Selects: How Itching Works

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Hi, everybody. Chuck here.
It's May 9th, 2017 and podcast time. I know it's really 2025, but we're

going all the way back

to May of 2017 to talk

about itching. Oh boy, just seeing

that title probably makes you itch.

And that's one of the deals with itching

if I remember correctly. So

I hope you dig it, and I hope you're not too itchy right

now.

Welcome to Stuff You Should Know, a production of iHeartRadio. Hey, and welcome to the podcast.
I'm Josh Clark. There's Charles W.
Chuck Bryant, and there's Jerry Rowland. So this is Stuff You Should Know, scratching edition.
Yeah, this is one of many you remember when we did uh yawning yeah um well that's the only one i can think of where just researching something makes you do the thing you're researching this definitely happened with this one yeah well we ran across that and poison ivy and scabies for sure oh yeah and talked talked about some of this stuff but i think itch we had a itch we needed to scratch yeah with this particular topic well i'm glad um i've been wanting to do this one for a while yeah you did a video about this right yes a short video no it was three four hours long okay I remember correctly. Does that mean we have to do this?

Do I have to be here for the next four hours?

Yeah, we have to just play the whole thing,

and then we'll talk about it for an hour after.

That sounds good.

Okay.

I think it was a Brain Stuff video, wasn't it?

Yeah, I watched it.

Did it scratch your itch?

Yeah, I watched it yesterday.

Oh, okay.

Nice work.

Thank you very much.

You're just like...

Now we finally arrive at what I was after.

Compliment? Yeah. No, it was great.
Thanks, man. So I guess the point of all that is to say you guys are going.
You're going. My videos are the best.
That you're going to scratch. You're going to feel an itch, which is one of the great mysteries of itches it turns out we only very very recently have started to get a handle on what itches are yeah um and there's still plenty of mysteries left to it like for example it's bizarre and there's really no evolutionary reason as far as anyone can tell why just hearing about itches or seeing someone else scratch can make you itch right that's that's odd that's that's weird or seeing a video of an ant crawling up an arm will make you itch it will but i mean think about it if somebody is sitting there um you see a video of some schmo who's got his hand like near an oven and he pulls it away really quick it doesn't hurt your your hand.
It doesn't make you feel like your hand is burned. No.
That doesn't happen. I don't even think that would excite mirror neurons like a leg break would.
No. You're just like, what a stupid idiot.
That's what it excites, you know? I hope that guy's hand just burns clean off. That's what I think, right? Right.
Yeah. You sourced a couple of, well, we had our own article on HowStuffWorks.com.
Yeah. But you also sent this great New Yorker article written by Dr.
Atul Gawande. One of the best names in writing today.
Yeah, that may be my new hotel name. Well, you may be thronged by science fans because that guy's pretty well known.
Actually, I've never used to alias at a hotel. That's dumb.
And I don't even know if you can, can you? I guess if you're a big shot, you can. Yeah, but you have to be like, I'm not Brad Pitt.
I'm Atul Gawande. Right.
But we'll get to some of the more interesting aspects of that article later, specifically a very specific patient that's quite distressing. So calm down for now, Atul's mom.
We'll get to it eventually. He did include a couple of neat historical tidbits, like in 1660, and Germans are all over this thing for some reason.
Yeah. Researchers, they're all German.
They had the itch to explain the itch. I guess so.
The itch. Right.
But there was a physician in 1660 named Samuel Hoffenreffer. Actually, that's my new hotel name.
Yeah. That's a good one.
He defined it by saying an itch is an unpleasant sensation that provokes the desire to scratch pretty simple yeah but right on the money it is and actually it's so it's so on the money that anywhere you look in the medical literature whenever they define itch word for word that's the the definition they use the hoffenre Yeah. Although poor Hoffmanreffer doesn't get credit for it all the time.
But that's the one. The only expansion of that that I've seen is that can occur anywhere on the body, which apparently is true.
I think Hoffmanreffer, he felt that was implied. Right.
He's like, it goes without saying. Yeah.
I'm scratching right now, by the way.

Yeah, it started.

I don't know if I just noticed more.

Because as I was doing it, I was thinking, well, now I'm scratching.

Then I thought, do I always scratch this much or itch this much?

Oh, I hadn't thought about that. I'm pretty sure that I was, I don't think I scratch as much as, I don't know.

You raise a really good question.

Maybe we can get an intern to follow us around and just record our scratching. Right.
I'm surprised that that's not already a TV show, frankly. Josh and Chuck scratch.
Just being followed around. Yeah.
Oh. You know? No one wants to see that.
Well, that's probably why it's not. You're scratching.
See, that's what I'm saying. I don't think I scratch this much.
I don't notice it. All right, moving on to Dante's Inferno.
It was in Dante's Inferno, the burning rage of fierce itching that nothing could relieve is how falsifiers were punished. Yeah, do you know what a falsifier is? Us?

No, really, isn't that somebody who bears false witness

or somebody who falsifies a document?

I don't know, is it just a fancy name for liar?

Maybe.

Oh, I thought you were going to tell me.

You were just wondering.

Yeah, I don't know.

All right.

Well, I don't know what Dante meant,

but they're bad people.

Sure, apparently.

There's a special place in health for him, literally.

Well, I don't know. All right.
Well, I don't know what Dante meant, but they're bad people. Sure, apparently.
There's a special place in health for him, literally. Well, I guess actually not literally.
Figuratively. Sure.
Literarily. Oh, very nice.
So itching scientifically is known as pruritis, P-R-U-R-I-T-I-S. Yeah.
It's one of those tough to pronounce things for me at least um and for well actually they still believe that the evolution of the itch was to help humans um survive basically because so many things that can kill you uh and and nature are things like mosquitoes or flies or spiders or fleas yeah that can have like malaria or the plague or any number of diseases attached to their tiny little insect bodies right so hey human um you've got a mosquito on your neck that could kill you you might want to slap it or scratch yeah and that's still as far as i know the the um evolutionary hypothesis for why we experience itching yeah and it's not just us either well you're scratching like crazy yeah it's found throughout the animal kingdom um from us to apparently fish have shown scratching behavior yeah that's crazy fruit flies how does the fish scratch you might ask it rubs up against rocks yeah it's kind of cute it is a little cute it's like i remember my dad uh did like the uh who was the bear in jungle book was that baloo yes he would do the baloo where he would get up against a tree or a wall yeah and then i did it probably because of that i'm sure that's where i got it and realized that it works. And I still do it every now and then.

Oh, yeah?

Yeah, I look kind of silly.

Do you sing while you do it?

Yeah.

Bare Necessities.

That's still my favorite.

What else are you going to sing?

Like Mambo No. 5?

I'm going to start doing that, actually.

You'd be like, I think something's wrong with Chuck.

So like you said, though, it was up until almost what was it 1987 the mid to late 80s yeah that another german h.o handwerker uh and his gang sure of tufts um they started to do actual research about it.

They were puzzled and wanted to solve it.

Right, because up to this point, up to actually 1987,

everyone thought that an itch was just a low-grade pain stimulus.

Yeah, I guess they were just happy with that.

That's just what they thought it was.

And Handwerker said, you know what?

Let's find out if this is actually true. I'm tired of sitting around just assuming this is fine.
I'm Handwerker. And he got to verk with his hands testing this, right? So what he, I know it was like Jonathan Strickland level.
What he did was, this is just awful. Yeah.
He introduced using like um electrical stimulation i guess he introduced histamine to skin cells right and histamine is a natural i don't know if it's a protein but it's it's a natural compound natural chemical right yeah that the body releases uh in response to certain stimuli say for example like mosquito bite or something, and it triggers the inflammation and immune response in that area, right? So, histamine is associated with itch, and it had been for a very long time. So, this guy was using electrical stimulation to introduce histamine in increasing amounts in these poor study participants.
And it went from barely noticeable to, this is a quote, the maximum imaginable itch. And they never felt pain.
Yeah. Like even though they ramped it up to 11, no one ever said like, holy crap, that hurts.
They said, please, please, for the love of God, stop. Let me out of this.
And Handwerker just cackled and cackled. Wow.
Right. These men with, like, black leather gloves were holding the participants down.
Yeah, they said, this is not worth the five Deutschmarks that I'm getting for this lousy study. Yeah, that's nice, man.
This would have been pre-Euro, I think. Oh, yeah.
Even though the EU was around, I don't think the Euro was around in 87, right?

No, no.

It was in the 90s? I traveled to Europe in 1997, and I was still on all that weird money. Oh, okay.
Yeah, so it was a while after that. So now scientists, I think this sort of introduced an itch to the scientific community because after hundreds and hundreds of years, Hanwaka sort of disrupted the thought process of the itch and the scratch.
Right. And all of a sudden scientists were like, oh, well, maybe we should start looking into this.
Maybe we can actually isolate the nerve and figure this thing out. Yeah, because I mean, if it's not just a low-level pain sensation, then that means it's its own thing.
And if it's its own thing, it probably has its own system and we need to know more about it. So they got to studying it.
Yeah. I wonder if all of this was under the notion that they were trying to uh cure itching i don't know because from what i was reading um and all this was pretty recent stuff yeah there is a real unmet medical need in dealing in addressing like chronic itch sure because you know most people who go through life just experiencing itch under normal circumstances, right? Let's say you or me, we're like an itch.
Yeah, they suck for a second, and then it goes away. Imagine it not going away ever, whether you're asleep or awake or swimming or in outer space or doing whatever.
You're itching constantly. Supposedly, it has as much of a pronounced effect on a patient's life as chronic pain does.
It's constant, persistent, and agonizing. And it's not being met or treated because it's not understood.
So they're just now starting to get into itch research. I saw somebody put it where pain research was about 20 years ago.
So it's starting to really heat up, but we're still just starting to understand it. So I would think that they weren't looking to cure it.
I think it was just pointed out that there was this whole branch of neuroscience that was totally not understood. So get to work, neurologists.
I wonder, I never really thought about it until just now, but I wonder what happens when a performer or somebody like that is in the public eye or on TV or on stage or like the president giving a address, like what, what, what do they do if they have poison IV or some other kind of contact dermatitis like have you ever thought about that like what if lin mail what manuel miranda has like a really bad case of point i guess they can get an understudy in that case sure but you can't have an understudy as president no which is too bad you just go out there with your hands bandaged up just holding them up like how do you fight that poison ivy on camera or like a news anchor when they're just like oh my god i'm dying uh i don't know i guess a news anchor can tape things but i'm talking about live what does tom petty do for god's sakes tom petty grins and bears it he had a hard scrabble childhood he sure did prepared him for that i'm going to see him tomorrow night. Oh yeah.
Nice. Tell him I said about that.
We're meeting for coffee. He's not performing.
Anyway, I was just curious about that. Well, it's a good question.
Thanks. Do you remember when Costas had red eye at the Olympics and he was so dedicated to being the commentator, the anchor for the Olympics they finally were like, you have to stop.
No one can look at you anymore. People are writing in.
You're disgusting them. It was gross.
One thing that made me think of that is I had recently, you can still kind of see it on my forearm, the scars. But I did a cement job.
I was building this fence, putting in a gate at my house. And Scotty, you know Scotty.
Sure. Pippin.
Huh? Pippin. Not Scotty Pippin.
He and I built this thing together, and we sank these huge posts for this gate. And I didn't know that cement could cause contact dermatitis or even burns.
Never knew this. Yeah.
And we were, it was kind of a tight spot, and we couldn't get shovels in there in the hole so we were literally mixing this stuff like up to our elbows with our arms and i was like this kind of feels good i even said like you know like oatmeal or something and then two days later my right arm was just covered in the nastiest dermatitis i've ever seen wow and then he got it yeah it. Yeah, still kind of hanging around.
So I went and got a prescription for steroids, which made me a little crazy for a week and a half. Okay.
Did you trash the gate and have to start over? No. In a droid rage? I think I was probably not the best husband, though.
I see. Over that time period.
Yeah. Judging from Emily saying, hey, you're a real a-hole get off the steroids gotcha um get off the juice and i was like shut up watch this watch me hit this homer so long story short i experienced this recently and it was awful and i can't imagine like shooting a tv show or something or like doing anything on or performing live yeah like I would have to address it because I would scratch and smack it was what I usually do.
That's what you're supposed to do, not scratch. Smack it? I guess we'll just cut to the chase here.
This is why everyone's listening. How do you scratch a niche correctly? You rub it.
Yeah, I didn't do it. You know what really did it was the uh we have a uh handheld uh implement in the shower along with the regular shower head okay yeah and put that sucker on the the tightest hardest most penetrating flow right and just put that hot water on it man and that was like i think i spent half my days in the shower yeah over that week a half.
Were you biting down like a broomstick while you were doing that?

No, it felt so good, man.

I was just like, I couldn't get enough of it.

And then the cortisone and all that junk, too.

So, we'll actually, we'll talk about this because you're raising some great points here.

Well, I just kind of did it ruin the spoiler?

No, no, this is good stuff.

We're going to analyze what was going on with your arm after this break. How about that? Sounds good.
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So, Chuck, you had contact dermatitis, right? I thought it was poison ivy because that area has some poison ivy. But each of us, Scotty and I, had it just on the arm that we sunk in cement.
And then we researched and found out that could happen. Yeah.
So, lesson learned on that. Yeah.
So what happened was you, something

in the cement, and I'm not sure what it was, reacted chemically with the mast cells in your

skin. Yeah.
And histamine was released, right? Apparently. And so the histamine sent a signal

through specialized nerve cells called C fibers. Yeahers.
Yeah, which C-fibers aren't just limited to itching. I think only about 5% handle that, and most of the rest are for pain.
Right, right. So they use the same type of neural pathway as pain, but for itch, basically it's just like, no, these are just for itches only.
And it sent a signal through your spinal column, and in your spinal column it released a neurotransmitter called gastrin-releasing peptide receptor. And so at the skin, the histamine would have released a neurotransmitter called what? Natriuretic polypeptide B.
Okay. So that says itch signal coming your way along those C fibers.
Yes. Okay.
It makes it to the spinal column. And I guess in about 2007, they found that there's another neurotransmitter in the spine that I guess accepts the NPPB.
The invitation. And says, I'm going to transfer this along up to the brain.
That's gastrin-releasing peptide receptor. That shoots up to the brain, and it starts this cascade of activity, right? Yeah.
Because after Handwerker said, hey, itching's its own thing, these other researchers went to town and traced and figured out that there were specific types of itch receptors that were dedicated just to itches, right? Yeah, more Germans. More Germans.
And Swedes in this case. A couple of Swedes, but mostly Germans.
Just for good measure. Yeah.
And what they found eventually from tracing this pathway, they were able to follow it into the wonder machine. And apparently they made some

people itch and would not let them scratch it. And then they had them lay down in an MRI and they took a brain scan and they found that there's this whole galaxy of stuff going on in your brain that combined is the itch sensation.
Yeah, it was pretty interesting too. There's a signature pattern in the brain when you get an itch.

And a few specific areas light up.

One is a cortex.

And it all makes sense when you put it together.

The cortex, in this case, just sort of geolocates where on your body you're getting that sensation.

Right.

So that helps.

It's like left elbow.

Yeah, or in my case, from right elbow to wrist right and then a little bit in other places but not too bad that that was the main area is this your cortex still saying this yeah it's very complex conversation going on uh and then the region i thought this was interesting the region that governments uh governments that governs emotional response um so basically this is your brain saying like i don't like this this makes me feel bad yeah it's the worst thing ever do something uh and then finally the limbic and motor areas and i thought this was the most interesting um those areas process irresistible urges the same ones that say I want to smoke crack or I want to eat too much cake, says you have an itch that is unbearable and you need to scratch it. Right.
And maybe go smoke some crack and eat some cake while you're at it. Because that'll help.
So I just, I don't know, I thought that was all very super interesting when you combine that pattern. Yeah, that's an itch and then followed by the irresistible urge to scratch it, which apparently research has shown those two do not happen independently.
They're part of a cycle. Yes.
There's something called the itch-scratch cycle, right? And so you have an irresistible urge to scratch the itch. It's weird if you think about it like on the one hand it makes sense where you you sense that there's a really hot heat source that your hand is really close to so you have an irresistible urge to pull it back but it doesn't feel like an urge it almost feels like an involuntary reflex yeah i think it's a scratch is I'm going to kill this itch.
I can't wait to scratch it. Like you're almost exacting revenge on the itch for itching you, right? So a scratch is, it's an irresistible urge, whereas like pulling your hand back from a hot source or something is like an involuntary reflex.
It just feels different. Like a scratch is its well it is you know they kind of found that out and and gawande dr gawande um pointed out something interesting too that i never thought about is that you can have like that short collar rubs against your neck all day and you might never notice it but if there's like one little string that's just poking one little area that might trigger an itch right and so you would think that you know itch receptors are super finely tuned and

they they cover just this one tiny like that's what it would seem like micron of skin as a matter

of fact no apparently an itch receptor can sense itch stimuli like three inches away from it on

the skin yeah so they're really sensitive yeah whereas pain receptors are that specific right

Thank you. stimuli like three inches away from it on the screen yeah so they're really sensitive yeah whereas pain receptors are that specific right uh down to like you know millimeters yeah um and the other thing they found out too is that not only can they sense it from a few inches away but it's a very slow acting thing right which um as opposed to like heat on the hand like a candle on your hand almost said candle in the wind uh that's super fast but um that that explains why an itch like is kind of slow to come and then slow to resolve by scratching yeah it's not like you scratch it you're like oh it's all better now yeah it helps a little bit so so the itching is a it's a good strategy if you think about, say, there's a mosquito on you and that's what's making you itch.
When you go to scratch it, you're getting rid of the mosquito, maybe even smooshed it or something like that. The problem is taken care of.
The issue is that that itch-scratch cycle eventually becomes a vicious cycle because when you scratch, this is what they think is going on. This is another mystery with itches.
We don't understand how scratching alleviates an itch or why we scratch, really, right? What they think, the current hypothesis is that when you scratch an itch, you're stimulating other receptors in the area that aren't itch receptors. Yeah, so I got that.
But what does that do to sort of like say, hey, body, don't worry about that for a minute. I think so.
A pain receptor is now active. Right, exactly.
It's sending feedback to the brain saying it's being taken care of. You can settle down with the itch.
Gotcha. Right? i think the problem is is that neurologically or neurochemically when you scratch an itch you're activating those pain receptors in the area pain pressure that kind of thing you're causing um serotonin to be released right natural pain reliever right yeah or at least mood enhancer and what they found is that serotonin among other

neurochemicals actually exacerbates the itch sensation so your itch not only comes back it gets worse ah so you go to scratch it again and then same thing happens over and over again that's the itch scratch cycle which it's not the best cycle around no you can think of better cycles not a bad band name yeah it's okay a little too cute maybe prog folk prog well they'd have to be german probably german folk prog okay yeah uh another interesting thing they learned too was that um i guess we're kind of jumping around but Who cares, right? If you scratch, you don't have to scratch the point of the itch to relieve it apparently right like if you have i had that itch on my right uh forearm and i could scratch maybe it doesn't have to be the left forearm so it's not like you have to mirror it um but i could scratch like my neck and apparently that might help relieve it. Yeah, I tried it.
It didn't work for me.

No?

No.

But I think the reason why it's possible that it could have that effect

is supposedly scratching also activates your pleasure center.

Yeah, you bet it does.

But there's different places where you're scratching on your body have different amounts of pleasure associated with them. Did you know that? I mean, I guess so, but.
Yeah, interesting. Yeah, but I mean, think about it.
It's like if you scratch your clavicle, who cares? It's nothing, right? But then you scratch your head above and behind your ear. It's great.
Well, and I think they did find that like your back and your ankles supposedly are some of the most rewarding places to scratch. Exactly.
And I don't know. I've never really thought about the ankles, but my mom would give me back scratches when I was a kid.
That's nice. was always like one of my favorite things ever sure and so i don't get those anymore now that i'm a grown-up because that's gross mom scratch my back right i'm 46 years old lay down uh but yeah it was like i think i prefer to back scratch to a back rub even.
Oh, yeah. When I was younger.
But now, you know, a massage is probably way better. Sure.
But if a masseuse could include a little back scratch in there, get ready for a huge tip for me. Yeah, I guess so.
Or does that, what, is that sexual? I think it crosses a line once they're potentially clawing away skin cells i think that's it's no longer in the masseuse range or masseur range yeah i get that once skin cells are involved you know under the nails sure then you're a murder suspect right exactly uh all right well should we take another break yeah and talk a little bit about one of the most distressing articles I've ever read. For adults with moderate to severe obstructive sleep apnea, or OSA, and obesity, refreshing sleep may be hard to come by.
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during sleep, which may cause breathing interruptions and oxygen deprivation that

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Need flexibility? Our modular design lets you rearrange your sofa anytime to fit your space,

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trusted by over 200,000 happy customers. Starting at just $699, it's time to upgrade to a stress-free,

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All right, so we've referenced this article from The New Yorker, from Dr. Atul Gawande.
And he talked a lot about itching and just had good information on the science of it all. Well, that's what he does.
But most of the article was focused on a patient, a woman in Massachusetts, that they named M for the article.

Just M.

The letter M.

Right.

In other words, she's anonymous.

And I think she was anonymous because she kind of had a rough go after her divorce.

She ended up getting HIV from getting on heroin.

Kind of spun out, it seems like. That's sad her life back by all accounts, but ended up getting shingles as a result of HIV complications.
Right. And the shingles went away, but the itching did not, to say the least.
Yeah, I think the itching came after the shingles even. And at first her physicians were like, well, I mean, you must have damaged some nerves in there.
So T.S. for you, I guess.
Yeah. And then eventually, after treating it like all these different ways and it's still being scratching, they said, okay, you're crazy.
How about that well whatever i still have this itch do whatever you need to to treat it because i'm literally scratching this itch in my sleep it was on her scalp wasn't it yeah it was on her head and she um she kind of managed to to control it during the day but like you said at night she couldn't't control it to the point where I think she was restrained in her sleep.

That came after.

Oh, okay.

After they realized it's a problem because your brain is oozing out of your head.

Yeah.

Can you believe that? She scratched her scalp so much that she scratched through her skull,

and she went into her doctor one day and said,

they've got this green fluid coming down, then apparently the doctor fainted the doctor didn't even say anything he was just she or she was like excuse me went and called an ambulance and came back and said please lay down and don't talk or move or do anything else and they finally told her after she was at the er you scratched through to your brain. That's your brain you're touching right now.

The doctor's like, very interesting.

Just give me a second here.

Oh, my God.

Well, they gathered up all the other doctors and nurses.

Sure.

Yeah, you got to come see this.

She said also in this article, she said that she had a, what do they call them? A roommate.

Yeah.

Okay, a roommate. Yeah.

So she

had a roommate while she was

like they treated it, gave her

a skin graft and then she

itched, she scratched away the skin

graft. Oh man.

And then they finally were like okay you're

going to an asylum. And she's like do they even call it that anymore and they're like just shut up yeah and they put her in this asylum and restrained her like you said while she was sleeping and she had a roommate in there she said in the article she heard didn't survive he had scratched through his carotid artery and died blood death yeah um so they never really got to the bottom of this.
She finally got a doctor. The doctors were like, it's something that had to do with the shingles.
This is what we think happens at our doctors, that the nerve endings around the area where she had shingles were so devastated by the shingles that there were just a couple of nerve endings left and it just so happened that they were itch receptors or itch itch um yeah itch receptors bad luck and that those were like really exacerbated by the fact that there was no other competing sensations oh ipso facto there's your problem right so they said well let's we'll just cut the main nerve to the to your face and that should solve the problem they cut the main nerve to her face and um she said thanks a lot yeah and then the itch came back and she's like you have to be kidding me so finally she met a doctor who said i don't think it's your uh your receptors or the nerve transmission i think it's your brain yeah not psychologically i don't think it's a psychosis i think there's that the actual itch signal in your brain is being set off without any stimulation or transmission going on yeah and um apparently she was right but then they were like good luck treating that right you know i didn't see much follow-up on this i did read one article that um a follow-up with dr gawande because there were a lot of skeptics after that article came out that said it's impossible with your fingernail because she said she didn't use an implement it's not like she got out a metal file right to scratch through your skull right and he said that his theory was that bacteria it became infected it had eaten it away such that the skull became soft turned it to mush yeah yuck uh and then people also said you know you don't have men and women in the same room in hospitals or asylums that's that's false and he said uh that it was like the the room next door um and quit being pedantic yeah really man i think people just didn't believe it So all these folks wrote into the New Yorker. All these coastal elites said, no way.
They said, Atul, Atul, come on. So the idea, though, that even if this woman was hypothetical, I think Atul Gawande is a pretty upstanding cat and didn't make this up.
But even if, say she was hypothetical, her problem, what the doctors initially thought it was, was that she had a neuropathic itch, type of chronic itch. But then the doctor who apparently figured it all out said, no, no, no, it's a neurogenic itch, another type of chronic itch.
And it has to do with whether it's the brain going off or the nerve transmissions going off. Either way, you don't actually have an itch, although you're experiencing the itch sensation.
Well, and they also then said at some point she had a psychogenic itch. Right.
So they basically covered three out of the four kinds of itches, the last one being, man, I have such a hard time, pre-receptive. And that's what you get from like a mosquito bite or if you have a skin disorder like eczema or something.
Sure. So they basically ruled out the most common one and at various stages said, you've got this other one for the other three.
Right. Finally.
And then again, they said, there's really nothing we can do to treat it. The one that they've got down pretty well is pre-receptive.
We've got all sorts of stuff to treat that because that's basically histamine is being released and your skin is itching. So you can treat histamines with antihistamines.
You can reduce that response and then your itch will go away. Well, I took Benadryl at night and they also make this Benadryl spray uh a topical spray that just it really helps right so between that and cortisone and then the benadryl at night i did okay right and those awesome showers so the like the pro-receptive itch we've got treatment for basically yeah the other three you're you're in trouble it turns out as far as it stands right now.
Maybe five or 10 years from now, there'll be something. Apparently, there is a lot of movement right now on treating this stuff, but it's like they're having to figure out how to block some really otherwise important chemicals in the body, like that NPPB, right? Yeah, that one, what is it, can help regulate your blood pressure as well? Yeah, right.
You can't just switch that off. Right.
Just turn off the gene that produces that. You won't itch, but you might die early.
Right. Not worth it.
Right. The one that really, I mean, they're all sad, but the psychogenic, when you have a mental illness where you feel like parasites and bugs and bugs on your skin um you remember our morgulons disease yeah how did you said it morgulons right and i said morgulons i can't remember i i know that i said it the way everyone else else says it though that's all i remember morgulons that's right that's how i said it man but all this stuff I just had so much empathy for m yeah and wanted to follow up so bad to see how she was doing you know yeah and if she kept scratching holes in her skull i don't know jeez so there's i read another article called accidental therapists uh-huh it's by a guy named eric broman, and it was published on a website called STAT.
And it's all about delusional parasitosis, but how it's treated sometimes by entomologists, like those extension services at universities. Here in the U.S., state universities have what are called extension services where like a um a scientist will just basically be there for the public to come talk to about whatever usually it's like household stuff or farm stuff something like that um and apparently entomologists frequently are approached with people who are like i've got these bugs like crawling all over me here's a sample them.
And it turns out it's like carpet fiber or something like that. And these people just can't stop itching or whatever.
But it turns out they have a delusion. They don't actually have parasites.
My question is, is that our understanding of it now? And in five or 10 years, we're going to know that they had neurogenic itches and we just treated them like they were crazy, even though they weren't yeah and it's going to be like a real blemish on the history of neuroscience maybe or will this idea of psychogenic itches you know hold up yeah i wonder did you ever see the todd haynes movie safe with julianne moore no it was one of his first movies after the karen carpenter thing he did that wasn't like, I mean, it was a real movie, but it wasn't released. But Safe was very disturbing.
It was about a woman who kind of slowly drifted into madness from believing that the world was poisoning her. Wow.
And like household chemicals and everything. And it kind of started slow.
And eventually she ended up at this kind of safe camp for people like her right um very distressing movie and one of her first movies too i'll have to check it out yeah it's really good oh it's old yeah it was it was early 90s i think i know you're talking about no it's called the road to wellville is that what you mean no it's called safe okay i'll check it's good. Very distressing.
I'm trying to think of anything. And that wasn't necessarily itching, but it was just like that psychogenic thing of like, I think everything in my house is killing me.
Yeah. I mean, have you ever like stopped and thought about something and thought there's, there's the path to madness right there.
I'm staring down at right now. I should probably not keep thinking about this.
I don't really get like that. Oh, no? No, I'm very easily kind of led on to the next shiny thing.
I got you. I'm like a bird.
Yeah, basically. That's probably for the best.
It is. It has its drawbacks, though.
What else you got? Well, one thing it says in here is that having someone else scratch your itch apparently does not do the trick. So you have to scratch your own itch.
Yeah, I mean, somebody can. Like, obviously, like, you know, if you're like, a little left, a little left, up, up, up.
Yeah, see, I don't know if I agree with that. Oh, man.
Not you. Them saying.
Oh, right. I think it definitely helps.

I think what they're saying is it doesn't have quite the same relieving properties as if you do it yourself.

Oh, yeah.

And if you could reach that area of your back, it would be better than that.

Yeah, I guess so.

I got a pretty good back scratcher now, though.

Oh, yeah?

What's it made of?

Bamboo?

No, it's metal, but it's telescoping, so it's not, you's not two feet long. Gotcha.
But it can be. But it's metal? Yeah, it looks like a bear claw.
Not the pastry, but a real bear claw, which actually looks like the pastry. Yeah, I guess it does.
That's why they call it that. I never thought about that.
Why did you think that was called that? I'm just kidding.

They actually should call it a bear paw.

It looks more like a bear paw than a bear paw.

I'm going to try and bring that around.

Unless you get somebody who really goes the extra mile

and puts almonds on the tips to make it look like the claw.

Yes.

And not just haphazardly scattered about the bear paw.

Exactly.

That's the difference between a baker who loves their job and one who's just in it for the money. Yeah.
A couple more things, Charles. Like we said, there's still plenty of mysteries around itches.
Yeah. Why, say, does a feather tickle sometimes but itch other times? Uh-huh.
Big question. They don't know.
Right I'd like to know. Maybe the Germans will get active on this again.
They're the only ones who can solve it. Only the Germans can save us.
You got anything else? No, I don't. I don't either.
Itching. Nice work.
Thanks, man. Same to you.
Thank you. And you haven't scratched in a while, so.
No, I'm actually, I've been scratching the same spot, and it's starting to get a little tender, so I'm stopping. Man, there's nothing worse in a movie.
And I've seen, I feel like I've seen this a few times in movies, where someone is compulsively, like, scratching until it becomes a sore, and then they're scratching it.

It's just like, ugh, I can't watch that.

Through to their brain?

Well, yeah.

So I guess the moral of this one is, what would Tom Petty do?

I'll ask him tomorrow.

If you want to know more about itching or what Tom Petty would do,

you can type those words in the search bar at HowStuffWorks.com.

And since I said search bar, it's time for listener mail. I'm going to call this one of the many emails we got on the swearing episode.
Did you notice that? People really seemed to like that one. Yeah, they did.
A lot of response. Yeah.
Mostly from fellow potty mouths, which were very filthy emails, too, which were great. Yeah.
And I responded in turn by cursing at them in my replies, which I hope they enjoyed. In all caps? No.
I didn't want to be too aggressive. So this is from Emily Allen.
Hey, guys. Long time listener.
First time writing in. Writing about swearing, I should start by saying that it's funny I'm writing about this episode because I almost never curse.
And when I do, it's normally not a very offensive swear. However, your intro made me think of something interesting I wanted to share.
You talked about how you really censor yourself during recording in order to keep your show family-friendly. It got me thinking about how our jobs really shape our vocabulary, how we express ourselves.
I noticed a major change in the way I speak since becoming a teacher. I primarily teach kindergarten to second grade students, and I found this really changed the way I express myself.
For example, I try to avoid even saying things are dumb or stupid around kids. We'll often say, well, isn't that silly? Instead, this works in the classroom, but I often get laughs from friends and family when I refer to a situation as silly, like a disagreement with a colleague or something a politician does.
There are other expressions I use with kids that often slip into regular conversation as well. The most embarrassing, when I'm out and excuse myself to go potty.
That always gets a laugh. Anyway, I just wanted to share and thank you for all the great work you do.
Learn so much from listening each week. And I'm always excited to see the new episode offerings every Tuesday and Thursday.
That is from Emily Allen. Thank you, Ms.
Allen. Very silly.
That was a very nice email. Yeah.
If you want to get in touch with us like Ms. Allen did,

you can send us an email to the Stuff Podcast at HowStuffWorks.com.

And as always, join us at our home on the web, StuffYouShouldKnow.com.

Stuff You Should Know is a production of iHeartRadio. For more podcasts from iHeartRadio, visit the iHeartRadio app, Apple Podcasts, or wherever you listen to your favorite shows.
For adults with moderate to severe obstructive sleep apnea, or OSA, and obesity, refreshing sleep may be hard to come by. And who likes to lag and drag through the day? OSA is a serious condition where your airway partially or completely collapses during sleep, which may cause breathing interruptions and oxygen deprivation that could leave you feeling tired and fatigued.
Loud snoring, choking, or gasping for air during sleep could be signs of OSA. Don't sleep on the symptoms.
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