Pruritus (itching) is an unpleasant sensation of the skin that causes the need to scratch. Specific receptors responsible for mediating itch have not been found. It is believed that pruritus is mediated by unmyelinated free nerve fibres. From there, the impulse travels to the spinothalamic tract and the cerebral cortex. Itching can be caused by external stimuli ( like gentle touch) as well as by many skin and internal diseases and drugs. The most common mediator of itch is histamine; other substances responsible for pruritus have also been identified. Pruritus may be acute or chronic, and localized or generalized. Scratching can be caused by dermal, systemic, neurologic or psychologic diseases. It is important to find out the cause of itching and to focus on the treatment of the underlying disease. This requires a thorough disease history, examination and sometimes blood analyses and imaging studies. As dry skin is commonly associated with pruritus, proper skin care is of importance.