Itchy skin at night, or nocturnal pruritus, can occur for a range of reasons, including hormonal changes and dehydration. It is common in people with chronic itchy skin.
Home remedies, as well as over-the-counter and prescription medications, may help reduce symptoms.
Itchy skin at night is usually not a sign of something serious, but rarely, it may indicate a condition such as cancer or organ failure.
Nocturnal pruritus (NP) refers to itchiness that occurs at night. It is a symptom, rather than a condition in itself.
In some cases, the skin may only feel itchier during the night because of a lack of outside distractions. However, other people may only experience itchiness at night, or find their existing itchiness gets significantly worse.
NP often disrupts sleep. Over time, this can negatively affect mental health, workplace performance, and overall well-being.
Potential causes of nighttime itchiness include:
Circadian rhythm
Circadian rhythm is the body’s natural 24-hour cycle. Hormones and brain chemicals regulate this cycle, influencing when a person feels awake or sleepy.
A 2024 study notes that shifts in these chemicals may result in itchy skin at night, including:
- cortisol
- melatonin
- cytokines
- prostaglandins
Body temperature also changes at night, which could lead to itching.
Some genes that regulate circadian rhythm may have an association with itchiness at night, too. However, researchers are still learning about this.
Hormone changes
Changes in the level of the hormone estrogen may cause dryness, itchy skin, or flushed skin. These changes can occur during the menstrual cycle, or during pregnancy or menopause.
According to the National Health Service (NHS) in the United Kingdom, itchy skin due to menopause is common but often improves over time.
Skin conditions
Skin conditions that may cause nighttime itchiness include:
- dry skin
- hives
- eczema
- psoriasis
- contact dermatitis, which could occur due to an irritant or allergen, such as laundry detergent
- bug bites, including those from bed bugs, lice, flies, or fleas
- fungal skin infections, such as athlete’s foot (ringworm) and pinworm infections
- other infections, such as scabies or chickenpox
Serious conditions
Less often, itchy skin at night can be a sign of a more serious condition. These include:
- thyroid conditions
- skin cancer
- other cancers, especially lymphoma and leukemia
- conditions that affect the nervous system, such as diabetes and multiple sclerosis
- HIV
- kidney disease
- liver disease
Other causes
Other common causes of nighttime itchiness include:
- stress
- excessive sweating (hyperhidrosis)
- medications, including some antibiotics, antifungals, steroids, statins, and opioids
- iron deficiency anemia
Treatment for itchy skin may vary depending on the cause. People need to get a diagnosis from a doctor in order to find what will help them.
Over-the-counter (OTC) options may include:
- moisturizers
- corticosteroid creams
- antihistamines
- supplements that increase drowsiness, such as melatonin, which may help a person get to sleep
People with bed bugs, fleas, or other pests may need to take steps to eradicate them from the environment and any household pets.
Prescription options a doctor may suggest include:
- Corticosteroid creams or pills: These are stronger than over-the-counter medications and can help reduce itchiness caused by skin inflammation.
- Hormone therapy: People experiencing menopause may benefit from this, particularly estrogen therapy, which may help reduce dry skin and itchiness.
- Antidepressants: Drugs such as mirtazapine (Remeron) may help reduce itchiness associated with anxiety or depression.
- Immunosuppressants: These may reduce inflammation in people with autoimmune conditions.
- Phototherapy: This uses UV light to help reduce the skin’s immune response and decrease inflammation.
There are several ways people can reduce itchy skin at home, such as by:
- bathing in cool or lukewarm water before bed
- using only moisturizing, gentle soaps
- patting the skin dry instead of rubbing
- applying alcohol- and fragrance-free moisturizers before bedtime
- running a humidifier in the bedroom to moisten the air, if the air is dry
- applying a cool compress, such as a cold, damp cloth, to the skin
- trimming the fingernails to reduce scratching
- wearing gloves or mittens during sleep to stop scratching
- using meditation or relaxation techniques when falling asleep
- wearing soft, loose clothing that consists of natural fibers, such as cotton
Prevention
Preventing itchy skin at night may not always be possible, as this symptom can occur for a wide range of reasons.
Some strategies that may help include:
- staying hydrated
- avoiding hot baths, showers, or saunas
- avoiding scented or irritating cosmetic, cleansing, or beauty treatments
- keeping the bedroom cool and comfortable
- trying not to do activities that raise body temperature and increase blood flow to the skin before bedtime
- changing bedding regularly, ideally weekly
- using laundry detergent that is suitable for sensitive skin
- treating all household pets that go outdoors with veterinarian-approved medications to prevent fleas and tics
Speak to a doctor about any persistent nighttime itchiness. They can rule out serious conditions and provide suggestions for treatment.
People should also consult a doctor if they have itchiness that:
- is sudden or unexplained
- does not improve with the use of home remedies or lifestyle changes
- interferes with daily life or sleep quality
- affects the whole body
- happens during pregnancy
- dry skin accompanied by other symptoms, such as skin changes, fever, tiredness, or weight loss
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