TV doctor warns itchy skin could be sign of serious condition - and how to diagnose it

Dr Mark Porter told how he has seen a surge in cases of scabies - which causes incredibly itchy skin - among his patients, adding that the condition is often missed in the early stages

Renowned TV doc Dr Mark Porter, famous from BBC Breakfast and ITV's This Morning, has noticed an increase in scabies cases in his practice, and even his pals aren't immune. Writing in The Times, the GP highlighted that scabies can be overlooked in its earlier, more treatable phases, explaining: "While often missed in the early stages, the classical rash and distribution should, as with other visible causes such as eczema, eventually give the game away.

"However, millions of people in the UK with distressing itching lack such clues as to why they are continually scratching." Discussing the prevalence of general itchiness lacking clear reasons like rash or swelling, he remarked it's 'surprisingly common', affecting one in six adults at some point. This figure jumps for those over 75.

He further added: " Working out the cause can require a little detective work. Here are some of the more likely culprits, which may help to identify the reason for constant scratching." Dr Porter has highlighted that the most common cause of itching, especially among older people, is dry skin (xerosis).

He said: "It may sound trivial but it isn't. Xerosis is prevalent at this time of year, when cold weather and low humidity exacerbate the problem, as does, paradoxically, taking a long soak in a hot bath. Legs tend to be most affected, but it can strike anywhere. Lashings of moisturiser normally fix the problem. Sounds too simple to be true? Don't knock it till you've tried it."

He also pointed out that certain medications can trigger itching. "Did your itching start after you were prescribed a new medicine or following an increase in dose? Common drug triggers include painkillers such as codeine and morphine, anti-inflammatories including naproxen and ibuprofen, and some types of blood-pressure pills (eg ACE inhibitors ending in "-pril", like ramipril).

"Statins can cause issues too. If you suspect your medication may be the cause, don't stop taking it, but book an appointment with your GP to discuss switching to an alternative where possible (it can take a while for the itching to settle)."

Furthermore, Dr Porter warned that itching could be a symptom of 'underlying health issues' such as liver, kidney and thyroid disease, diabetes, polycythaemia ("thickened" blood) and iron deficiency, all of which can be detected using standard blood tests available at GP practices.

Pruritus, which can be a symptom of underlying conditions like Hodgkin's lymphoma, should not be ignored, according to health experts. "All good reasons not to ignore it. Anxiety and stress can trigger an itch and exacerbate any caused by other issues, and if you are not sleeping because you are scratching all the time, it's all too easy to become stressed and anxious and enter a downward spiral. Itching can be a sign of more severe mental illness, such as psychosis, where people believe that their skin is infested (delusional parasitosis)."

When it comes to scabies, an itchy rash caused by mites typically starting between the fingers, wrists, or around the waist and groin, the first-line treatment involves a neck-to-toe application of pesticide cream or lotion - permethrin (Lyclear) or malathion (Derbac M).

Due to recent shortages, partly due to increased demand, alternatives may need to be considered. Close contacts should also be treated, and bedding, towels, and clothing must be washed and tumble dried simultaneously.

Oral ivermectin is another option if creams fail, with two doses usually recommended two weeks apart. After treatment, individuals can resume work or close contact with others after 24 hours, but the itch may continue for weeks even after the mites are gone.

• For more information on the diagnosis and treatment of scabies, visit nice.org.uk/topics/scabies.