Why Do Wounds Itch?

Everyone has experienced itch. It might simply be the nuisance of a mosquito bite or a transient itch on the scalp that is relieved by a simple scratch. For wounds such as venous ulcers, itch may be present but is usually mild. For some of the 40% of people with neuropathic itch or pain that can develop and persist following mastectomy, itch can be overwhelming, intractable, not widely appreciated by the medical community, and poorly responsive to current treatment regimens. Why are some wounds in some patients itchy whereas seemingly equivalent ones in the same or other patients not? Why is the sensation of itch present in the wound itself in some cases while in the surrounding skin in others? Why are burns so frequently associated with itch? How commonly do wounds itch? Detailed answers to these questions are lacking, but this area is beginning to be explored. Herein, the author provides an overview of the current understanding of the physiology of itch. An effort is made to place that understanding in the context of wounds, and therapeutic approaches that may be outside of the conventional toolkit are made based on this background.