Senile pruritus is one of the most common conditions in the elderly or people over 65 years of age with an emerging itch that may be accompanied with changes in temperature and textural characteristics. In the elderly, xerosis, is the most common cause for an itch due to the degradation of the skin barrier over time. However, the cause of senile pruritus is not clearly known. Diagnosis is based on an elimination criteria during a full body examination that can be done by either a dermatologist or non-dermatologist physician.

This type of itch is just one out of six different classifications.

The IFSI (International Forum for the Study of Itch) created another classification process for pruritus in the senile population. There are three groups within the classification, the first being those who have pruritus on diseased skin, the second being those who non-diseased skin with pruritus, and the third being those who have secondary skin scratch lesions. The secondary scratch lesions can include abrasions, pimples, bumps, crusts and other lesions that can be caused by irritating the skin through pinching, rubbing or scratching which can cause scarring. This most often appears in group two or group three patients. Patients that fall into category two and three often have pruritus associated with the classifications listed above.

Risk factors of senile pruritus may include:

An itch can be caused by various reasons. The cause of senile pruritus is not clearly known, this type of itch in elderly patients may be a result of other reasons, like:

While identifying the cause of senile pruritus can be challenging, there are some correlations between classifications/diagnosis of senile pruritus and clinical manifestation. For cutaneous diseases, the diagnosis could be dry skin (with flare ups at dry climate), irritant and allergic contact dermatitis (skin lesions), seborrheic dermatitis (skin lesions), atopic dermatitis (scratching, allokinesis, stinging, burning), psoriasis (skin lesions), urticaria (welts/skin swelling). Sometimes senile pruritus can manifest without a primary rash and with the absence of xerosis.

Systemic diseases can lead to a senile pruritus diagnosis. For example, chronic kidney disease (generalized or localized pruritus), hepatobiliary diseases (generalized pruritus), thyroid disorders (urticaria), polycythemia vera (generalized pruritus), iron deficiency anemia  (skin lesions/scratching) and hodgkin's lymphoma (the area where lymph nodes are affected) can all lead to clinical manifestations of pruritus. Various drugs can also induce pruritus which can manifest with or without a skin rash and can happen immediately or even months after the drug has been used by the patient. Neurological disorders such as postherpetic neuralgia, brachioradial pruritus and notalgia paraesthetica can also lead to senile pruritus with burning, stinging, scratching and/or lesions. Psychiatric disorders such as schizophrenia, somatoform disorders, dissociative disorders, hallucinations, and delusional parasitosis can cause severe lesions, burning, stinging, as well as sensations of bugs crawling on skin over the entire body.

Common pathways for the development of senile pruritus may include: