What is Itchy Throat?
Itchy throat is an irritating sensation in the throat that provokes desire to cough. Other symptoms like pain, secretions, difficulty eating or speaking, runny nose or itchy eyes may accompany throat itch, depending on the cause.
Picture 1. Structures in the throat
The pharynx can be divided into:
- The nasal part (nasopharynx) that receives inhaled air from the nose
- The oral part (oropharynx) that receives ingested food from the mouth
- The laryngopharyx – the part between epiglottis and esophagus
The larynx carries inhaled air from the pharynx into breathing tubes (trachea and bronchi). Vocal cords in larynx enable speaking.
The epiglottis covers the entrance of the larynx during swallowing. Sometimes a piece of food, like a small fish bone, can stick in a pocket above the epiglottis.
Why Does the Throat Itch?
The inner walls of the throat are covered with mucosal membrane containing nerves, which may be irritated by polluted air, food, inflammatory or allergic reaction. Mucosal glands secrete mucus, a sticky fluid that covers the throat walls, thus protecting them and allowing smooth passage of the air and food. When mucous glands do not secrete enough mucus, for example, due to dehydration, medications or dry air, throat nerves become exposed and irritable.
Causes of Itchy Throat
Conditions that may cause itchy throat:
1. Dry Throat
Dry throat often appears together with dry eyes, mouth and skin. Common causes are:
- Cold windy weather
- ‘Sick building disease’ from excessive indoor heating or air condition
- Stuffed nose and breathing through mouth
- Acute or chronic throat inflammation
- Under-active salivary glands in old people
- Marijuana and tobacco smoking
- Caffeine in coffee, sodas and energy drinks
- Sjögren’s syndrome
- Medications, such as antidepressants, drugs to treat urine incontinence, belladonna (atropine), barbiturates, ergotamine, opium, diuretics, antihistamines or sprays to treat asthma.
Treating of a Dry Throat
Treatment of a dry throat includes removing a cause and drinking enough water or herbal tea with honey that soothes the throat. Herbal candies without sugar and menthol may provide temporary relief by making a thin protective film over the throat mucosa. Breathing with mouth closed and avoiding speaking also helps. In Sjögren’s syndrome, rinses and artificial saliva may be used to moist the throat. Indoor air humidifiers are available.
Teas containing licorice root, Marshmallow root, honeysuckle flowers, barberry, eucalyptus, chamomile, or slippery elm may help in sore and itchy throat.
2. Loud Speaking or Singing
Prolonged speaking, singing or yelling may leave you with sore itchy throat that may need few days to resolve. Abovementioned measures should be considered; pain killers are rarely needed.
3. Foreign Body
A piece of fish bone or a seed may stuck in the pocket above the epiglottis, or a sharp piece of glass may be stabbed in the throat wall. Foreign body should be tried to cough out, or swallowed with the help of gargling water. Stabbed pieces usually resolve on their own. Painkillers may be used to relieve pain.
4. Irritant Substances
Gases from industrial pollution containing sulphur dioxide or metal fumes, dust, solvents, laboratory chemicals or household cleaners may all irritate the throat. Marijuana, cigarette smoke or inhaled cocaine are also irritating. Burning and itching from hot spices should resolve in about an hour after ingesting. Treatment is by avoiding irritant substances and measures described in ‘dry throat’ above.
Burns after drinking hot liquids or corrosive substances (acids, petrol) may cause itchy throat for prolong periods.
5. Psychological Causes
Repeating dry cough without apparent reason is an obvious sign of psychologically induced cough. The coughing person feels the need to attract attention.
6. Infections of the Throat
Viral infections, like common cold (rhinovirus), flu (influenza virus), infectious mononucleosis (Epstein-Barr virus), mumps, chickenpox or measles usually cause infection of upper respiratory tract with an itchy sore throat. Treatment is like in sore throat. Aspirin should be avoided, since in rare cases can cause a dangerous Reye’s syndrome with liver damage, especially in children.
Bird flu is caused by Avian influenza virus, transmitted from birds or poultry (like chicken). Infected persons suffer from influenza-like illness with sore throat and cough. Bird flu becomes dangerous when it affects lungs.
Herpes simplex or Herpes zoster virus may, rarely, affect the mouth or throat.
Some tropical viral illnesses, like Dengue fever or Q fever, can also cause itchy throat.
Bacteria Haemophilus influenzae and Streptococcus pneumoniae can cause infection of the tonsils (strep throat) or epiglottis, especially in children. Diphtheria or anthrax are still common in Africa, south Asia and South America. Bacterial infections are treated with antibiotics. Brucellosis spreads from animals in rural environment and may cause a flu-like disease.
Bacterial infection may persist for long time, causing chronic pharyngitis. White streaks of pus on enlarged tonsils, and bad mouth smell are characteristic symptoms. The ENT (Ear-Nose-Throat) doctor should know how to treat chronic pharyngitis, and if it is appropriate to remove enlarged tonsils. Collection of pus (abscess) may form beneath the mucosal layer in the pharyngeal wall and cause pain and fever. Antibiotics and ,occasionally, surgical incision may be needed.
Candida or other fungi may overgrow in the mouth and throat (oral thrush) in persons with low immunity due to diabetes, AIDS, cancer, chemotherapy, corticosteroid therapy, or other causes. Treatment is with anti-fungal rinses or pills containing nystatin. Mucormycosis is fungal infection of the upper airways by Mucorales molds, often found on bread.
Croup is an inflammation of the throat in children with characteristic harsh, barking cough. It may be caused by a viral or bacterial infection or allergy. Treatment is with providing moist air for breathing, corticosteroids in inflammation, or antibiotics in bacterial infection.
7. Itchy Throat due to Disorders of Near Organs
Sinusitis symptoms are blocked nose and pain in para-nasal sinuses. Characteristic symptom in chest cold (tracheitis) is pain under the breastbone during coughing.
Ozena is chronic inflammation of mucosa in the nose or throat. It appears as a dry, crusty, itchy mucosa in the nose and throat with an intense bad smell. This disorder of an uncertain cause affects mainly young women in non-developed countries. It may run in families and it may be caused by bacterium Klebsiella. Treatment is with nasal drops or surgery.
Acute bronchitis may develop as a complication of a chest cold or flu. Chronic bronchitis is common in smokers. In both cases, coughing results in dry itchy throat.
Bacterial pneumonia is severe infection of the lungs. Increased frequency of breathing and heartbeat, malaise, chest pain, productive cough and sweating are main symptoms. Treatment is with rest, antibiotics and fluid replacement. Treated pneumonia should resolve within a week.
Atypical pneumonia is caused by viruses or other microbes, such as Mycoplasma pneumonie or Chlamidia psittaci. Insidious onset, low grade fever, dry cough, vague chest pains, and prolonged course are main symptoms. Treatment is with avoiding hard work, and treating the cause.
Tuberculosis, lung parasites, like Echinococcus, or any other lung disease with cough may cause itchy throat.
Cystic fibrosis is a genetic disease, marked by excessive secretion of saliva, sweat and dense bronchial and gastrointestinal secretions. Repeating lung infections and constant productive cough are characteristic. Many children die before adulthood. Treatment includes clearing of airways and fighting with infections.
In pericarditis, inflammation of the heart sac, this may press upon the nerves that innervate the throat and thus irritate it. The same may happen in aneurysm or dissection of the thoracic aorta.
8. Throat Itch in Systemic Diseases
Throat may be affected in systemic connective tissue diseases, like Sjögren’s syndrome, systemic sclerosis, rheumatoid arthritis, SLE or vasculitis.
9. Allergies to Food, and Environmental Allergens
Food allergies commonly cause an itchy throat, itchy/tingling lips, swelling of the face, and hives (urticaria) on the upper part of the body.
Allergies to pollens, pet dander, molds, dust mites and other inhaled allergens (substances that may trigger allergy) usually cause itchy, pink, watery eyes (conjunctivitis), runny nose and itchy throat. Asthma, due to breathing through the mouth and using inhalation sprays, can also cause itchy throat.
Treatment is by avoiding triggering foods or substances, and by using oral antihistamines after an allergic attack. Diagnosis of allergy is made by skin tests. Allergies often improve with time.
Tumors in the pharynx or larynx may cause itchy throat. Small benign tumors are common in singers or other people who speak loudly a lot. Malign tumors are common in adult smokers after 50 years of age. Treatment is by surgical removal of a tumor.
Lymphomas, metastases in neck lymph nodes, or cancers in the neck and chest may also trigger cough.
11. Disorders in the Neck
Enlarged thyroid or lymph nodes, abscess, tumor, dislodged tissues after an injury, or fibrous tissue (adhesions) after a surgery may press upon the throat from outside and irritate it.
In gastro-esophageal reflux disease (GERD), acid from the stomach comes up into the throat and irritates it, causing itching and burning feeling known as heartburn.
Treating of hyper-acidity with anti-acid drugs, such as H2 antagonists (cimetidine, ranitidine) or proton pump inhibitors (omeprazol), is essential. Eventual underlying infection of the stomach with bacterium Helycobacter pylori has to be considered.
After vomiting, the throat may itch due to irritation by gastric acid. If vomited content is inhaled, it may cause inflammation of the larynx and lungs (aspiration pneumonia).
14. Diagnostic and Therapeutic Procedures
Endotracheal intubation (a plastic tube inserted into the throat to keep mouth open during artificial breathing or other procedures), gastric or bronchial endoscopy may leave a sore itchy throat lasting for few days.
End Notes about Itchy Throat Treatment
Immediate relief from an itchy throat, when your throat is dry, is by drinking some water. Having a bottle of water or a cup of herbal tea (without teine) in the reach of the hand can really help in dry indoor air. Being well hydrated is essential. If you excrete at least 200 ml of clear white or yellow urine every morning, you are well hydrated.
Try to remove the cause. If you have a hay fever, do not hang around the woods and parks. In air pollution, close the windows. Breath through the nose, and do not speak loudly all the day, if possible.
Pain killers, antibiotics, anti-cough syrups, corticosteroids and antihistamines should be used only when a cause is obvious and symptoms are disturbing your daily activities. Antibiotics quite often cause antibiotic associated diarrhea, even after only few days of use, and steroids have several side effect, including fungal infection of the mouth and throat.
Remedies help in a mild itch due to a dry throat, but not in a severe inflammation. Throat itch is often transitional, so there is no need to spend money for several remedies.