While it isn’t a common topic for the break room or happy hour conversation, many people suffer in silence from nighttime skin itching.
In some cases, there may be an underlying undiagnosed medical condition that is responsible for the skin itching. In other cases, it may be a side effect from a medication, the natural process of aging or contact with an environmental irritant such as pollen or chemicals.
Of course, knowing that there are many possible explanations is no consolation when you are lying in bed at night, so tired you can’t keep your eyes open yet way too itchy to fall asleep.
In this article, learn what you need to know to figure out the next steps for diagnosing and treating your night-time skin itching issues.
How Many People Suffer From Itchy Skin At Night?
According to the Mayo Clinic, the condition of having chronic itchy skin is called “pruritus,” and it can arise for any number of reasons.(1) When skin itching occurs predominantly or exclusively during the night, it is called “nocturnal pruritus.”
Because there are so many different underlying issues that can cause the skin to itch during the night, there is no single estimate available for how many people currently suffer from this type of discomfort.
Given the range of potential causes, people of every age, from childhood through their golden years, have experienced the sleeplessness that can arise from skin that itches during the night.
What Causes Nighttime Itching?
As Phaa points out, the most common causes for nighttime skin itching can be divided into a number of umbrella categories as follows:(2)
» Simple dry skin. Simple dry skin is a condition that affects everyone at some point in life. In some cases, dry skin itself can be caused by an underlying genetic predisposition. hands and feet, shins and sides of the torso are common areas where general dry skin can cause itching in bed.
» Skin conditions. Some of the best-known skin conditions that can lead to itching at night include psoriasis, eczema (atopic dermatitis), hives and over 70 other potential conditions, as reported by Healthline.(3)
» Systemic health issues. Measles, chicken pox, hepatitis, liver disease, kidney disease, scarlet fever, sarcoidosis, yellow fever and many other systemic health issues can cause nighttime skin itching.
» Changes to circadian rhythms. During the normal sleep cycle, the body goes through stages that are called “circadian rhythms.” During these stages, the body’s temperature can warm or cool and protein levels can rise or fall, which are thought to increase the likelihood of itching without a rash.
» Psychogenic awareness. Psycho-genic means “of mental origin or cause” according to Drugs.com.(4) Here, a bout or few with night-time skin itching may cause increased mental thoughts and emotions, that can, in fact, make the sensation of itching worse.
» Psychiatric issues. Certain eating disorders, depression, anxiety and schizophrenia have each been linked to night-time skin itching.
» Environmental triggers. According to the Cleveland Clinic, over-exposure to the sun, smoking, smoking, stress and other simple environmental issues or habits can cause the skin to dry out more and itch at night, which is when the body does the majority of its systemic repair work.(5)
» Insect bites or stings. According to the New York Times, more than a million species of insects live here on Earth.(6) Many of these have advanced defensive systems, including the ability to secrete, bite or sting. Of particular concern are lice, bed bugs, mites (which can cause scabies) and mosquitoes, all of which are known to be nocturnal feeders.
» Fungal infections. Pinworms, roundworms, jock itch and athlete’s foot are among the many fungal infections that can cause skin itching.
» Nerve disorders. Some nerve disorders, including neuropathy, diabetes, MS, shingles, pinched nerves and others, can cause the sensation of itching.
» Hyperthyroidism. One of the symptoms of an overactive thyroid is thickened skin. As the skin’s surface thickens, it becomes redder and starts to itch, especially at night.
» Pregnancy. For some women, as the skin stretches more and more to accommodate the growing infant, the skin on the thighs and abdomen, in particular, can become quite itchy at night.(7)
» Menopause. As a woman’s body ages, hormone production decreases. One of the symptoms this causes is thinner, dryer skin.(8) It is also worth noting that men’s bodies also produce fewer hormones during aging, although symptoms are often not so noticeable.
» Allergies. Food allergies, material allergies (wool is a common one), allergic reactions to personal or skin care products, pollen and ragweed allergies, contact with poison ivy or other plant-based irritants and other allergies can all lead to skin itching.
» Cancer. Skin cancer can be a primary cause for itching skin, as are many medications used to treat cancer.(9)
» Medications. Many different medications, including prescriptions and over-the-counter preparations, have skin itching as a side effect.
NOTE: These categories represent the best-known reasons why skin can itch at night, but they are not meant to be a fully representative list of all possible reasons.
What Are the Major Symptoms?
Additional symptoms of itching skin only at night may vary depending on the underlying cause.
However, the major symptom – the itching itself – will always be present at some level.
» Intense urge to scratch, even after the initial itchy sensation has subsided.
» Visible redness, patchiness, scaliness, dryness, bumpiness or blistering.
» Visible abrasions where intense itching has caused the skin to abrade and tear.
» A feeling like the itching is coming from underneath the skin (beneath the surface layer that is being scratched).
» All-over itching or itching only in certain places.
» Skin that remains itchy even if there are no detectable signs (of bites, blisters, et al).
» Infection that arises from continual abrasions to skin.
» Skin scarring from previous scratching bouts.
» A feeling like the skin is “crawling.”
How Is Itchy Skin Diagnosed?
The primary way that the diagnostic process begins is when the patient brings in a primary complaint about itchy skin. Here, it can be helpful to also provide a symptoms journal or log, especially when the itching seems to be all over or when it moves around (versus being confined to a specific area of the body).
If there is no known underlying medical issue and a physical exam yields no specific insights into the nature of the itching, the normal next step according to Patient Info is to order a blood test.(11)
The blood test can provide insight into each of the following:
» The overall composition and chemical makeup of the blood.
» The presence of proteins or antibodies that can highlight an underlying health condition such as liver or kidney issues, cancer or HIV/AIDS.
» Abnormal levels of thyroid hormones that may point to hyperthyroidism.
» Low iron levels that may point to anemia.
If the blood work returns any suspicious or abnormal levels, additional tests may be ordered, such as a liver or kidney function test to check for liver or kidney disease.
Another common test that can provide insight into potential causes for night-time skin itching is the chest X-ray. For example, enlarged lymph nodes may signal the onset of a health condition known to cause itching.
If testing reveals no useful information, a next step can be a simple process of elimination. For example, the patient may be directed to change their brand of laundry detergent or switch to all-natural, organic soap and skin care products.
Using organic cotton bed linens and night wear may also help to alleviate the night-time itching.
Another route to diagnosis is to prescribe allergy testing. Testing for food and environmental allergies can reveal whether personal habits or seasonal allergens may be causing the night-time skin itching.
What Types of Treatment Options Are Available for Itchy Skin At Night?
Once a diagnosis is reached, the treatment phase to alleviate symptoms of nighttime skin itching can begin.
Where the diagnosis points to an underlying health condition as the cause, topical preparations can be used to ease the skin itching while the health condition is being treated.
Generally, if the underlying condition can be resolved, the skin itching will likely resolve as well.
However, if the skin itching is not linked to a larger medical issue, there is still plenty that can be done to treat the symptoms, including these common helps:(12)
» Corticosteroids. Creams, ointments, gels or pads can help ease itching.
» Antihistamines. If seasonal allergies are the culprit, these medicines can help.
» Anti-depressants. In some cases, taking an anti-depressant can ease skin itching.
» Calcineurin inhibitors. These creams are best used when the itching is very contained (such as just on hands or abdomen).
» Moisturizers. This can be an especially helpful remedy in cases where the itching is linked to simple dry skin.
If you are suffering from itching in bed, you don’t have to endure your discomfort silently. Help is available!
Here are the steps to take:
» Keep a symptoms log.
» Make an appointment with a dermatologist.
» Complete any recommended tests.
» Follow the doctor’s treatment regimen.