What Is Causing My Itchiness?

Have you been dealing with persistent itchiness and don’t know why?

Five Keck Medicine of USC experts share possible causes and treatment options.

Dermatologic issues

“One of the most common explanations for itch is dry skin,” says dermatologist Melvin Chiu, MD. “Another common reason is eczema, where skin is predisposed to itchy rashes. And a reaction to something touching the skin can create itchy rashes called contact dermatitis.”

Symptoms:

• Rashes at itch site
• Worsening itch after scratching
• Asthma or seasonal allergies (with eczema)

Treatment:

• Warm (not hot) showers
• Fragrance-free moisturizers
• Anti-inflammatory creams and medications
• Avoiding the trigger causing the itch

Vascular issues

Venous insufficiency is a condition in which veins’ valves don’t work well, causing fluid to pool in the legs and produce ulcers, swelling and inflammation. As podiatrist Chia-Ding Shih, DPM, explains, “This inflammation is called stasis dermatitis, and it can itch.”

Symptoms:

• Brown discoloration around ankle and lower leg
• Dry skin
• May affect only one leg

Treatment:

• Unna boot (a calamine-impregnated bandage)
• Compression dressing
• Topical steroid

Consult a vascular surgeon if you’re experiencing these issues.

Liver issues

“Persistent chronic itch is a common manifestation of some types of liver disease, especially in the absence of rash,” says hepatologist Lily Dara, MD.

In some forms of liver disease, such as primary biliary cholangitis, immune cells attack the liver’s bile ducts, destroying them and causing bile acids to accumulate in the bloodstream and cause an itch called cholestatic pruritus.

Symptoms:

• No associated rash
• Itch that worsens at night
• Sudden onset of itch later in life
• Family history of autoimmune disorders
• Use of medications that damage the liver (hepatoxicity)

Treatment:

• Medications: bile-acid sequestrants, rifampicin, opioid antagonists, SSRIs, ileal bile acid transporter inhibitors (IBATs)

Diabetes

Pain management physician Michael Bottros, MD, notes that high blood sugar associated with diabetes can cause itchy skin, as can damage to blood vessels. Diabetes-related nerve damage can lead to “aberrant signaling” that might also feel like an itch, Dr. Bottros says.

Symptoms:

• Prickly, “crawling-ants” itch
• Itch that worsens at night

Treatment:

• Medications that address nerve pain
• Physical therapy

Neurologic issues

As with diabetes-related itch, “Itching can represent a form of neuropathic sensory disturbance,” says neurologist Lilyana Amezcua, MD. For example, nerve pain following shingles can manifest as itch, she says, and some patients with multiple sclerosis also experience itch because of the condition.

Symptoms:

• Other neuropathic symptoms, like tingling, burning and numbness
• Itch on one side of the body (with shingles)
• Heat sensitivity in addition to itch (with multiple sclerosis)

Treatment:

• Depends on cause; speak to your doctor

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