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Itchy skin (pruritus)

Medically reviewed on Nov 17, 2017

Overview

Itchy skin is an uncomfortable, irritating sensation that makes you want to scratch. Also known as pruritus (proo-RIE-tus), itchy skin is usually caused by dry skin. It's common in older adults, as skin tends to become drier with age.

Depending on the cause of your itchy skin, it may appear normal. Or it may be red or rough or have bumps or blisters. Repeated scratching can cause raised, thickened areas of skin that may bleed or become infected.

Self-care measures such as moisturizing, using anti-itch products and taking cool baths can help relieve itchy skin. Long-term relief requires identifying and treating the cause of itchy skin. Itchy skin treatments include medications, wet dressings and light therapy.

Symptoms

You may have itchy skin over certain small areas, such as on an arm or leg, or over your whole body. Itchy skin can occur without any other noticeable changes on the skin. Or it may be associated with:

  • Redness
  • Bumps, spots or blisters
  • Dry, cracked skin
  • Leathery or scaly texture to the skin

Sometimes itchiness lasts a long time and can be intense. As you rub or scratch the area, it gets itchier. And the more it itches, the more you scratch. Breaking this itch-scratch cycle can be difficult, but continued scratching can damage your skin or cause infection.

When to see a doctor

See your doctor or a skin disease specialist (dermatologist) if the itching:

  • Lasts more than two weeks and doesn't improve with self-care measures
  • Is severe and distracts you from your daily routines or prevents you from sleeping
  • Comes on suddenly and can't be easily explained
  • Affects your whole body
  • Is accompanied by other signs and symptoms, such as extreme tiredness, weight loss, changes in bowel habits or urinary frequency, fever, or redness of the skin

Causes

Possible causes of itchy skin include:

  • Dry skin. If you don't see a crop of bright, red bumps or some other dramatic change in the itchy area, dry skin (xerosis) is a likely cause. Dry skin usually results from older age or environmental factors such as long-term use of air conditioning or central heating, and washing or bathing too much.
  • Skin conditions and rashes. Many skin conditions itch, including eczema (dermatitis), psoriasis, scabies, lice, chickenpox and hives. The itching usually affects specific areas and is accompanied by other signs, such as red, irritated skin or bumps and blisters.
  • Internal diseases. Itchy skin can be a symptom of an underlying illness. These include liver disease, kidney failure, iron deficiency anemia, thyroid problems and cancers, including leukemia and lymphoma. The itching usually affects the whole body. The skin may look otherwise normal except for the repeatedly scratched areas.
  • Nerve disorders. Conditions that affect the nervous system — such as multiple sclerosis, diabetes mellitus, pinched nerves and shingles (herpes zoster) — can cause itching.
  • Irritation and allergic reactions. Wool, chemicals, soaps and other substances can irritate the skin and cause itching. Sometimes the substance, such as poison ivy or cosmetics, causes an allergic reaction. Food allergies also may cause skin to itch.
  • Drugs. Reactions to drugs, such as antibiotics, antifungal drugs or narcotic pain medications, can cause widespread rashes and itching.
  • Pregnancy. During pregnancy, some women experience itchy skin, especially on the abdomen and thighs. Also, itchy skin conditions, such as dermatitis, can worsen during pregnancy.

Complications

Itching skin can affect the quality of your life. Prolonged itching and scratching may increase the intensity of the itch, possibly leading to:

  • Skin injury
  • Infection
  • Scarring

Diagnosis

Tracking down the cause of your itch can take time and involve a physical exam and a careful history. If your doctor suspects your itchy skin is the result of an underlying medical condition, he or she may perform tests, including:

  • Blood test. A complete blood count can provide evidence of an internal condition causing your itch, such as iron deficiency.
  • Tests of thyroid, liver and kidney function. Liver or kidney disorders and thyroid abnormalities, such as hyperthyroidism, may cause itching.
  • Chest X-rays. Signs of underlying disease that are associated with itchy skin, such as enlarged lymph nodes, can be seen by using X-rays.

Treatment

Once a cause is identified, treatments for itchy skin may include:

Medications

  • Corticosteroid creams. If your skin is itchy and red, your doctor may suggest applying a medicated cream to the affected areas. He or she may also suggest that you cover these areas with damp cotton material that has been soaked in water or other solutions. The moisture in the wet dressings helps the skin absorb the cream and also has a cooling effect on the skin, reducing itch.
  • Calcineurin inhibitors. Certain drugs, such as tacrolimus (Protopic) and pimecrolimus (Elidel), can be used instead of corticosteroid creams in some cases, especially if the itchy area isn't large.
  • Antidepressants. Selective serotonin reuptake inhibitors, such as fluoxetine (Prozac) and sertraline (Zoloft), may help reduce various types of skin itching.

Treating the underlying disease

If an internal disease is found — whether it's kidney disease, iron deficiency or a thyroid problem — treating that disease often relieves the itch. Other itch-relief methods also may be recommended.

Light therapy (phototherapy)

Phototherapy involves exposing your skin to certain wavelengths of ultraviolet light. Multiple sessions are usually scheduled until the itching is under control.

Lifestyle and home remedies

For temporary relief of itching, try these self-care measures:

  • Avoid items or situations that cause you to itch. Try to identify what's causing your symptoms and avoid it. This might be rough clothing, an overly heated room, too many hot baths, or an irritating substance such as perfumed soap or detergent, jewelry, or a cleaning product.
  • Use a high-quality moisturizing cream on your skin. Apply cream (Cetaphil, Eucerin, CeraVe, others) to affected skin at least once a day.
  • Use creams or gels that cool the skin. Try calamine lotion or a product with up to 1 percent menthol.
  • Apply an anti-itch cream or lotion to the affected area. Short-term use of nonprescription hydrocortisone cream containing at least 1 percent hydrocortisone can temporarily relieve an itch accompanied by red, inflamed skin. So can calamine lotion or creams that include capsaicin.

    Topical anesthetics, such as pramoxine, may be helpful.

  • Avoid scratching whenever possible. Cover the itchy area if you can't keep from scratching it. Trim nails and wear gloves at night.
  • Apply cool, wet compresses. Covering the affected area with wet bandages and dressings can help protect the skin and prevent scratching.
  • Take a bath or shower. Use lukewarm bath water and sprinkle in baking soda, uncooked oatmeal or colloidal oatmeal — a finely ground oatmeal that is made for bathing (Aveeno, others). Some people with long-term pruritus say that a hot shower eases their symptoms for hours. Others say a cold shower helps. Whatever method you use, rinse thoroughly and apply moisturizer.
  • Reduce stress. Stress can worsen itching. Counseling, behavior modification therapy, meditation and yoga are some ways of relieving stress.
  • Try over-the-counter allergy medicine. Some of these drugs, such as diphenhydramine (Benadryl), can make you drowsy. They might be helpful at night if your itchy skin keeps you awake.

Alternative medicine

For stress-related itching, you might find some relief of your symptoms through meditation, acupuncture or yoga.

Preparing for an appointment

You're likely to start by seeing your family doctor or primary care doctor. In some cases, you may be referred to a specialist in skin diseases (dermatologist).

Here is information to help you get ready for your appointment and to know what to expect from your doctor.

What you can do

Write down your signs and symptoms, when they occurred, and how long they lasted. Also, make a list of all medications, including vitamins, herbs and over-the-counter drugs, you're taking. Or take the original bottles and a written list of the dosages and directions.

Write down questions to ask your doctor. For itchy skin, questions you may want to ask include:

  • What is likely causing my symptoms?
  • Are tests needed to confirm the diagnosis?
  • What are other possible causes for my symptoms?
  • Is my condition likely temporary or chronic?
  • What is the best course of action?
  • I have other health problems. How can I manage them together?
  • What are the alternatives to the primary approach you're suggesting?
  • Do I need prescription medication, or can I use over-the-counter medications to treat the condition?
  • What results can I expect?
  • Can I wait to see if the condition goes away without treatment?

Don't hesitate to ask any other questions you have.

What to expect from your doctor

Your doctor is likely to begin with your medical history and to ask you some questions, such as:

  • When did you begin experiencing symptoms?
  • What did your skin look like when your symptoms started?
  • Have your symptoms changed?
  • What, if anything, appears to worsen your symptoms?
  • What, if anything, appears to improve your symptoms?
  • What at-home treatments have you tried?
  • What prescription and over-the-counter medications are you taking?
  • Have you traveled recently?
  • What is your typical diet?
  • Are you in contact with possible irritants, such as pets or certain metals, at home or at work?

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