• Introduction
• Causes
• Diagnosis
• Treatment
• Selected links
• Useful Article?

Introduction

Itching is an unpleasant sensation that compels a person to scratch the affected area. It is a common symptom but occasionally may be severe and frustrating. The medical name for itching is pruritus.

Itching can affect any area of the body. It can either be:

• generalised – where itching occurs over the whole body
• localised – where itching only occurs in a particular area

Sometimes, there is a rash or a spot where the itching occurs.

Common causes of itching

Itching can be caused by a number of different conditions. For example:

• a skin condition, such as eczema
• an allergy or skin reaction
• a parasitic infestation, such as scabies
• insect bites and insect stings
• a fungal infection, such as athlete’s foot or thrush
• a systemic condition (one that affects the whole body), such as an overactive thyroid gland(hyperthyroidism)
• hormonal changes during pregnancy or the menopause

See Itching - causes for more detailed information about these possible causes of itching.

Simple changes

Treating an underlying condition that is causing itching may help to relieve the itching. However, other types of itching may be relieved by making some simple lifestyle changes. For example:

• using unperfumed personal hygiene products
• not wearing clothing that is made from wool, which may irritate your skin
• keeping skin moist 

There are also medicines that can help to relieve the symptoms of itching, such as antihistamines and steroid creams.

See Itching - treatment for more information.

How to avoid scratching

Scratching can damage the skin and irritate it further, leading to pain, more itching and more scratching. To avoid scratching you should

• keep your nails short and clean (nails should be filed not clipped; clipped nails can often have jagged edges that could irritate your skin)
• pinch the skin near to the itch through your clothing as it is less damaging than scratching
• rub or press the affected area with your palm
• keep the itchy skin moist with a fat cream, which makes scratching less damaging to the skin 

Causes

There are many different possible causes of itching.

For example, itching can be a symptom of:

• a skin condition, such as eczema
• an allergy – for example, to nickel (a metal that is often used to make costume jewellery)
• insect bites or scabies (a contagious skin condition where tiny mites burrow into the skin)
• fungal infections, such as athlete’s foot and female thrush or male thrush (a fungal infection that affects the male and female genitals) 
• certain chronic (long-term) conditions, such as liver disease
• hormonal changes in the body, such as during the menopause (when a woman’s periods stop, usually at around 52 years of age)  

Each of these possible causes of itching is described in more detail below.

Skin conditions

Skin conditions that can cause itching include:

• dry skin
• eczema – a chronic (long-term) condition where the skin is dry, red, flaky and itchy
• contact dermatitis – a condition where the skin becomes inflamed
• urticaria – also known as hives, welts or nettle rash, urticaria is triggered by an allergen, such as food or latex, and causes a raised, red itchy rash to develop
• lichen planus – an itchy, non-infectious rash of unknown cause
• psoriasis – a non-infectious skin condition that causes red, flaky, crusty patches of skin and silvery scales
• dandruff – a common, non-contagious skin condition that affects the scalp
• folliculitis – a skin condition that is caused by inflamed hair follicles
• prurigo – small blisters (fluid-filled swellings) that are very itchy  

Allergies and skin reactions

Itching is sometimes caused by environmental factors, such as:

• cosmetics
• dyes or coatings on fabrics
• contact with certain metals, such as nickel
• contact with the juices of certain plants or stinging plants
• an allergy to certain foods or types of medication (for example, aspirin and a group of medicines called opioids) 
• prickly heat – an itchy rash that appears in hot, humid weather conditions
• sunburn – skin damage that is caused by exposure to ultraviolet (UV) rays

Parasites and insects

Itching can also be caused by the following pests:

• the scabies mite, which burrows into the skin and causes a skin condition called scabies
• head lice, pubic lice or body lice
• stinging insects, such as bees, wasps or hornets and insects that bite, such as midges, mosquitoes, fleas, bedbugs and ticks

Infections

Itching may also be a symptom of an infection, such as:

• chickenpox or another viral infection
• a fungal infection, such as athlete's foot, which causes itching in between the toes, jock itch which affects the groin, and ringworm, which is a contagious condition that causes a ring-like red rash to develop on the body
• a yeast infection, such as female thrush or male thrush, which can cause itching in and around the genitals

Fungal and yeast infections tend to cause itching in a specific area of the body. But in untreated cases, or cases that do not respond well to treatment, itching may become generalised.

Systemic conditions

Systemic conditions are conditions that affect the entire body. Sometimes, itching can be a symptom of systemic conditions, such as:

• an overactive thyroid or underactive thyroid – the thyroid gland is found in the neck; it produces hormones to help control the body's growth and metabolism (the process of turning food into energy)
• liver-related conditions, such as primary biliary cirrhosis, liver cancer, pancreatic cancer and hepatitis
• long standing kidney failure
• leukaemia – cancer of the blood
• some types of cancers, such as breast, lung and prostate cancer
• Hodgkin's lymphoma – cancer of the lymphatic system, which is a series of glands (or nodes) that are spread throughout your body and produce many of the specialised cells that are needed by your immune system

Pregnancy and the menopause

In women, itching can sometimes be caused by hormonal changes.

Pregnancy

Itching often affects pregnant women and usually disappears after the birth. A number of skin conditions can develop during pregnancy and cause itchy skin. They include:

• pruritic urticarial papules and plaques of pregnancy (PUPPP) – a common skin condition during pregnancy that causes itchy, red, raised bumps that appear on the thighs and abdomen (tummy)
• prurigo gestationis – a skin rash that appears as red, itchy dots and mainly affects the arms, legs and torso
• obstetric cholestasis – a rare disorder that affects the liver during pregnancy and causes itching of the skin without a skin rash

Eczema and psoriasis are also skin conditions that pregnant women may experience.

Seek advice from your midwife or GP if you have itching or any unusual skin rashes during your pregnancy.

Menopause

Itching is also a common symptom of the menopause, which is where a woman’s periods stop, at around 52 years of age, as a result of hormonal changes. Changes in the levels of hormones, such as oestrogen, that occur during the menopause are thought to be responsible for the itching.

See the topic about Menopause for more information.

Itchy bottom

Itchy bottom, also known as pruritus ani, is a common condition where there is a very strong urge to scratch the skin around the anus (back passage). It can have a number of different causes, including:

• threadworms – small worm parasites that infect the bowels of humans
• haemorrhoids (piles) – enlarged and swollen blood vessels in or around the lower rectum or anus

See the topic about Itchy bottom for more information about the condition.

Diagnosis

You should see your GP if your itching is:

• severe
• prolonged (lasts for a long time)
• recurring (keeps coming back)
• associated with other symptoms, such as breathing problems, skin inflammation (swelling) or jaundice (yellowing of the skin and eyes)

Also visit your GP as soon as possible if your entire body itches and there is no obvious cause. It could be a symptom of a serious underlying condition.

Your GP will try to determine the cause of your itching by carrying out a physical examination. They may also carry out a number of tests, such as:

• a blood test to see if the cause is an underlying disease, such as diabetes, thyroid or kidney disease
• a skin scraping – the affected area of skin is scraped to obtain a sample, which can be analysed to help diagnose a skin condition
• a vaginal or penile swab if a yeast infection is suspected; a small plastic rod with a cotton ball on one end will be used to obtain the sample
• a biopsy – the area is numbed and a tissue sample is removed for analysis

Once the cause of your itching has been identified, appropriate treatment can begin. See Itching - treatment for more information.

Further investigations

If necessary, your GP may recommend that you are referred for further investigations to help identify the underlying cause of your itching. Depending on what your GP thinks is causing your itching, you may be referred for:

• an ultrasound scan – a type of scan that uses high-frequency sound waves to produce a detailed image of the inside of your body; ultrasound scans can be used to help diagnose a range of different health conditions 
• an X-ray – a scan that uses radiation to produce an image of the inside of your body 

Treatment

The type of treatment that you receive for itching will depend on the cause. If you are referred for further investigations, the treatment advice outlined below may help to provide some relief in the meantime.

Bathing

When bathing or showering you should:

• use cool or lukewarm water (not hot)
• avoid using perfumed soap, shower gel or deodorants; unperfumed lotions or aqueous cream are available from your pharmacist
• use unperfumed moisturising lotions and emollients after bathing or showering to help prevent your skin becoming too dry 

Clothing and fabric

Regarding clothing and bed linen, you should:

• avoid wearing clothes that irritate your skin, such as wool and some man-made fabrics
• wear cotton whenever possible
• avoid tight-fitting clothes
• use mild laundry detergent that will not irritate your skin
• use cool, light, loose bedclothes

Medication

With regard to medication, you can:

• use an oily moisturiser if your skin is dry or flaky
• use mild steroid cream (for no longer than seven days); for localised itchy areas, hydrocortisone cream is available from pharmacies over the counter, or your GP can prescribe a steroid cream for you
• use antihistamine tablets to help control allergic reactions and help break the itch-scratch cycle; however, consult your GP before using these because they are not suitable for all cases of itching

Some antidepressants such as paroxetine or sertraline can help relieve itching (if your GP prescribes these, it does not mean that you are depressed).

If you have itching in hairy areas, such as your scalp, lotions can be prescribed specifically for these areas, rather than using sticky creams.

Additional advice

Using a cold compress such as damp flannel, or applying soothing calamine lotion to the affected area of skin, may help to relieve your itching.

Vulval itching

If you have itching around the outside of your vagina, your GP will treat the underlying cause. This could be:

• a yeast infection, such as vaginal thrush 
• contact dermatitis, which is sometimes caused by excessive washing or perfumed hygiene products
• a skin condition

Your GP may prescribe emollients or antihistamines to help relieve the itching.

Selected links

NHS Direct Wales Topics

Antihistamines

Contact dermatitis

Eczema, atopic

Itchy bottom

Scabies

External links

Allergy UK

BAD: contact dermatitis

BAD: eczema