Key takeaway
- Itchy skin is a less common symptom of rheumatoid arthritis (RA). It can develop due to inflammation from RA itself or side effects from RA medications. It may also occur due to coexisting conditions, such as eczema.
- General prevention tips, such as using fragrance-free skin care products and bathing with lukewarm water, may help manage RA-related itching.
- If home remedies do not provide relief, a doctor may recommend prescription treatments or suggest switching medications. However, people should never stop or change medications without consulting a doctor first. A doctor can also help identify or rule out other potential causes of itchy skin.
RA is an autoimmune condition that primarily causes inflammation and pain in the joints.
RA can also sometimes cause skin problems, including itchiness. Skin symptoms may be the result of RA itself or other factors, including medications.
Learn about the causes of itching in people with RA, along with some tips for prevention and relief.
People with RA often experience symptoms including:
- joint pain, swelling, and stiffness that:
- lasts for at least 6 weeks
- usually affects both sides of the body
- frequently starts in the hands and feet
- morning stiffness that does not go away within 30 minutes
RA can also affect other areas of the body, including the skin. For example, some people with RA report itchy skin.
Rashes are uncommon in RA, but a person does not need to have a rash to have itchy skin.
The causes of chronic itch are generally poorly understood.
For people with RA, it can be difficult to determine the exact cause of itching. Some possible explanations include:
- inflammation linked to the condition itself
- medication side effects or allergies
- another cause, such as eczema
Hives
Hives (urticaria) appear as welts on the skin. They often itch and appear discolored, such as darker or lighter than a person’s typical skin color. If symptoms last for longer than 6 weeks, doctors tend to consider it chronic hives.
Some research suggests that people with autoimmune conditions such as RA have a higher risk of developing chronic hives.
In individuals with an autoimmune condition, hives may be caused by an overactive immune system that mistakenly attacks healthy tissues.
Medications
Itchy skin can develop due to a several medications, such as:
- antibiotics
- antifungals
- contrast media, dye medications used with imaging scans
For example, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can cause an itchy, measles-like rash in some people. NSAIDS can also make hives worse.
Doctors sometimes prescribe biologic medications to treat RA. These can also cause itchiness in some people.
Sometimes, itching may be a symptom of an allergic reaction to a medication. Get emergency medical help for any other allergy symptoms alongside itching, such as difficulty breathing, swelling, or faintness.
Eczema
People who have eczema, or atopic dermatitis, experience discolored, scaly, itchy skin that sometimes blisters or weeps fluids.
With eczema, the immune system becomes overactive when an irritant or allergen triggers it. This causes inflammation and skin symptoms.
Some researchers have reported that people who are susceptible to eczema and asthma may have a higher risk of RA.
Is it RA and eczema, or is it psoriatic arthritis?
The skin condition psoriasis can lead to psoriatic arthritis (PsA). RA and PsA symptoms are similar, which can make it difficult for doctors to tell the difference between the two conditions.
Also, they sometimes incorrectly diagnose psoriasis as eczema. As a consequence, some people receive a diagnosis of RA and eczema when they really have PsA, or vice versa.
A dermatologist can help determine whether a rash is due to eczema or psoriasis. Diagnosis often involves a blood test, and sometimes includes a skin biopsy.
A person should always talk with a doctor to determine the potential cause and best treatment for itching.
General guidelines from the American Academy of Dermatology (AAD) to prevent or reduce itchy skin include:
- bathing in lukewarm, not hot, water
- limiting showers and baths to 5 to 10 minutes
- using fragrance-free soap, lotions, and laundry detergents
- wearing loose-fitting clothes made of cotton
- avoiding scratchy or wool clothing, which can irritate the skin and cause itching
- avoiding extreme changes in temperature, when possible
- using a humidifier in winter, especially for people who are prone to eczema or have dry skin
- reducing stress whenever possible, as stress can make itchy skin worse
If a doctor determines that a medication is causing itching, they may recommend a different treatment.
For some people with RA, tofacitinib (Xeljanz, Xeljanz XR) may help treat chronic itch. Tofacitinib is a Janus kinase inhibitor that doctors sometimes prescribe to treat RA or PsA.
A
A person should never stop or change their medications without consulting a doctor first. Stopping medications prescribed for RA can impact the disease course and may even worsen skin symptoms.
Simple home remedies can help many cases of itchy skin. The AAD recommend the following tips:
- Place a cool compress on itchy skin for 5 to 10 minutes.
- Take a colloidal oatmeal bath.
- Moisturize the skin with a product that is free of additives and fragrances — particularly after getting the skin wet. Store the moisturizer in the refrigerator for a soothing, cooling effect.
- Ask a pharmacist for advice on which anti-itch ointments or topical anesthetics may help, such as products containing:
- calamine
- menthol
- pramoxine
RA can affect multiple areas of the body, including the skin. People with RA may experience itchy skin due to the condition itself, certain RA medications, or other coexisting conditions, such as eczema.
Home remedies may provide some relief from itching. Also, changing medications may be an option with a doctor’s approval.
Anyone with persistent, severe, or difficult-to-manage itchy skin should contact a doctor for diagnosis and treatment.