Why Is My Skin So Itchy?
Medically reviewed by Marisa Garshick, MDMedically reviewed by Marisa Garshick, MD
"Pruritus" is the medical term used to describe the feeling of itchy skin. There are many potential causes, ranging from skin conditions or rashes, such as eczema, to more serious systemic health issues, such as liver disease or kidney failure.
This article discusses the types, causes, and remedy options for pruritus.
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What Does Pruritus Feel Like?
Pruritus is a feeling of itchiness or irritation on the skin that drives you to scratch the affected area. The sensation feels similar to pain, but it does not develop in precisely the same way. When people feel pain, their initial reflex is to withdraw, whereas pruritus drives them to scratch. The itch sensation can feel tingly and uncomfortable.
Types of Pruritus
There are various types of pruritus according to cause, including:
Pruriceptive itch: Driven by physiological reactions, such as allergies, inflammation, dryness, or skin damage
Neuropathic itch: Driven by nervous system damage
Neurogenic itch: Driven by underlying health disorders and diseases
Psychogenic itch: Caused by chemical changes in the brain often driven by mood disorders and stress
How to Tell the Difference
It can be challenging to tell the difference between the types of itch until you go through proper testing to determine the cause. In many cases, itching sensations are nothing to worry about and are caused by minor physiological reactions, meaning they are types of pruriceptive itch.
What Causes Pruritus (Itchy Skin)?
There are many underlying causes of itchy skin, including:
Injuries such as burns
Insect bites and infestations
Systemic diseases
The following are common causes of pruritus.
Learn More: Common Causes and Treatments for Itching
Dehydration and Dry Skin
Dehydration occurs when the skin has lost a significant amount of its moisture, leading to dryness. When the skin lacks moisture and becomes excessively dry, an itch can develop.
Other Signs of Dehydrated and Dry Skin
To determine if dry skin is causing the itchy sensation, it’s essential to look for other signs of dry skin, including:
Flaking or peeling skin
A rough texture
Increased visibility of fine lines
Cracks in the skin
Raw, irritated skin that could sting or burn
Related: How to Treat Winter Itch
Eczema
Eczema is a group of inflammatory skin conditions that cause various symptoms, including itchiness. The itchiness that develops in eczema is often intense, making it challenging to avoid scratching. There are multiple types of eczema, all of which can lead to itching.
Other Signs of Eczema
Along with itchiness, if you have eczema, you may also develop:
Dry skin
Rashes
Scaly patches of skin
Skin infections
Inflammation
Discolored skin
Oozing or crusting
A rough or leathery appearance
Swelling in the affected area
Related: What Is Pruritic Dermatitis?
Allergies
Allergies develop as a heightened immune response to substances the immune system considers harmful. The overreaction by the immune system is what drives symptoms, including itch.
Allergies can develop as a response to environmental triggers, including pollen, pet dander, household dust, and mold, as well as to foods, insect bites, plants, and ingredients in household or beauty products.
Other Signs of Allergies
Itchiness in allergies can develop in many places, including the skin, nose, and eyes. Other signs you may be experiencing an allergic reaction include:
Watery eyes
Sneezing and runny nose
Rashes or hives
Gastrointestinal distress, including cramps, diarrhea, and bloating
Redness
Pain
Cough
Feeling as though your throat is closing, you can’t get a full breath, or your chest is tight
Wheezing
Feeling faint or light-headed, or blacking out
Feeling a sense of impending doom
Hives
Hives, or urticaria, is a skin reaction that develops into itchy welts. Many things can bring on hives, including:
Certain foods or medications
Allergic reactions to insect bites, latex, pet dander, pollen, or plants
Sun, heat, or cold exposure
Viral infections
Blood transfusions
Exercise
Stress
Other Signs of Hives
Aside from the raised itchy bumps, the only other symptom associated with hives is blanching, which is when the center of a hive turns white when pressed.
Bug Bites
Bug bites are a common source of pruritus. When a bug bites or stings you, it injects saliva or venom under the skin. The immune system detects the unfamiliar substance as a threat, causing it to release histamines. Histamines drive the itchiness after a bug bite.
Other Signs of a Bug Bite
If you didn’t witness the bug bite when it happened and are unsure what's causing the itch, look for other signs of a bite or sting, including:
Swelling and inflammation at the bite site
Pain at the bite site
A small and swollen lump
Redness at the site
Psychological
Psychological itching, also known as psychogenic itch, occurs when the itch is the only symptom and there is no direct or noticeable underlying cause. The cause of psychogenic itch is poorly understood, and research continues to look for ways to identify why it occurs.
However, it has been associated with various mood disorders, including:
Anxiety
Substance use disorder
How Common Is Psychogenic Itch?
Research on the prevalence of psychogenic itch is scarce, but one study looked at outpatients complaining of itch and found that 6.5% of the cases were psychological in nature.
Related: All-Over Itchy Skin (Without) Rash
Vitamin Deficiency
The body needs an adequate amount of nutrients for it to function properly. When you don’t get enough through diet or supplementation, you may develop a deficiency. Vitamin deficiencies, including of the following, can lead to itchy skin:
Vitamin D
Vitamin A
Niacin
Zinc
Iron
These vitamin deficiencies are connected to increased dry skin, which can cause pruritus.
Other Causes
There are many other causes of itchy skin aside from the ones mentioned above. They include:
Other skin conditions, such as psoriasis and various forms of dermatitis
Parasitic infections, such as pinworms, scabies, or head and body lice
Pregnancy
Systemic diseases, such as liver, kidney, and thyroid diseases
Certain cancers or cancer treatments
Medications, including morphine, opioids, analgesics, and sulfonamides
Fungal infections, such as a yeast infection or athlete’s foot
Viral infections, such as chicken pox or measles
Contact with poisonous plants, such as poison oak, poison sumac, or poison ivy
Related: What Is Cholestatic Pruritus?
Who Does Pruritus Affect?
Pruritus is common and affects every person on the planet at some point in their lives. It does not discriminate, and people of all ages, ethnic groups, and socioeconomic groups can develop pruritus.
Symptoms of Pruritus
Itchiness is considered a symptom in and of itself, but other sensations may also occur, including:
Prickling or crawling feeling under the skin
An itch that comes and goes
Feels itchy but isn’t relieved through scratching
Patches of raw or dry skin after scratching
When Does Pruritus Flare Up the Worst?
While you can experience itchiness at any time and on any part of the body, it is typically worse at night, during times of high stress, and in extreme temperatures.
Learn More: Why Am I Itching All Over at Night?
Is Pruritus a Sign of an Underlying Condition?
While many causes of pruritus cause little to no harm to your overall health, it can be a sign of an underlying and more severe health condition. Some disorders that often present with itching are:
Liver disease
Kidney disease
Blood diseases
Diabetes
Systemic parasitosis
Human immunodeficiency virus (HIV)
Pregnancy
Psychological disorders
Hyperparathyroidism
Brain tumors
Looking for Signs of Underlying Disease
If you’re experiencing an itch caused by something you’re aware of, such as a bug bite or allergies, you likely have nothing to worry about. However, since itch can develop because of an underlying condition, it’s essential to pay attention to any other signs of ill health, including:
Chronic fatigue or tiredness
Changes in bathroom habits
Unexpected weight loss
Shortness of breath
New or more frequent headaches
New lumps or bumps
New onset of dizziness
Yellowing of the skin or eyes
Related: When Is Itchy Skin a Cancer Symptom?
How Is Itchy Skin Diagnosed?
To diagnose itchy skin, a healthcare provider will first look at the skin to see if there is any physical evidence to support why the itch developed. They may also ask questions to better understand the ailment, such as where the itch is located, how long it’s been there, whether it comes and goes, and how severe it is.
If there are no signs of skin diseases or other outward conditions that cause itch, a healthcare provider will ask about any other symptoms you’re experiencing. After they have a general idea of what may be going on, they will order tests to check for an underlying cause.
Some testing approaches include:
Blood tests to look for signs of underlying diseases
Stool samples to check for parasites
Once the diagnosis is made, medical treatment can begin if required. In some cases, at-home remedies are enough to help calm the itch, relieving the irritating sensation.
Home Remedies for Itchy Skin
There are various effective home remedies available for itchy skin. They can help to relieve the symptoms while you wait for a proper diagnosis or after being diagnosed with a benign cause.
They include:
Moisturizing agents to prevent dry skin
Staying in a cool environment
Avoiding irritants that could cause itchiness, such as harsh soaps or detergents
Breaking the itch-scratch cycle, which is a cycle that develops when scratching leads to more itchiness, which leads to more scratching, and so on
Using a cold compress on the itchy area
Over-the-Counter Medicated At-Home Options
You can buy anti-itch corticosteroid cream or allergy medications at your local pharmacy to help with itch. Calamine lotion and aloe may also help to reduce the sensation at home.
Related: Best Anti-Itch Creams to Relieve Itchy Skin On the Spot
Medical Treatment for Pruritus
Medical treatment for pruritus will depend on what is causing it. Several therapies may be given to help combat the symptom of itch in various diseases and disorders. They include:
Corticosteroids to alleviate inflammation in conditions like chronic hives, eczema, psoriasis, and severe allergic reactions
Calcineurin inhibitors (immunosuppressants) to treat inflammatory drivers of itchy skin
Topical lidocaine to relieve itch caused by burns, insect bites and stings, and contact with poisonous plants
Antidepressant medications to address itchy skin caused by liver disease
Antihistamines to relieve itchy skin caused by allergic reactions, bug bites, hives, and eczema
Opioid-receptor antagonists
Anticonvulsants (anti-seizure drugs) to address itchiness driven by nerve damage or nervous system issues
Bile acid sequestrants to lower bile salts in the body and treat itching related to liver diseases such as cirrhosis
Antibiotics to treat itch caused by bacterial infections
Antifungal medications to treat fungal infections such as Athlete’s foot
Antiparasitic drugs to treat itchiness caused by parasite infections, such as pinworm
Oral vs. Topical Treatments
The drugs mentioned above can, in some cases, be prescribed as topical agents, as is the case with antifungals, corticosteroids, and antibiotics. Other topical options include scabicide for scabies, pediculicide for lice, and anesthetics for rashes, hives, scabies, and insect bites or stings.
A healthcare provider will decide whether you need an oral or topical solution based on your health, health history, response to medication, and underlying cause.
How Long Does Pruritus Last?
Typically, pruritus shouldn’t last longer than a few weeks. If it does, you will likely need to see a healthcare provider to address the issue.
When to Contact a Healthcare Provider
If you have severe pruritus that interrupts your ability to perform daily tasks, you should see a healthcare provider. They will help to determine the cause and set up a treatment plan.
You should also see a healthcare provider if:
The itch is getting worse even with treatment.
A rash is forming or growing to spread across more areas of the body.
You have other signs of infection, such as fever and chills.
You are experiencing other generalized but abnormal symptoms, such as chronic fatigue, dizziness, or jaundice (indicated by yellowing of the skin or eyes).
Summary
Pruritus is an irritating itchy sensation that can occur in everyone. It can develop for many reasons, some of which are benign and some of which are more serious and could indicate the presence of an undiagnosed disease or condition.
To ensure itchy skin is treated appropriately, healthcare providers will perform a physical exam, collect any other symptoms of health complaints, and perform specific tests, such as a blood test or skin biopsy. In many cases, the cause is benign and can be treated at home using natural or over-the-counter remedies such as calamine lotion or an ice pack.
Treatments will vary if something more serious is causing the itch. If you experience itchiness that doesn't subside with home remedies or develops alongside other symptoms, you should see your healthcare provider for support and appropriate treatment.
Read the original article on Verywell Health.
