A 2025 ‘year in review’ for chronic itch: new insights, treatments and understanding

The topic of chronic pruritus, also known as chronic itch, has not been overlooked in the slightest among dermatologists and those covering skin conditions alike this year. Chronic itch is very common and affects approximately 22% of people in their lifetime. According to a 2024 JAMA Network review, chronic itch, a condition that is defined as itch experience for 6 weeks or longer, accounts for roughly 1% of physician visits and results in impaired sleep and reduced quality of life.

This year, conversations with leading dermatologists highlighted how research is advancing our understanding of itch, improving treatments and revealing the multiple ways biology, environment and lifestyle tie together to create or worsen symptoms.

Back in April, experts Shawn Kwatra, M.D., Brian Kim, M.D., and Gil Yosipovitch, M.D., all shared with Managed Healthcare Executive that chronic itch is a complex condition, influenced by the immune system, nerves and external factors.

“One element of this leadership is that we're trying to make a map of human itch subtypes, and where there's similarities between conditions with approvals and non-approvals,” Kwatra, chair of dermatology at the University of Maryland School of Medicine, said.

Kwatra’s team has created a blood test that finds increased cytokines, a step toward giving each patient treatment based on their own biology. Kwatra said that these biomarker-driven approaches could help match therapies more precisely and speed up regulatory approval for new treatments.

Kim, vice chair of dermatology at Mount Sinai, talked about access challenges, noting that insurance coverage typically depends on clinical trial data and narrow diagnoses, leaving many patients without access to effective therapies.

“The problem right now is that everything about whether medicines are covered or not is based on line diagnoses that have undergone phase three clinical trials,” he said. “But in reality, a lot of itch conditions over time—post-market, once a drug is already approved—off-label use of those medications demonstrate often very convincing efficacy for those conditions that are not textbook.”

Yosipovitch, a professor at the Miller School of Medicine at the University of Miami and a pioneer in itch research, shared that biomarkers are important for the future. He said that recent research has shown a neuropeptide called brain natriuretic peptide (BNP) could indicate chronic itch in humans.

“We saw that this is very highly correlated to chronic itch of undetermined origin, also in elderly itch and in patients with prurigo nodularis,” he said, adding that there’s potential of testing for cytokines and chemokines to better understand the causes of different itch types.

Treatment advances were another highlight of the year.

According to Kwatra, new biologic and small molecule inhibitors can reduce itch quickly by targeting the immune and neural systems more safely than older treatments. These therapies include Dupixent (dupilumab), IL-13 inhibitors like Adbry (tralokinumab) and Ebglyss (lebrikizumab), Nemluvio (nemolizumab) targeting IL-31 and JAK1 inhibitors.

He said that itch pathogenesis traverses both the immune system and the neural system. Stopping inflammation and the transmission of itch signals is a breakthrough in understanding and treating chronic itch.

The experts also looked at lifestyle and environmental factors. Kwatra’s team found links between gut microbiomes and some chronic itch cases. Kim shared that diet and environmental allergens can affect symptoms. He also said that processed or pickled foods could trigger immune responses, possibly making the itch worse.

Yosipovitch cautioned that diet only affects itch in certain cases, and strict diets without evidence may not help much. Pollution and other environmental exposures seem to significantly worsen conditions such as eczema, according to the experts, showing how complex itch triggers can be.

According to a report written by sister publication Dermatology Times (DT) in November, research from the 2025 Inflammatory Skin Disease Summit noted that itch can signal inflammation in the body.

In the article, Kim shared that itch is a way the body senses internal inflammation, not just an external reaction. New drug treatments now target the root causes of itch instead of just masking symptoms.

“Dermatology is actually emerging as a beautiful use case for medicine in general… solving problems in dermatology is allowing us to solve problems in other specialties of medicine,” Kim told DT.

Looking ahead, researchers are working to classify itch into different types, understand its biology and use biomarkers to guide care. The experts spoke for many dermatologists in the space with hopes these advances will shorten delays in treatment, expand coverage for effective therapies and improve outcomes for patients who have been struggling with this condition for far too long.

As awareness of chronic itch increases, research, treatments and understanding of lifestyle and environmental factors are improving and paving the way for better care and access for patients.