I recently received a significant burn that turned intensely pruritic during the healing process. For years, I have advised patients that itching is a sign of healing. Is there any science behind this? Doug Cobb, PA, Auburn, Calif.

The belief that itching is a sign of healing is supported by science. The skin is part of the human body’s defense system against infection and invaders. The body is unable to recognize the difference between a clean clinical wound made by a sterile scalpel and the dirty wound of a dog bite. Any injury to the skin is interpreted in an identical manner.

During the healing process, the body infiltrates a wound with inflammatory cytokines to clean the area of any foreign body or infection. These pro-inflammatory cytokines produce itch. In many skin diseases, such as atopic dermatitis and psoriasis, the body inappropriately delivers pro-inflammatory cytokines into the skin, thereby causing the sensation of itching.

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Additionally, a high level of histamine has been found in healing skin and scabs, which we know will create the sensation of itching. During an injury (especially a burn), nerves may have been damaged, creating inappropriate signals that the brain interprets as itch. Oil glands may also be damaged by injury, and dry skin is itchy. This is why it is recommended to keep healing skin clean, covered, and moist with petroleum jelly. — Abby A. Jacobson, PA-C

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