Itchy skin
Itching is one of the hardest sensations to tolerate: it disrupts sleep, exhausts you and creates a loop in which scratching produces more itch.
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Medicines commonly prescribed for Itchy skin
For informational purposes only. Always consult a doctor before taking any medication.
Dosage form: TABLET, 10 mgActive substance: cetirizineManufacturer: Tarbis Farma S.L.Prescription requiredDosage form: TABLET, 10 mg cetirizine dihydrochlorideActive substance: cetirizineManufacturer: Ucb Pharma S.A.Prescription requiredDosage form: ORAL SOLUTION/SUSPENSION DROPS, 10 mg cetirizine dihydrochloride/mlActive substance: cetirizineManufacturer: Sandoz Farmaceutica S.A.Prescription required
Itching is one of the hardest sensations to tolerate: it disrupts sleep, exhausts you and creates a loop in which scratching produces more itch. Sometimes the cause is in the skin itself, and sometimes the skin is normal and the origin is internal. That distinction organises the whole assessment, and it is the first thing a doctor establishes.
Two different scenarios
- with skin lesions: eczema, psoriasis, urticaria, scabies, fungal infection, lichen planus, insect bites, contact dermatitis;
- without skin lesions — apart from scratch marks: here an internal cause must be sought. This is the scenario most often overlooked.
Common skin causes
- dry skin, particularly in winter and in older people: the commonest cause by far;
- atopic dermatitis;
- contact dermatitis from cosmetics, detergents or metals;
- urticaria;
- psoriasis;
- scabies: intense itching, worse at night, between the fingers, at the wrists and around the waist, and frequently with several household members affected;
- fungal infections;
- insect bites and reactions;
- lichen planus;
- folliculitis.
Internal causes
- liver disease and cholestasis: itching of the palms and soles, sometimes with dark urine and jaundice;
- chronic kidney disease;
- thyroid disorders, both over- and underactive;
- iron deficiency, even without anaemia;
- diabetes;
- Hodgkin lymphoma and other blood disorders: the reason persistent generalised itching without a cause deserves investigation;
- polycythaemia vera: characteristically itching after contact with water;
- HIV and hepatitis;
- medicines: opioids, blood pressure drugs, antibiotics, statins, hydrochlorothiazide;
- pregnancy: obstetric cholestasis causes intense itching of the palms and soles and needs assessment;
- neurological causes: localised itching on the upper back or forearm from nerve compression;
- anxiety and depression, which amplify the perception of itch.
When to see a doctor
- the itching has lasted more than 2–6 weeks;
- it is stopping you sleeping;
- it is generalised and the skin looks normal;
- it comes with weight loss, fever, night sweats or enlarged lymph nodes;
- there is jaundice, dark urine or pale stools;
- there is marked tiredness or pallor;
- it started after beginning a medicine;
- you are pregnant and your palms and soles itch, especially at night: attend promptly;
- several people in your household are itching: think of scabies;
- the skin has become infected from scratching.
How it is investigated
The doctor examines the skin to see whether there are primary lesions or only scratch marks. If there are no skin lesions, the tests are: full blood count, ferritin, liver and kidney function, thyroid function, glucose, LDH and, depending on the case, serology, chest X-ray and assessment of lymph nodes. All medication is reviewed, including over-the-counter products.
What you can do
These measures are the foundation and, in itching from dry skin, they often solve the problem on their own.
- moisturise twice a day, generously and onto damp skin after showering;
- short showers with lukewarm — never hot — water;
- a gentle unfragranced cleanser instead of soap;
- pat dry rather than rubbing;
- loose cotton clothing, avoiding wool next to the skin;
- unfragranced detergent, no fabric conditioner and a double rinse;
- a humidifier during the heating season and a cool bedroom;
- short nails and, if necessary, cotton gloves at night;
- cold rather than scratching: a cool compress breaks the loop;
- avoid alcohol and very hot food if you notice they make it worse;
- manage stress.
Treatment
- treat the cause: the only thing that resolves itching of internal origin;
- emollients, which are treatment rather than cosmetics;
- topical corticosteroids where there is skin inflammation;
- antihistamines: highly effective in urticaria, of limited use in other types of itch, where they mainly help with sleep;
- topical menthol or polidocanol for relief;
- colestyramine or rifampicin for cholestatic itch;
- gabapentin or pregabalin for neuropathic itch and itch in kidney disease;
- phototherapy for resistant generalised itch;
- antidepressants at specific doses in chronic cases;
- treatment of scabies if that is the cause: in which case itching can persist for weeks after the mite has gone.
Common questions
Is itching always an allergy? No. The commonest cause is dry skin, and many others have nothing to do with allergy.
Why is it worse at night? Because of the skin's circadian rhythm and the absence of distraction. In scabies, the mite is also more active.
Why does scratching make it worse? Scratching releases mediators that produce more itch and damages the skin barrier.
Are antihistamines the answer? Only in urticaria and some allergies. In the rest they help little.
When should I be concerned? When itching is generalised, persistent, with normal skin and no explanation: that is when it should be investigated.
Online consultation
In an online consultation the doctor reviews photographs to establish whether there are skin lesions or only scratch marks, reviews your medication, directs the assessment towards internal causes where appropriate, pays particular attention to itching in pregnancy and sets out a skin care and immediate relief plan.
This material is for information only and does not replace a medical consultation.
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Medically reviewed by
Reviewed on Aug 3, 2026
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