Article snapshot:
Up to 70% of people with PBC experience “pruritus” or PBC itch
The cause of pruritus is unknown, but new data are emerging
Discussing pruritus with your doctor is essential
You can take steps to avoid aggravating your itch
Primary biliary cholangitis (PBC) itch is not just a “regular” itch. Some say it feels like bugs under the skin. Some want to tear their skin off. And some simply scratch until they bleed and scar. These are just a few of the ways people with PBC experience “pruritus”—the deep itch that’s a common symptom of PBC that can vary over time and from person to person.
In fact, up to 70% of people with PBC report they experience itch, and about 30% of those say their itch is so bad that it impacts their daily life. It can negatively impact their sleep, social life, work, and everyday activities. Despite this, sometimes people don’t make the connection between their PBC and their itch, so they don’t tell their doctors about it—and then don’t receive appropriate care.
Fortunately, coping with itch is not a lost cause. And the better informed you are about PBC itch, the better position you’ll be in to manage it. Let’s take a look at current research around PBC itch.
Why Does PBC Cause Itching?
The short answer is that no one is quite sure. Yet, researchers have made some progress in understanding what may be behind PBC itch. Some studies report that the buildup of bile acids (which normally aids in digestion) may cause itch.
The good news is that researchers are not only aware of the negative impact of PBC itch but are also looking for more ways to manage it. That’s why it’s critical to tell your doctor how much itch affects you.
Ways You Can Make Itch More Manageable
While they might not take away all of the itch, here are a few methods you can try that may help. You may need to ask your doctor for their recommendation or more information.
Try mild, nonalkaline soaps and oils for showering or bathing
Bathe/shower in lukewarm water
Limit showers or baths to 20 minutes
Apply mild moisturizers that contain urea
Use creams, salves, or lotions with cooling or anesthetic qualities with ingredients like menthol
Wear soft clothing made from natural materials like cotton
Consider using ultraviolet (UV) phototherapy
And here are things you may want to avoid that can cause your skin to feel dry or irritated and make the itch worse:
Washing and bathing with hot water
Ice packs
Skin contact with herbs like chamomile or tea tree oil, which could be irritating
Consuming large amounts of hot or spicy food, hot drinks, or alcohol
Tight clothes
Wool sweaters
Scented detergents
Rubbing your skin after showering/bathing
Stress
If you’ve tried these things and your itch is still affecting your daily life, talk to your doctor about medical treatments that could help. And if your primary care doctor is unable to offer solutions for your itch, it might make sense to ask for a referral to a specialist who is an expert at treating PBC.
