Why Am I So Itchy? Common Causes and How To Know if It’s Something Serious

There’s no feeling more urgent and frustrating than the need to scratch an itch — especially if it’s a spot you can’t reach. To add even more discomfort, it feels like the more you scratch, the more your skin itches. What gives?

Usually, the culprit behind an itchy skin mystery isn’t so threatening: dry skin. While dry skin is more common in the winter, aging also has an effect. As we get older, our hormone levels change and our skin becomes thinner and drier. Caring for your skin and using moisturizers regularly can help offset these effects.

But in other cases, a persistent itch (also known as pruritus) can signal other medical issues that need a doctor’s attention.

“Usually, the problem is traced to dry skin; however, reactions to medications and other underlying conditions can also cause itching,” explains dermatologist Shilpi Khetarpal, MD.

Dr. Khetarpal explains what conditions can cause itching and how to know if your need to scratch is a sign of something serious.

What makes us itch?

Just like sneezing or coughing, feeling an occasional itch is a part of life. But what causes this need to scratch? Usually, it’s something in our environment, the food we eat, or ingredients or allergens our skin is sensitive to.

The most common culprits of itchiness include:

• Dry skin. This is one of the most common causes of itch. There are many different things you can do to soothe dry skin. But it all depends on why your skin is feeling dehydrated in the first place. These include:
  • Winter air, inside and out. A drop in temperature and humidity can leave your skin parched, while indoor heating can strip it of even more moisture. Tip: To help your skin bounce back, use a humidifier at home set at 50% or higher.
  • Hot showers. While steamy showers can temporarily soothe your skin, they end up drying your skin out more quickly. Tip: Switch to quick showers with lukewarm water, rather than hot.
  • The wrong soap. Some soaps are harsh and strip your skin of its natural moisture. Sounds pleasant, doesn’t it? Tip: Read labels carefully and choose a mild, fragrance-free soap that moisturizes as it cleanses.
  • Too much towel action. Vigorous toweling off after showering can strip your skin and increase dryness. Tip: After a shower, pat yourself dry instead of rubbing.
  • Mediocre moisturizers. Use moisturizer after washing, but choose wisely. Avoid lotions containing fragrance, as they can dry out your skin. Tip: Go for fragrance-free lotions containing ceramide, a molecule that traps water to help restore your skin barrier.
  • Harsh detergents. Fragrance in laundry detergents and fabric softeners can irritate dry skin. Tip: Look for free and clear laundry products.
• Allergic reactions. Your itch may also be caused by a change in products that your body isn’t reacting to well. Tip: Using over-the-counter antihistamines like diphenhydramine (Benadryl®) can help reduce itching and apply a cool compress on the affected area.
• Sunburn or heat rash. If you recently spent some time in the sun without protection, a sunburn can start to feel itchy. Tip: A cool bath, applying aloe vera and wearing lighter clothing can help deal with itching symptoms.
• Insect bites or stings. We all know the familiar itch of a mosquito bite, but itchiness can even come from bee stings or other insect bites. Tip: Try using topical steroids like hydrocortisone to calm the inflammation, an ice pack to cool the numbing and most importantly: avoid scratching!
• Reactions to medications. If you start a new medication that your body isn’t used to or rejects in some way, it can cause itchiness or other skin irritations. Tip: The best thing to do is to stop using the medication, contact your healthcare provider and use a cold compress and take antihistamines to reduce the itching.
• Eczema. A common skin condition, eczema commonly causes itchiness in different parts of the body. Tip: use a thick moisturizer or cream to soothe the area, try a warm bath and avoid any triggers.
• Hives. Hives can occur often during an allergic reaction due to a food or something you’ve touched. Tip: Switch to loose clothing, take antihistamines and apply a cool compress to soothe the area.
• Being 65 or older. If you’re over 65, your skin probably has a lot of stories to tell. But that means it’s also extra sensitive to becoming itchy or irritated. Tip: Be more intentional about using lotion.

Does the time of day matter?

In some cases, the time of day can also tell you something about your itch. For example, some people experience severe itching at night. If you find yourself persistently scratching a nighttime itch, it can be due to a lot of reasons.

Sometimes, it’s simply due to the environment or an increase in dry air (for example: if you use a heater in your bedroom during the winter). Other times, it’s due to hormonal changes or a flare-up of a skin condition like eczema. In some rare cases, itchiness at night can be a sign of an underlying condition like diabetes or kidney failure — but you won’t know for sure until you get tested by a healthcare provider. But you’d likely be experiencing other symptoms like rapid weight loss, fever and sleep disturbances.

You may also notice a rise in itchiness during certain times of the day because of your bathing routine. Do you shower in the morning or evening? If your itchiness is triggered by over-bathing, hot water or harsh soaps, you may notice more itchiness after you bathe.

If you notice a pattern in the time of day that your itchiness starts, it may give you a clue to the underlying cause. Be sure to mention any details like this with a healthcare provider or dermatologist.

When is it a sign of something serious?

Can itchy skin point to something more serious? In some cases, yes. Underlying conditions can sometimes cause itching and other skin-related symptoms.

Depending on the condition or cause, symptoms of itching can occur on different parts of the body — from your hands, legs and even genital areas.

The itching is considered chronic if it goes on for six weeks or more. “It’s a symptom you don’t want to ignore, especially if it continues for an extended period of time,” Dr. Khetarpal points out.

In some cases, persistent itching can be a sign of underlying conditions like:

Liver disease

A 2019 study found that people with chronic liver disease reported symptoms of itching. According to the American Academy of Dermatology, itching related to liver disease will usually start in your palms and then spread throughout your body.

Itchiness is often associated with alcohol-related liver disease, as well as nonalcoholic fatty liver disease, though not everyone with these conditions will experience this symptom.

Iron deficiency anemia or aplastic anemia

Certain types of itchiness can also be a sign of iron deficiency or anemia. In some rare cases, people with iron deficiency or aplastic anemia can develop something called an anemia rash. If it’s anemia due to iron deficiency, you would experience red, bumpy skin that feels sore after scratching. If the underlying cause is aplastic anemia, it’s more likely to appear as tiny red or purple dots under your skin.

Thyroid problems

Issues with your thyroid can lead to itchiness as well. When your thyroid isn’t working as it should, it means it’s either making too much or not enough thyroid hormone. As a result, an underactive thyroid can cause dry, flaky and often itchy skin. In the same way, an overactive thyroid can also cause a full-body rash that feels itchy.

Your healthcare provider can perform thyroid tests to find out if there’s an issue with your thyroid.

Diabetes

If you live with diabetes, you may be more likely to experience itchiness. This is because certain types of diabetes (diabetic polyneuropathy or peripheral neuropathy) can cause nerve damage. This damage can cause itchy skin that is localized to certain parts of your body like your hands, feet or legs.

You may also experience a tingling or loss of sensation in your feet or hands along with these symptoms. If you have diabetes and you’re experiencing itchiness that isn’t going away, talk to your healthcare provider right away.

Kidney disease

Itchiness can also be the result of chronic kidney disease. You won’t see this symptom early on, but if your kidney disease has progressed, your skin may start to feel dry, scaly and itchy. Look out for signs of your skin changing color or hue, such as yellow or gray.

This type of itching (uremic pruritus) may be due to changes in your immune system or nerve issues. You may also experience intense itching at night and a worsening of the itchiness when your skin is extra dry.

Certain types of cancer

In rare cases, even certain cancers like leukemia, lymphoma or skin cancer can cause itchiness symptoms. In these situations, itching typically affects your whole body even though your skin appears normal.

When to see a doctor

In general, your itchy skin should improve within a few weeks if you follow simple skin care steps. Sometimes, an intense itch may need different types of treatment or environmental and lifestyle changes. “When skin is very dry, it may require a prescription ointment or cream,” Dr. Khetarpal says.

And if you think an underlying medical problem could be involved with your itching, reach out to a healthcare provider. Treatment of the underlying illness will likely improve the itching.