Pruritus is a common condition in the elderly population and, when severe, can cause as much discomfort as chronic pain. There is minimal evidence to support the treatment of pruritus, thus limiting the treatment options for the condition. Over 50% of elderly patients treated in dermatology clinics have symptoms of dry skin. Clinically rare neurodermatitis (pruritus) can lead to localized pruritus (especially in the genital area) and generalized pruritus of the trunk (especially in diabetic patients). Certain skin disorders are most often seen in older patients, including scabies, herpetiform aspergillosis, and temporary acantholytic dermatosis, and mycosis fungoides should also be considered. The etiology of senile pruritus is generally thought to be due to factors such as sebaceous gland hypofunction, dry skin, and degenerative atrophy. The following other causes are currently considered: 1. Barrier function deficiency One of the most important functions of the skin is to retain moisture. The superficial layer of complex lipids on the skin helps it to lock in moisture. This superficial layer is so thin that it can be completely removed by using sticky tape strips 10-20 times. The superficial water-locking layer is self-repairing, but as we age, both the rate of repair and the epidermal barrier function decrease. This makes dryness disease (dry skin) the most common skin problem in the elderly, involving more than 50% of the elderly (65 years and older). The love of bathing with very hot water, the number of times too often, the use of alkaline soap or medicinal soap, so that the already dry skin lost the sebum nourishment, and destroy the barrier function of the skin. 2, immune aging Immune aging is a pro-inflammatory state of the skin that may lead to a higher frequency of eczema and other inflammatory skin reactions in older patients. 3. Neuropathy Age-related neurological disorders lead to pruritus in 2 ways: (1) sensory neuropathy (mostly because of diabetes) may lead to generalized pruritus; (2) nerve involvement may lead to localized pruritus, commonly in the genital area. If pruritic disorders (e.g., anal pruritus) are accompanied by impaired nerve function, pruritus may be exacerbated and often responds poorly to anti-inflammatory medications. Treatment and prevention More than 7 million outpatient visits for pruritic symptoms are reported each year in the United States. Of these visits, 1.8 million (25%) are for elderly patients 65 years of age and older. Studies based on the prevalence of pruritus in the elderly population are lacking. However, it is generally accepted that all elderly patients with pruritus should include treatment of dryness at the outset of their treatment. Chronic pruritus is often difficult to treat and predisposes patients to feelings of helplessness and despair. Chronic pruritus can lead to significant sleep disturbances, which in turn can exacerbate these problems. Lack of family support and the presence of depression may lead to more frequent and more severe itching symptoms. Treatment: Western medicine: oral antihistamines, calcium, vitamin A, vitamin C, and vitamin B complex; sex hormone therapy with testosterone propionate or methyltestosterone for men. Female patients can take hexestrol or use progesterone. Topical corticosteroid ointment or cream and anti-itch drops and emollient drops can be used topically. Chinese medicine treatment: Chinese medicine believes that this disease is due to blood deficiency and wind dryness, treatment should be to nourish the blood and moisten the skin, remove wind and stop itching. Chinese medicine uses angelica, red peony, chuanxiong, fangfeng, raw earth, rehmannia, chicken blood vine, shouwu vine, tribulus terrestris, ground bark, etc. In cases of persistent itching with mossy skin, add whole worm, wuxia flesh, fried soapberry, etc.; in cases of secondary skin infection or eczema-like changes, add gentian grass, scutellaria, zedoary, bitter ginseng, white moss bark, etc.; in cases of heart trouble and insomnia with red tongue, add lotus seed heart, fried gardenia, mother of pearl. You can also take acupuncture points such as Quchi, Foot Sanli and Sanyinjiao for acupoint injection. Prevention: 1. Avoid scratching, rubbing and hot water scalding to relieve itching; 2. Avoid smoking, drinking, strong tea and eating spicy food; 3. If itchy skin is a symptom of certain diseases, treatment of the primary disease should be the main focus.