Itchiness can be a symptom of lymphoma or a side-effect of treatments. It’s not fully understood why people with lymphoma feel itchy, but it’s thought that immune cells fighting the lymphoma, or the destruction of lymphoma cells causes chemicals to be released from your cells. These chemicals may then irritate nerve endings near your skin, resulting in the feeling of itchiness.
The medical name for itchy skin is Pruritus (sounds like Proo-rye-tis).
How does my immune system make me itchy?
Our immune system is very complex and is made up of our skin, our lymphatic system and white blood cells. Our white blood cells make chemicals called cytokines and histamines that they release into our blood stream and lymphatic system that help to fight infection and disease to keep us healthy. When the white blood cells move out into other tissue in our bodies such as our skin to fight infection or help repair injury, they release these chemicals in those areas too.
Unfortunately, cytokines and histamine can be toxic to our nerve cells and can irritate them. When the nerve endings are close to your skin, that part of your body can become itchy as the nerve endings react.
How does treatment make me itchy?
Some treatments like chemotherapy or radiotherapy work by directly targeting and destroying lymphoma cells. When lymphoma cells are destroyed, they can also release cytokines that can irritate your nerve cells and make you itchy.
Other treatments like immunotherapies engage or tartget your immune system to help it work more effectively at fighting the lymphoma. In doing so, your white blood cells will release more cytokines and histamine than they previously did to help fight the lymphoma. As mentioned above, this then not only fights the lymphoma, but also can irritate the nerves cells close to your skin, giving you the sensation of itchiness.
Hypersensitivity reaction
In some cases, you may have a hypersensitivity reaction to your treatment. This can feel like an allergic reaction. When you have a hypersensitivity reaction your white cells called basophils and mast cells release histamine. Other white cells will release cytokines that can cause the itchiness.
Are there other causes of itchiness?
Liver function
If you have lymphoma in your liver, or for some other reason your liver is not working properly you may feel itchy. Our liver is major organ that helps to process food and medicines and helps with digestion by producing a fluid called bile, that flows into our bowels to help to break down food. Our liver also helps filter our blood and makes proteins for healthy blood clotting.
If your liver is not working properly or the bile becomes blocked and unable to enter your bowels it can build up in your blood and gather in your skin. This can then cause more itching.
Another symptom that may indicate your itching is related to your liver is if your skin or the whites of your eyes start to have a yellowish change to them. Always tell your doctor if you have these symptoms.
Skin infection
Bacterial and fungal skin infections can also cause itching. When you have lymphoma you are at increased risk of infections as your immune system is unable to protect you as well it normally would. If you have a rash or skin changes of any kind near where you are itchy tell your doctor.
Cutaneous (skin) Lymphoma
Some rare lymphomas start with the lymphocytes in the layers of your skin becoming cancerous and can be very itchy. Most of these cancers only affect your skin, and rarely spread to areas inside your body. This page will provide information on itching that is NOT related to cutaneous lymphoma. For more information on cutaneous lymphomas, click the button below.
What is the itching like?
You may only feel itchy in the areas near where your lymphoma is. For example, if you have a localised lymphoma that is only in the lymph nodes in your neck, you may only feel itchy in that area of your neck. However, you may feel itchy all over your body too.
Similarly, if your itching is related to your liver not working properly the itching may be only in 1 or 2 places, or all over your body.
The itching is not like a normal itch. It does not improve with scratching and can last for weeks or months without relief. It can be very frustrating and sometimes distressing as it is not easily relieved and happens over long periods of time. In some cases, it may even affect your ability to sleep through the night.
How to get relief from itching
As tempting as it may be, it is important to avoid scratching. Scratching is unlikely to improve the itching and can cause you to break the top layers of your skin which puts you at increased risk of infection and bleeding.
Also, when your skin becomes damaged from scratching, more immune cells will migrate to that area, resulting in further release of the chemicals resulting in even worse itching.
However, some changes in sensation may help interrupt the “itchy signals” between your brain and the itchy area. So, instead of scratching, try gently tapping your fingers over the area as though you are typing on a keyboard or typewritter.
Other things to try include:
- Avoid extreme temperatures such as becoming too hot or too cold. For example, when in the shower or bath make sure the water is just warm.
- Have a luke warm bath with a non-scented anti-itching solution such as those with pine tar, oatmeal or baking soda. Make sure you check for allergies and ask your pharmacist for advice before buying. Use only as directed by pharmacist or on packaging.
- Wear loose fitting clothes that are made from natural material such as 100% cotton, bamboo or linen.
- Keep your skin moisturised using an unscented moisturiser for very dry skin or for itchy skin.
- Keep hydrated by drinking at least 2 litres of water every day to prevent your skin from getting dry.
- Use a cool compress on the itchy area, such as face cloth or towel rinsed under cold water.
- Do not swim in pools with chlorine.
- Where possible minimise extra stressors in your life – easier said than done. But it is worth thinking about what needs your attention, and what gets your attention that could do without it.
- Talk to your pharmacist about getting an over the counter antihistamine that can help reduce the amount of histamine in your body. Because histamine can also trigger cytokines to be released, an antihistamine may reduce both histamine and cytokine levels to prevent or reduce your itching.
- Call our lymphoma nurses for advice on 1800 953 081.
What if nothing works?
If none of the above tips help, see your doctor and ask for advice.
If none of the above tips work, see your doctor. They will need to check your skin and make sure you do not have an infection of your skin. They may also be able to prescribe you creams or medicine that can help.
They will also need to check that your liver is functioning properly and determine if the itch is related to your lymphoma, its treatments or a different cause altogether.
In some cases, the itching may improve as treatment goes on and the amount of lymphoma in your body becomes less. However, it may take weeks or months after finishing treatment for you to notice a change.
Summary
- Itching can be a symptom of lymphoma, side-effect of treatment or caused by liver issues or infection.
- Itching from lymphoma and its treatment can be persistent and distressing.
- Chemicals such as cytokines and histamine made and released by your white blood cells while fighting lymphoma may be the cause of your itching, as they irritate the nerve cells near your skin.
- Scratching will make itching worse as it may break your skin, resulting in more white blood cells coming to the area, releasing more chemicals that cause itching. Try gently tapping your skin instead.
- Breaking the skin during scratching will also increase your risk of infection and bleeding.
- If the tips above don’t work, talk to your doctor so they can assess you and work out the cause and treat your itching.
- You can also call our lymphoma nurses for advice. Click the Contact Us button below for details.
