Pruritus, which refers to itchy skin, is a constant battle for some people. It can be difficult to understand exactly what is causing the skin to itch.

Itchy skin can be the result of a rash or another skin condition. It can also be a symptom of a more serious condition such as liver disease or kidney failure. To get relief, it is important to identify the problem and treat the underlying cause.

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Hives can cause itching and may be a sign of an allergic reaction.
Image credit: areeya_ann / iStock

Skin serves a vital purpose as the barrier that protects the inside of the body. It is filled with special cells of the immune system that can protect the body and skin from viruses, bacteria, and other hidden threats.

Once the skin cells detect any type of suspicious substance, they trigger a reaction that causes the area to become inflamed. Medical professionals refer to this inflammation as a rash or dermatitis. This can lead to itching.

Immune cells can react to something that touches the skin, a whole-body infection, or an illness. Some rashes are red, painful, and irritated, while others can lead to blisters or patches of raw skin.

Itching is a symptom common to many skin complaints. Skin can itch all over the body or only in specific areas.

Here are some specific causes of pruritus:

Dry skin

Dry skin is one of the most common causes of itchy skin. If a person does not see any bright red bumps or notice a sudden change in their skin, dry skin is a likely cause.

Environmental factors that can lead to dry skin include excessively hot or cold weather with low humidity. Washing too much can also cause dry skin.

It can affect any age group. However, as people age, their skin becomes thinner and drier.

A good moisturizer can usually help relieve symptoms of dry skin. Extremely dry skin can be a warning sign of dermatitis, so it may be necessary to see a dermatologist to help get relief and keep the condition from becoming worse.

Common signs and symptoms of dry skin include:

  • rough, scaly, or flaking skin
  • excessive itching
  • gray or ashy-looking skin in people with darker skin
  • cracks in the skin that are prone to bleeding
  • chapped or cracked skin or lips

It is important to seek help to treat very dry skin because cracks in the skin can allow germs to enter. Once inside the skin, these germs can cause an infection. Red, sore spots on the skin are often an early sign of a potential infection.

A skin specialist may prescribe a special moisturizer to apply throughout the day or a topical medicine to apply directly to the skin.

Learn about what causes patches of dry skin.

Eczema

Eczema, or atopic dermatitis, is a common cause of skin rash in children.

The American College of Allergy, Asthma & Immunology (ACAAI) reports that eczema affects 10–20% of children but only 1–3% of adults.

The cause is linked to the leakiness of the skin barrier. This causes the area to dry out and allows irritants or allergens to enter the skin, putting it at risk of irritation and inflammation. It is vital to keep the skin moisturized.

Eczema often improves over time. However, people with eczema must be careful, as they are more vulnerable to skin infections.

Learn about natural remedies for eczema.

Allergies

Irritation and allergic reactions can also cause itchy skin. Allergic contact dermatitis occurs when the skin comes into direct contact with an allergen.

The result of the skin allergy is a red, itchy rash that can include small blisters or bumps. The rash arises whenever the skin comes into contact with the allergen, a substance that the immune system attacks. Often, there is a time delay between exposure to the allergen and when the rash occurs.

Touching clothing, pets, chemicals, soaps, and substances such as poison ivy or cosmetics can trigger allergic reactions. Food allergies can also cause the skin to itch.

Nickel allergies are quite common. When a person comes into contact with jewelry that contains even a small amount of nickel, they can develop red, bumpy, itchy, and swollen skin at the point of contact.

For a person with an allergic reaction to a particular substance, one of the easiest things to do is to avoid that product or substance. Over-the-counter creams or medicated creams can help clear up a rash.

Learn about how allergies develop.

Dehydration

Not getting enough fluids puts the body in a state of dehydration. If you have prolonged or reoccurring bouts where you are not taking in enough fluids, this can lead to dehydration. Dehydration often causes dry skin, which can lead to itching.

A dehydrated person’s skin may look dry, dull, or sunken. Other symptoms of dehydration include headaches, fatigue, and muscle cramps.

A dehydrated person will also notice a reduced amount of urine that might also be darker yellow and stronger smelling. Their mouth will feel dry, and their skin will not bounce back as well when squeezed.

Mild cases of dehydration can be treated by drinking more fluids, especially water. Serious cases require medical attention. People can lower their risk of becoming dehydrated by reducing caffeine and alcohol intake.

Hives

Hives are a type of skin inflammation caused by the release of a chemical in the body called histamine. This release causes small blood vessels to leak, which causes the skin to swell. Hives can cause uncomfortable itching and be painful. However, they are not contagious.

While hives themselves are not typically dangerous, swelling reactions that affect the lips, tongue, throat, or breathing require emergency medical attention.

There are two kinds of hives:

  • Acute hives: These most commonly occur after coming into contact with an allergic trigger, such as a particular food or medication. Non-allergic causes, such as excessively hot or cold weather, sun exposure, or exercise, can also serve as a trigger.
  • Chronic hives: Some long-term conditions are associated with hives. In other cases, it is difficult to know what is causing a person’s hives. They can come back regularly for months or even years. Even when a doctor cannot determine the cause, the condition often improves over time.

The ACAAI says that hives affect about 20% of people at some point in their life.

Learn more about treating hives.

Bug bites

Bug bites often cause a person’s skin to flare up, resulting in itchiness. Mosquito and spider bites will often produce a red, swollen bite mark.

Bites from bed bugs and scabies may be grouped across larger areas of skin and can cause itchiness all over the body. If scabies is suspected, see a doctor.

Bed bugs are difficult to eliminate. If a person suspects a bed bug infestation, they should consult a pest control professional.

Learn more about mosquito bites.

Psychological

People may experience an itching feeling that has no physical cause. Some mental health conditions can make a person feel as if their skin is crawling, which creates an urge to scratch. Excessive scratching can lead to skin damage.

Compulsive scratching may be the result of conditions such as:

Other causes

Itching can also happen with conditions caused by parasites such as pinworms or lice. Fungal infections, such as athlete’s foot, can also cause itching between and around the toes. Tinea, or ringworm, can also cause an itchy red rash.

Itchy skin could also be due to more serious medical conditions. Nerve conditions caused by diabetes, pinched nerves, and shingles can cause severe itching.

The skin condition psoriasis causes changes to the skin that can also produce itching and discomfort.

Chronic kidney disease can also cause itching. Doctors refer to this condition as uremic pruritus, renal itch, or chronic kidney disease-associated pruritus. Uremia is a broad syndrome that occurs when the kidneys are severely damaged and cannot filter toxins from the body.

The following home remedies may help reduce itching:

  • drinking more water to help keep skin hydrated
  • using a high quality moisturizing cream on the skin and applying it at least once or twice each day
  • applying a cool, wet compress to the affected area
  • applying an anti-itch cream to relieve symptoms, such as nonprescription hydrocortisone cream
  • taking a lukewarm bath
  • choosing mild soaps without dyes or perfumes
  • using mild or unscented laundry detergent
  • for people with allergies or sensitivities, avoiding specific substances that cause a skin reaction, such as nickel, jewelry, and wool

Perhaps the most important self-care measure is to avoid scratching. Scratching can ultimately lead to further inflammation and damage to the skin and can worsen the itching.

If over-the-counter creams do not work, if a rash spreads, or if someone experiences additional symptoms beyond itching, they should see a doctor or dermatologist to identify the cause and treat the particular problem.

Learn more about how to keep skin healthy.

The treatment plan will depend on the cause of the itching. For people who are experiencing dry skin, a good moisturizer may be all that is needed.

People who have conditions such as psoriasis or may be recommended alternative treatments if there are reasons to avoid medication therapy. Light therapy, or phototherapy, is one such treatment method. The treatment involves exposing the skin to certain wavelengths of ultraviolet light to help get the itching under control.

Low water intake

Drinking too little water can cause chronic dehydration. Keeping water nearby throughout the day can help. Drink a few sips of water at least every 20 minutes.

Eating fruits and vegetables also increases fluid intake. Consider electrolyte drinks when sweating heavily due to exercise or heat or losing fluid due to vomiting or diarrhea.

Eczema, dermatitis, and hives

To treat these conditions, a dermatologist may recommend corticosteroid creams. These can be applied directly to the skin to help with itching. Sometimes, a doctor may recommend topical calcineurin inhibitors or oral antihistamines.

Allergies

Oral antihistamines are common anti-allergy medications. Some over-the-counter (OTC) examples include cetirizine (Zyrtec), loratadine (Claritin), and diphenhydramine (Benadryl). Prescription options are also available.

Fungal infections

Ringworm, athlete’s foot, and other fungal infections can be treated with antifungal treatment. Topical treatments include creams and shampoos.

For severe infections, the doctor may prescribe oral medication. Terbinafine (Lamisil) is commonly used.

Insect bites and stings

Topical antihistamines can relieve itching. To prevent mosquito bites, use an insect repellant, keep window screens in good repair, and keep the body covered with clothing.

If itchy skin causes problems over time or comes with other symptoms, a person should talk with their doctor. Medical treatments and home care strategies can often provide relief from skin itch.

Read the article in Spanish.