectoplasmosis



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COMMENT

13 comments to "The Neurobiology of Itching"

  1. SenorMysterioso
    June 26th, 2008 at 12:23 pm

    How many people when reading the headline and seeing that picture got itchy? I did. I dont think Im going to read the article.

  2. prophet
    June 26th, 2008 at 12:30 pm

    Great article. I can“t imagine her suffering.

  3. Neatoramawontsendmeapassword
    June 26th, 2008 at 12:30 pm

    Those are some strong fingernails she has! If I started scratching at my head, I’m pretty sure my nails would wear away before my skull did.

  4. anon
    June 26th, 2008 at 12:48 pm

    Could we hold these kind of posts until night(EST)? I just about lost my lunch…

  5. bean
    June 26th, 2008 at 1:16 pm

    You can scratch through your skull with fingernails? I call shenanigans.

  6. Stew
    June 26th, 2008 at 1:36 pm

    That last part just made me go “Aww…” and look away from the screen. Nasty.

  7. sw
    June 26th, 2008 at 2:47 pm

    dagnabit, i am totally itchy now.

  8. jason
    June 26th, 2008 at 2:53 pm

    i call a big shenanigans on this too… my wife (a physician) said “um…. yeah…” in a very lumberghian way…

  9. Christophe
    June 26th, 2008 at 9:12 pm

    brain scratching? farfetched.

    Although, being allergic, I can tell that the pain of scratching to the blood, or burning the itch with hot water is much more bearable than the itch itself ;(

  10. The Manticore
    June 26th, 2008 at 9:33 pm

    I think I have some kind of OCD about scalp scratching and picking. I have all kinds of fun scabs (though none the size of half dollars) and I totally zone out when Im doing it

  11. Justin
    June 26th, 2008 at 9:57 pm

    Did anyone else freak out when you got to the end of the description? ITCHED DOWN TO THE BRAIN JESUS!

  12. girlzeuy
    June 27th, 2008 at 12:42 am

    that article is absolutely sad

  13. MoonCake
    June 27th, 2008 at 6:49 am

    how terrible that must be.. i have dreadlocks and my scalp itches because i can’t really wash them every single day, and using conditioner to saturate my skin just makes the dreads loose. so i’ve had some bad itches at times and have had to mentally disable myself from scratching because it was just so persistent and ridiculous. (why have them at all, you may be asking? it’s difficult to come to terms with shaving your head when you’re female). but i can empathize with constant itching.. it sucks. i could barely deal with poison ivy when i was a kid, but not having any sort of relief would drive me absolutely insane.


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