Itching and rashes are symptoms that seem to go together. However, it is possible to experience itchy skin without having a visible rash or any noticeable skin changes.
The causes of skin itching, or pruritis, are usually harmless. They are often linked with temporary issues, such as dry skin or a bug bite.
Less commonly, problems with the nerves, kidneys, thyroid, or liver can cause itching sensations without necessarily causing a rash.
Depending on the cause, a person may experience an itching sensation all over their body or in one specific area. The itching can vary from mild to extreme.
If a person is concerned about unexplained itching, extreme itching, or itching that lasts a long time, they should see their doctor to determine the cause and get advice about treatments.
This article will explore eight potential causes of itching without a rash and the various treatment options available.
Dry skin, or xerosis, is a very common complaint. The skin can start to feel itchy when it loses moisture.
Dry skin can present as flaky or scaly. It is common among older adults, especially during the colder months.
The following tips can help relieve dry skin and prevent it from drying out further:
- Avoid using soaps with harsh chemicals, as these can dry out the skin. Instead, try to use hypoallergenic and fragrance free soaps and skin care products.
- Use a humidifier at home to add moisture to the air. This helps prevent winter related dry skin.
- Apply moisturizer regularly, especially after getting out of the shower or bath. Vaseline or heavy creams such as Vanicream or Cerave are popular options.
- Avoid taking showers that are longer than 10 minutes. Also, keep the water lukewarm rather than hot.
- Do not bathe multiple times per day.
- Avoid scratching dry skin, as this can damage the skin's surface. If the skin breaks, a person is more likely to experience scarring and infection.
Mosquito, spider, and other bug bites can make skin around the bite feel itchy and irritated.
Bug bites can leave behind a very small hole or pinprick-like area. However, they can be so small that a person may experiencing itching but not see the actual bites.
Many bugs can bite a person — including bed bugs, mosquitos, and lice — and the treatments can vary depending on the type of bug that caused the bite.
If a person experiences continued itching after a bug bite or bites, they should see their doctor.
Avoid scratching the area, as this can make the itching worse. Also, do not use over-the-counter topical antibiotics such as Neosporin, as some people can develop an allergic reaction on their skin.
Itchy skin is a common side effect of many medications. This can occur with or without a rash. Not every person will experience this side effect when taking these medications, however.
The following drugs have itching skin as a possible side effect:
- prescription pain relievers in the opioid category, such as acetaminophen, morphine, and fentanyl
- some medications that lower blood pressure
If a person suspects that a medication is causing itching skin, they should speak to a doctor before coming off the drug. The doctor can advise about the best course of action and alternative medications if needed.
Sometimes, a doctor may halt the current medication to see whether that is causing the itching. At other times, they may recommend taking diphenhydramine (Benadryl) or hydroxyzine to reduce itching symptoms.
Nerves relay messages from the skin to the brain. Problems with the nerves can cause itchiness or pain on the skin without causing any actual damage to it.
Several nerve related conditions can cause itching or other sensations on the skin without causing a rash. These conditions include:
According to the American Academy of Dermatology, diabetes can cause a range of skin issues. For example, itching can result from diabetic neuropathy, which is a complication of diabetes that causes nerve damage.
Injuries that affect the nerves or cause nerve damage can also make the skin feel itchy. The area that feels itchy will depend on the location of the injury.
Treatments for nerve related itching depend on the underlying cause. If a person suspects that they have a nerve disorder, they can talk to a doctor to learn about what might be causing specific symptoms.
Kidney disease, especially in the advanced stages, can cause itching without a rash. The cause of itching in kidney disease is not well known, but scientists believe that many factors are involved.
If a person knows that they have kidney problems and starts to develop itching skin, they should contact their doctor. Their doctor will run tests to see how well the kidneys are working.
In some cases, a person may need dialysis. This is a medical procedure wherein a doctor uses a machine to act in the place of the kidneys to filter the blood.
Dermatologists can prescribe one of several medications to help people with itching skin from kidney disease.
The itching tends to be worse in the palms of the hands and soles of the feet. Exposure to heat usually worsens the itching, and people usually notice that it is worse at night.
Treatment options usually depend on what type of liver disease a person has. Some doctors may prescribe cholestyramine (Questran), which results in less itching.
Skin cancers do not always cause significant symptoms. However, some people may notice skin itching on a previous or new skin lesion as an early symptom. Other symptoms may include the development of a new or changing lesion on the skin.
People should check their skin regularly and report any unusual moles or skin changes to their doctor.
If a doctor is unsure about what is causing the skin change, they may take a small skin sample and send it to the laboratory for testing. This is called a skin biopsy.
The best treatment option for skin cancer depends on its type, location, and stage.
Other symptoms of Hodgkin lymphoma include:
- swelling of the lymph nodes, such as those in the neck, groin, or armpits
- appetite loss
- night sweats unexplained weight loss
When diagnosing potential causes of itching skin without rash, a doctor will likely consider the most common causes first. This includes excessively dry skin or as a side effect of new medications.
A doctor will consider any other symptoms a person has to guide other diagnostic methods. Examples can include blood testing for liver, kidney, thyroid, or blood cell line problems.
Most causes of itching without rash are treatable.
If a person uses a moisturizer, sets up a humidifier, and practices good skin care but still has itchy skin, they should talk to their doctor about the potential underlying causes.
Although there are some serious causes of itching without rash, they are relatively rare.
Talking to a doctor can help a person determine the most likely cause and identify the best treatments.