Why does your skin itch at night?

There can be many reasons your skin might itch at night, and it’s important to find out what’s causing it so you can get the right support and treatment if you need it.

A pharmacist can often provide advice and over-the-counter medication for itchy skin, but always see your doctor if you are worried that your itchy skin is occurring along with other symptoms or if it persists despite over the counter treatment

The medical term for itchy skin is pruritus or nocturnal pruritus for itchy skin at night.

Common causes of itchy skin at night

The same factors that cause itchy skin during the day can cause it at night. It can often feel worse because there are fewer distractions than during the day, so you notice the itchy sensation more.

Circadian rhythm

• At night, your body temperature increases and your skin loses more water, making your skin itchier.

Sunburn

• Skin exposed to the sun during the day can become sore and itchy during the night.
• It is itchy because the sun’s rays have damaged the skin.
• Treatments include cooling the skin with a damp clean towel, applying a soothing moisturiser or gel such as aloe vera or calamine lotion, and taking anti-histamines.

• Menopause can make your skin itchier because oestrogen is essential for healthy skin and your oestrogen levels fall during the menopause. When the hormone levels fall, your skin can become thin, dry and itchy.

Pregnancy

• Itching is common in pregnancy because of increased blood flow to the skin.
• However, it can also signify a more severe liver condition called intrahepatic cholestasis of pregnancy (ICP).
• Symptoms of ICP include itching without a rash, often on the hands and feet. It can be worse at night.
• Other symptoms include dark urine, pale poo and signs of jaundice such as yellow eyes.
• Talk to your midwife if you experience itchy skin so you can be tested for ICP if necessary.

Hives & allergic rashes

• Hives are raised and itchy red patches of skin that can cover a large area or just one part of the body. An allergic rash can have itchy bumps and blisters as well as make the skin rough and scaly.
• Hives and allergic rashes are caused when high levels of histamine are released, e.g., by an allergic reaction or eating certain foods
• Treatment includes antihistamines available from a pharmacist.

Bed bugs or insect bites

• Small red raised marks that swell and become itchy. 
• Avoid scratching the bites, and keep the area clean to avoid infection. 
• If the itching impacts your sleep, a pharmacist can help with antihistamines and mild steroid creams.
• It can be hard to get rid of bed bugs yourself: the NHS recommend people use a professional service to get rid of them.

Eczema

• Eczema causes the skin to become dry, cracked and sore, which can be very itchy, especially at night. 
• Certain substances or environments can trigger eczema. Understanding what causes your eczema can help keep it under control, but often there is no one clear factor.
• Treatment is usually either an emollient or topical corticosteroids. Superdrug Online Doctor offers treatments for eczema.

Psoriasis

• Psoriasis is flaky, red skin with silvery patches most often found on the scalp, elbows, lower back and knees. 
• Patches can be sore and itchy but are not contagious.
• Treatment includes prescription creams from a doctor.

Ringworm

• A circular rash which is usually red, dry and itchy,  caused by a fungal infection 
• You can get ringworm anywhere on your body, including the groin (jock itch), feet (athlete’s foot) and scalp.
• Treatment is usually with an antifungal medication available from a pharmacist.

Iron deficiency anaemia

• Itchy skin is a less common symptom of iron deficiency anaemia. Common symptoms include tiredness, shortness of breath, pale skin and palpitations.
• Iron deficiency anaemia occurs when you don’t have enough iron in your blood.
• Treatment includes changing your diet to include more iron-rich foods and taking iron tablets.
• Contact your doctor if you have any symptoms of iron deficiency anaemia. Your doctor will take your iron levels and provide advice if these are found to be low.

Shingles & Chickenpox

• The same virus causes shingles and chicken pox. They can both cause itchy skin, but they are not the same illness.
• A shingles rash has itchy blisters, which can become filled with pus. It is usually found on your chest and tummy but can be elsewhere on the body. If you have shingles, you typically feel unwell and have an itchy rash.
• Chickenpox is usually lots of small itchy spots which blister and then scab. It can be found anywhere on the body, accompanied by a high temperature and feeling unwell.
• With both shingles and chicken pox, you must not infect others, especially people with weakened immune systems, newborn babies and pregnant people. The best way to avoid infecting others is to avoid close contact and keep rashes covered. 
• Take paracetamol for the pain, keep the rash or spots clean and avoid scratching.

Folliculitis

• Folliculitis is small itchy pus-filled pimples around the hair follicles which can be tender and painful.
• It is caused by the follicles becoming infected and often clears up through keeping the skin clean, using emollients and wearing loose clothing. More severe cases may need prescription medications such as antibiotic creams or medicines.
• Folliculitis can be confused with ingrown hairs, which can also be itchy and painful.

Kidney and liver disease

• Itchy skin can be a sign of liver disease (​​cirrhosis) or chronic kidney disease. 
• These conditions are linked with several other symptoms, including weakness, tiredness and weight loss.
• A doctor can ask further questions, examine you and advise you on whether your symptoms are likely to be caused by kidney or liver disease.

Thyroid problems

• A raised itchy rash can signify that you have an overactive thyroid, but there are many other symptoms and signs associated with this condition.
• Common symptoms include hyperactivity, difficulty sleeping, tiredness and muscle weakness, persistent thirst and needing to pee more often.
• Talk to your doctor if you are concerned that an overactive thyroid is causing your itchy skin. 

Diabetes

• Itchy skin around your penis or vagina can be a sign of diabetes. Fungal infections such as thrush or balanitis are more common in people who suffer with poorly controlled diabetes.
• Other symptoms include weight loss, tiredness, wounds that heal slowly, blurred vision, extreme thirst and peeing more often, especially at night.
• A doctor will test your blood sugar levels and suggest the right treatment if you are diagnosed with diabetes. 
• Superdrug Online Doctor can help you with testing and treatment for Type 2 diabetes.

Should I see a doctor?

If you have itchy skin at night, see a doctor if:

• you are pregnant
• it is impacting your sleep and ability to function in daily life
• it is not getting better with self-care
• there is a new lump, swelling or rash, or other symptoms that concern you
• it is all over your body
• you have any other new or worsening symptoms

If you have an itchy rash and you experience the following signs of a severe allergic reaction, get immediate medical attention:

• breathing difficulties 
• swelling around the mouth, nose, lips and tongue 
• wheezing and tightness in the chest

How do I know what’s causing my skin to itch at night?

It can be challenging to work out what is causing your itchy skin at night. Keep a note of all your symptoms and talk to your GP. They may decide to do some blood tests or refer you to a dermatologist (specialist skin doctor).

You can also use Superdrug’s Online Skin Diagnosis service to identify if it is a skin condition that is causing your itchy skin.

Sources

• Diabetes NHS [accessed 4 October 2022]
• Iron Deficiency Anaemia NHS [accessed 4 October 2022]
• Itchy Skin NHS [accessed 4 October 2022]
• Itching & Intrahepatic Cholestasis NHS [accessed 4 October 2022]
• Kidney Disease NHS [accessed 4 October 2022]
• Nocturnal Pruritus: The Battle for a Peaceful Night’s Sleep NCBI [accessed 4 October 2022]