People with rheumatoid arthritis (RA) sometimes experience itchy skin. This may be due to the condition itself, the medications they are taking, or another condition, such as eczema. Switching medications with a doctor’s approval may be an option. Home remedies can also provide relief.
RA is an autoimmune condition that primarily causes inflammation and pain in the joints.
RA can also sometimes cause skin problems, including itchiness. This may be related to RA itself or to 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
- a side effect from a medication
- another cause, such as eczema
Hives (urticaria) appear as red or dark welts on the skin. They often itch. 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 people with an autoimmune condition, hives may be due to an overactive immune system that attacks healthy tissues.
Itchy skin may be due to a number of medications.
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, stopping an RA medication that was controlling an inflammatory skin condition can cause a rash to appear.
People who have eczema, or atopic dermatitis, experience red, scaly, itchy skin that sometimes blisters over and weeps fluids.
Eczema is another type of autoimmune condition. In people with eczema, the immune system goes into overdrive when an irritant or allergen triggers it. This causes inflammation and skin symptoms.
Some researchers have found that RA is more common in people with inflammatory conditions, including eczema.
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, and vice versa.
A dermatologist can help determine whether a rash is due to eczema or psoriasis. Diagnosis often involves a blood test, and it sometimes involves 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 itchy skin include:
- bathing in lukewarm, not hot, water
- limiting showers and baths to up to 10 minutes
- using fragrance-free soap, lotions, and laundry detergents
- wearing loose-fitting clothes made of cotton
- avoiding wool clothing, which can irritate the skin and cause itching
- avoiding extreme changes in temperature, when possible
- keeping the home relatively cool
- 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 may help treat chronic itch. Tofacitinib is a Janus kinase inhibitor that doctors sometimes prescribe to treat RA or PsA.
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 an ice pack or cold, wet cloth on itchy skin for 5–10 minutes.
- Take an oatmeal bath. This can be particularly helpful for hives.
- Moisturize the skin with a product that is free of additives and fragrances. Store it in the refrigerator for a soothing, cooling effect.
- Apply anti-itch ointments containing ingredients such as calamine or menthol to itchy areas.
- Use topical anesthetics containing pramoxine on itchy skin.
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 chronic conditions, such as eczema.
Home remedies may provide some relief from itching. Also, changing medications may be an option with a doctor’s approval.