Itchy Skin (pruritus)
Itchy skin is an irritating sensation that makes you want to scratch. It’s also called pruritus (proo-RIE-tus). Itchy skin is often caused by dry skin and is common in older adults, as skin tends to become drier with age.
Depending on the cause of your itchiness, your skin may look no different than usual or it may be inflamed, rough or have bumps. Repeated scratching can cause raised thick areas of skin that might bleed or become infected.
Many people find relief with self-care measures such as moisturizers, gentle cleansers and lukewarm baths. Long-term relief requires identifying and treating the cause of itchy skin. Common treatments are medicated creams, moist dressings and anti-itch medicines taken by mouth.
Itchy skin can affect small areas, such as the scalp, an arm or a leg. Or it can cover the whole body. Itchy skin can occur without any other noticeable changes on the skin. Or it may come with:
- Inflamed skin
- Scratch marks
- Bumps, spots or blisters
- Dry, cracked skin
- Leathery or scaly patches
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.
When to see a doctor
See your health care provider 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
- Comes with other symptoms, such as weight loss, fever or night sweats
If the condition persists for three months despite treatment, see a dermatologist to be evaluated for skin disease. You may also need to see a doctor who specializes in internal medicine (internist) to check for other diseases.
Causes of itchy skin include:
- Skin conditions. Examples include dry skin (xerosis), eczema (dermatitis), psoriasis, scabies, parasites, burns, scars, insect bites and hives.
- Internal diseases. Itching on the whole body might be a symptom of an underlying illness, such as liver disease, kidney disease, anemia, diabetes, thyroid problems and certain cancers.
- Nerve disorders. Examples include multiple sclerosis, pinched nerves and shingles (herpes zoster).
- Psychiatric conditions. Examples include anxiety, obsessive-compulsive disorder and depression.
- Irritation and allergic reactions. Wool, chemicals, soaps and other things can irritate the skin and cause rashes and itching. Sometimes a substance, such as poison ivy or cosmetics, causes an allergic reaction. Also, reactions to certain medicines, such as narcotics to treat pain (opioids) can cause itchy skin.
Sometimes the cause of the itching can’t be determined.
Anyone can develop itchy skin. But you may be more likely to develop it if you:
- Have a condition that can cause itching, such as dermatitis, kidney disease, anemia or thyroid disease.
- Are an older adult, as skin can become drier with age.
Itchy skin that is severe or lasts more than six weeks can affect the quality of your life. This type is called chronic pruritus. It might disturb your sleep or cause anxiety or depression. Prolonged itching and scratching can increase the intensity of the itch, possibly leading to skin injury, infection and scarring.
Diagnosing the cause of itchy skin starts with a physical exam and questions about your medical history. If your health care provider thinks your itchy skin is the result of a medical condition, you might have tests, including:
- Blood test. A complete blood count can provide evidence of an internal condition causing your itch, such as anemia.
- Tests of liver and kidney function. Liver or kidney disorders and thyroid conditions, such as hyperthyroidism, can cause itching.
- Chest X-rays. A chest X-ray can show if you have enlarged lymph nodes, which can go along with itchy skin.
Itchy skin treatment focuses on removing the cause of the itch. If home remedies don’t ease your symptoms, your health care provider may recommend prescription medicine or other treatments. Controlling itchy skin symptoms can be challenging and may require long-term therapy. Options include:
Corticosteroid creams and ointments. If your skin is itchy and inflamed, your health care provider may suggest applying a medicated cream or ointment to the affected areas. You might then cover the treated skin with damp cotton material. Moisture helps the skin absorb the cream and has a cooling effect.
If you have severe or long-term itching, your health care provider might suggest this bedtime routine: Bathe in plain lukewarm water for 20 minutes, and then apply triamcinolone .025% to 0.1% ointment to the wet skin. This traps the moisture and helps the medicine absorb. Then put on pajamas. Repeat this routine at bedtime for several nights.
- Other creams and ointments. Other treatments that you apply to your skin include calcineurin inhibitors, such as tacrolimus (Protopic) and pimecrolimus (Elidel). Or you may find some relief with topical anesthetics, capsaicin cream or doxepin cream.
- Oral medicines. Antidepressants called selective serotonin reuptake inhibitors (SSRIs) may be helpful in easing some types of long-term itch. Examples of SSRIs include fluoxetine (Prozac) and sertraline (Zoloft). Another option is a tricyclic antidepressants, such as doxepin, You may not feel the full benefit of some of these medicines until 8 to 12 weeks after starting treatment.
- Light therapy (phototherapy). Phototherapy involves exposing your skin to a specific type of light. This can be a good option for people who can’t take oral medicines. You’ll likely need a few phototherapy sessions, until the itching is under control.
References
- Fazio SB, et al. Pruritis: Therapies for generalized pruritus. https://www.uptodate.com/contents/search. Accessed Nov. 1, 2022.
- AskMayoExpert. Pruritus without rash. Mayo Clinic; 2021.
- James WD, et al. Pruritus and neurocutaneous dermatoses. In: Andrews’ Diseases of the Skin: Clinical Dermatology. 13th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Nov. 17, 2020.
- Yosipovitch G, et al. Chronic pruritis. The New England Journal of Medicine. 2013;368:1625.
- Medical review (expert opinion). Mayo Clinic. Nov. 25, 2020.
- Fazio SB, et al. Pruritis: Etiology and patient evaluation. https://www.uptodate.com/contents/search. Accessed Sept. 30, 2020.
- James WD, et al. Eczema, atopic dermatitis, and noninfectious immunodeficiency disorders. In: Andrews’ Diseases of the Skin: Clinical Dermatology. 13th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Nov. 17, 2020.
- Taylor, SC. Cosmetic applications. In: Treatments for Skin of Color. Elsevier; 2011.
- Kermott CA, et al., eds. Poison ivy rash. In: Mayo Clinic Book of Home Remedies. 2nd ed. Time; 2017.
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