This post will help to answer the question which many people always ask “Why do wounds itch”, You will also know the stages in wound healing, how to stop itching from healing wounds, and how to care for itchy wounds.
Why Do Wounds Itch
Pruritis is a normal thing, albeit frustrating, part of cell reconstruction. Itching, or pruritis are parts of the recovery process when you have a healing wound being a traumatic wound or surgical wound that is closed either by stitches, staples, or glue. Sensitive nerves are found beneath our skin and they react whenever there is an irritation on the skin. It usually feels like something simple e.g like a bug crawling on the skin or more complex like a cut that is healing.
As cells rebuild, there are chemical and mechanical reactions that cause itching. The important thing is to not disrupt this process. You’ll delay your healing, and go back to square one if you do. During the wound-healing process, these nerves gives signal to the spinal cord that the skin is being stimulated, the brain perceives those signals as itchy. These nerves are sensitive to chemicals like histamine: which is released by the body in response to an injury.
Histamine supports regrowth of the skin cell and is necessary to the body’s healing process but it can cause a reactions including itching which is similar to an allergy. New skin growth can also cause itchiness. As collagen cells expand new skin begins to grow on the wound which results in a scab. When a scab is dry and crusty, it stimulates an itchy sensation. These messages of itchiness from your brain are ones that are to be ignored.
Scratching a wounded area or picking at a scab can tear new skin cells that your body is producing to heal the wound. Scratching the itch can re-injure the wound and set back the healing process.
Stages in Wounds healing Process
1. The Bleeding Stage
It is also called the hemostasis stage, this is the point where the injury occurs, the body responds to the injury by activating an outpouring of blood, lymphatic fluid, and coagulation (clotting) to stop the loss of blood.
2. Inflammatory Phase
This is the beginning of the repair process. It begins immediately after the injury has occur and typically lasts for six days. The body will send white blood cells to fight harmful bacteria at the injury site, swelling at the wound site starts and the skin begins the repair process because by this time clot has formed and the bleeding has stopped. The body sends antibodies, enzymes and nutrients to begin the healing process, which can lead to swelling and tenderness.
This next stage of wound healing is where the real pain and itching begin, inflammatory cells rush to the wound site to help clean the base of the wound and prepare for new cells. Some of these cells, called histamines, help open the vessels around the wound for immune cells to begin cleanup.
Note: Histamine are the primary chemical that causes itching in wounds. An infected wound will create additional itching, as inflammatory and immune cells work overtime to fight bacteria. In some unfortunate cases, wounds stop healing properly and become stuck in this phase.
When wounds don’t move past the inflammation stage, they are considered chronic wounds. Itching is a major problem with complications that result in chronic wounds.
3. The Proliferative Stage
This stage last for up to four weeks, the proliferative stage is also known as the granulation stage or tissue-regrowth stage, this is where the signs of skin repair: scabs protecting the new skin cells that are growing. Cells flock to the wound site to build new tissue in the proliferation phase trusted source of healing, the layer cells create a matrix that’s filled in with various types of cells, creating a sensitive area of new growth.
As these new layers are pulled together in the final phase and fluid builds below the wound surface. That’s when new nerve connections are joined to the old, creating a mechanical reaction trusted source that results in an itching sensation.
4. The Scarring Stage
This stage is also referred to as the maturation phase or remodeling stage, this stage may last from three weeks to four years as the case may be. In this stage, the scab goes off as the new tissue gains strength and flexibility and collagen fibers forms the scars.
How to Stop Itching from Healing Wounds
- By applying an ice pack or cold compress to the wound area
- By using antihistamines like Benadryl
- By proper dressing and bandaging
- By frequently keeping the skin moisturized
- By protecting the wound from irritation with a covering or clothing
- Use of tissue debridement
- Use of topical anti-inflammatories like steroid creams, gabapentinoids
- Use of certain antidepressants like paroxetine and amitriptyline
- Avoiding tight clothing or accessories worn around the wound
- Covering the wound with a bandage
- Applying over-the-counter (OTC) anti-itch creams
- Bathing in lukewarm water with added moisturizers or oat meal
People Prone to Slow Wound Healing
Some people are at a higher risk of experiencing slow wound healing, which can lead to infection. Below are people that have a higher risk of complications from a wound;
- People living with diabetes
- Older adults
- People on certain medications
- Chronic Smokers
- People who drink heavy amounts of alcohol
- People with poor blood flow
How to Care for Itchy Wounds
1. Keeping stitches dry for the first 24 to 48 hours.
2. After the first few days, clean gently around the stitches with cool water and mild soap for once or twice per day.
3. Dabbing the incision site dry making sure you don’t rub it.
4. Do not scratch or scrub incision area
5. Avoiding strenuous activity that may cause the stitches to tear.
6. Do not remove adhesive strips (Steri-Strips) that covers stitches, allow it to fall off on their own.
7. Change the wound dressing as directed by your doctor.
8. Do not apply any creams or ointments to your stitches except it is prescribed by the doctor.
9. Notify the doctor in case of persistent fever or increasing redness and pain, purulent drainage like yellow or green pus, or bleeding at the site because it may be as a sign of an infection.
10. Do not pull off stitches or staples, or scabs covering the wound.
11. Keep your hands and supplies clean during dressing changes.
Why You Should Avoid Wounds Itching
Scratching or even a gentle rub does not help relieve an itchy wound but scratching stitches or any other healing wound can disrupt the wound healing process because delicate new layers of tissue can easily be ripped apart forcing the wound to return to earlier healing stages. This will make the wound take even a longer period to completely heal, before prolonging the itch which will possibly lead to more complications like chronic wounds or infections.
When you injure yourself and cut, scrape, or burn your skin, blood begins to clot in order to stop the blood from excessively leaving your body. Blood clotting happens, thanks to cells called platelets. Forming platelets is the body’s way to patch up a leak. Example, when you scraped your knee pretty badly you will then clean it and make sure to bandage it. But if a scab has form excessive itching can be as a result of a complication in the wound healing process.
Necrotic tissue, infection, excessive fluid buildup, can lead to increased itching and problems with wound healing. When you injure yourself and cut, scrape, or burn your skin, blood begins to clot in order to stop the blood from excessively leaving your body. Blood clotting happens and credit goes to the cells called platelets. Forming platelets is the body’s way to patch up a leak. Eventually, when the wound stops bleeding, a scab forms. The scab which helps to protect the freshly injured skin from contaminants like bacteria and allows the skin to heal completely underneath a scab, the body is working hard to repair the damages on the skin and blood vessels.
The body also enlists white blood cells to assist clean up all foreign matter and bacteria present in the wound. After some time, a scab will fall off to reveal brand-new skin. Which is a pretty amazing process. Since the body can’t repair all wounds this way. Very deep wounds and severe burns require emergency medical treatment but most small nicks, cuts, scrapes, and surface burns heal completely well on their own in a healthy person.
Additionally, most itching that occurs during wound healing might be the result of poorly translated nerve signals. The nerves under the skin transmit information to the brain, but they’re not always good at passing along the message in a comprehensive way. Excessive itching can be as a result of a complication in the wound healing process. Necrotic tissue, infection, excessive fluid buildup, can lead to increased itching and problems with wound healing. If you have doubt that your wound is not healing right, or you have any of the below listed problems it is wise to visit a medical professional for further evaluation. The problems include;
- Fever of 100 degrees Fahrenheit or higher
- Yellow, thick, cloudy, or foul-smelling draining from the site of injury
- Excessive bleeding from wounds
- Stitches that fall out
- Opening in the incision before your stitches are removed
- New numbness or tingling at the site of injury
- Increasing pain or redness around wounds