Allergies Chicago | Pesky Itch Meaning | Chicago ENT

What that pesky itch may really mean

Fast Facts:

  • Allergies are the 6th leading cause of chronic illness in the U.S. with an annual cost in excess of $18 billion.
  • In a U.S. survey, more than half (54.6 percent) of the people reported indicated that they had positive reactions to one or more allergens.

Q&A with Dr. Ayesha Siddiqi, Allergist at Chicago ENT

BJ: I want to talk with you a bit today about itching. I’ve had a recent bout of itchy skin for the last few weeks and it can be maddening! I don’t know what is causing it. Is it a common problem?

AS: I see at least three to four patients every day with itching. It can be a symptom all by itself, or it can be accompanied by a rash. The rash could be one of many forms of rashes such as hives, eczema, contact dermatitis. So, if there’s a rash present, the first order of business is to determine what kind of rash it is. If the itching is present without a rash, then it’s just called pruritis. Pruritis is also seen to occur commonly in temperature extremes, both hot and cold.

BJ: For itching without rash, what is the treatment?

AS: Antihistamines can help, but most times before I prescribe a certain treatment, we’ll run a blood test to see if there is something more sinister going on. There are some systemic conditions that can cause non-specific itching and hives (urticaria) such as thyroid disease, hepatitis, and even parasitic infections.

BJ: If it is a histamine issue, are some people simply more sensitive to histamine than others?

AS: I wouldn’t say exactly that. Someone might get a mosquito bite and get a huge reaction. So they might say, “Oh, I’m so sensitive to mosquito bites!” But the elevated response probably means already have a high level of histamine in their bodies, and that high histamine level could be caused by environmental allergens that they are unaware of. They could be allergic to pollen, dust, or even their pet, but it’s undiagnosed.

Another condition that causes high histamine in the blood is mastocytosis. Mast cells release histamine and other substances during inflammatory and allergic reactions. With mastocytosis, these mast cells abnormally accumulate in the skin and/or internal organs such as the liver, spleen, bone marrow, and small intestines. Mastocytosis can run in families and can be confirmed by a skin biopsy or blood test.

BJ: Histamine is also present in foods, correct? Do you encourage patients to follow a low-histamine diet?

AS: Not everyone needs to go on a histamine restrictive diet, but it can certainly help some patients. I’ve been seeing a trend in this health-conscious society where people are eating a lot of foods such as smoothies with citrus fruit, berries, and cherries, which actually trigger histamine release. High histamine foods include other popular items such as wine, yogurt, and avocados.

BJ: There are a lot of over-the-counter antihistamines available. Are there any that you’d recommend over another?

AS: The older generations of antihistamines such as Benadryl do work, but they can also make you drowsy. The newer, non-sedating drugs like Claritin, Zyrtec, Allegra, and others are preferred. However, if you rely on an over-the-counter for ongoing relief from itching or hives, you should get yourself checked out to determine the actual cause of your symptoms, and we can more accurately and effectively treat your particular condition.

Itch-Scratch-Itch Cycle diagram

BJ: Let’s get back to the itching, which can be terribly unpleasant and disruptive. Are there any topical products that can offer immediate relief?

AS: Yes. There are a variety of topicals products, such as calamine lotion or hydrocortisone cream. A cold compress or ice pack can also stave off the itching. It’s difficult yet important to avoid scratching. Scratching causes additional inflammation, which in turn, heightens the itch response. It’s called the itch-scratch cycle.

BJ: What would you say is the tipping point when one should see an allergist?

AS: If symptoms don’t resolve within a week or two, or if they return when you stop using an over-the-counter medication, it’s time to see a doctor.

To schedule an appointment, call 773-296-5500.


Chicago ENT has six convenient locations throughout the greater Chicago area. For the exact location and/or directions, simply click on the map next to your desired location. To book an appointment, call 773-296-5500 to speak to a scheduler or conveniently online 24/7.

Advanced Center for Specialty Care
3000 N. Halsted Street, Suite #400
Chicago, IL  60657

Phone: 773-296-5500

Office hours:
Monday 8:30 am – 5:00 pm
Tuesday 8:30 am – 6:30 pm
Wednesday 8:30 am – 5:00 pm
Thursday 8:30 am – 6:30 pm
Friday 8:30 am – 5:00 pm
Saturday 9:00 am – 12:00 pm

Allergy Shot Clinic hours:
Monday 8:30 am -4 pm
Tuesday 8:30 am - 1:30 pm
Wednesday 12:00 pm - 3:30 pm
Thursday 9:30 am – 12:00 pm
Friday 8:30 am - 1:00 pm
Saturday 9 am- 11:30 am
*Shot appointments are by appointment only
*All patient’s are required to wait 30 minutes after receiving allergy shot(s)

Map of the Chicago ENT Lincoln Park Location

St. Mary’s Hospital Professional Building
2222 W. Division Street,
Suite #330
Chicago, IL  60622

Phone: 773-296-5500
Map of the Chicago ENT Bucktown Location

8930 Gross Point Road,
Suite #700
Skokie, IL 60077

Phone: 773-262-4110
Map of the Chicago ENT Skokie Location

2740 W. Foster,
Suite #405
Chicago, IL 60625

Phone: 773-296-5500
Map of the Chicago ENT Chicago North Location

2522 W. Peterson Avenue
Chicago, IL 60659

Phone: 773-262-4110
Map of the Chicago ENT Peterson Location

St. Joseph Ascension Health Outpatient Pavilion
2845 N. Sheridan Rd,
Suite #807
Chicago, IL 60657

Phone: 773-296-5500
Map of the Chicago ENT Lakeview Location