Itchy Skin at Night? Here’s 8 Reasons Why It Happens – and How to Deal

·5-min read
Photo credit: Westend61 - Getty Images
Photo credit: Westend61 - Getty Images

Much like your train being cancelled or spilling coffee down your white top, itchy skin at night is one of those irritations that can seem to come out of nowhere.So: why do the dark hours sometimes bring the need to scratch relentlessly – and what can you do, to control it?

The vast majority of causes of itchy skin are pretty harmless – but a persistent itch can be a sign of serious conditions. If you are at all worried, book in to see your GP or call NHS 111.

WH called in the experts, to get their knowledge.

Why does my skin itch at night?

Itching at night can be a symptom of a skin issue like atopic eczema, seborrhoeic dermatitis or psoriasis.

But if that’s the case then you’re likely to know what it is – or at least you have something to show your doctor that can, in most cases, be easily diagnosed.

Why do I get so itchy at night?

The kind of skin itching that happens at night, seemingly out of nowhere, and with no sign of a rash is called nocturnal pruritus. As you'll know if you've dealt with it, it can wreak havoc with your sleep.

A 2016 study explains the various different causes of this itchy skin at night:

1. Your circadian rhythm is doing its thing

As you know, your circadian rhythm governs your sleep-wake cycle: helping you to feel drowsy at night and alert in the morning (unless you're a natural night owl and experience surges of energy later in the day and later at night.) Part of this process means that our core temperature rises in the evening which can increase blood flow to the skin and, in turn, itching.

2. Your skin barrier has been compromised

At night, the heat generated in our body leads to Trans Epidermal Water Loss (TEWL), which can also contribute to itching. This is because Trans Epidermal Water Loss can compromise the integrity of your skin barrier, which can therefore allow pruritogens (any substance that causes itching) to enter your skin.

That's not the only way an impacted skin barrier can cause itchy skin at night, though. 'If your skin barrier is compromised and the skin is not in a healthy condition, then any changes in the body or external environment can cause "uncomfortable skin," says celebrity facialist and skin expert, Nataliya Robinson. 'So, itching late at night can be caused by:

  • overly hot showers

  • air-conditioning

  • or central heating present in the room,' she adds.

3. You have creepy crawlies in bed with you

Not to cause alarm, but... 'Nocturnal pruritus is commonly associated with infestations, including scabies and bed bugs,' said the study's authors. The fact that mites are more active at night could cause itching, as can their feces (sorry), as can any infection that they cause on your skin.

4. There are psychological factors at play

The study noted that, in a cross-sectional study of patients who were being treated in a psychiatric ward, 32% reported suffering from itch, of which 24% felt their itch was worse at night. So, there may be a link between some psychological diagnoses and this issue.

What else can cause extreme itching, without a rash?

5. Hormonal changes

Itchy skin is common 'during pregnancy or after the menopause,' says the NHS. 'This is caused by hormonal changes and usually gets better over time.'

6. Polycythaemia

As to other maybe causes? Dermatologist Dr. Stefanie Williams, founder of the Eudelo skin clinic, also notes that ‘a serious condition called polycythaemia can lead to itching at night.

'Polycythaemia, means having a high concentration of red blood cells, which makes the blood thicker and its flow more sluggish. People with polycythaemia may experience red skin, particularly on the face, hands and feet.

The skin might be itchy, especially after a bath or shower. There might also be bleeding problems such as nosebleeds and easy bruising. Other symptoms may include headaches, tiredness, high blood pressure, blurred vision and tummy pain.’

To note: this condition can cause blood clots. If you think you might have it, head to your GP, sharpish.

7. Some cancers

Not to be alarmist, but it's important to note that a 2018 study monitored almost 17,000 patients and found that patients with skin itching were more likely to have cancer than those without.

Cancers of the liver, gallbladder and biliary tract, hematopoietic system and skin were most strongly associated with skin itching. But, that doesn’t mean that if your skin is itching you have anything else wrong with you.

If you are worried, book an appointment with your GP.

8. Liver problems

Primary biliary cirrhosis (PBC) is a chronic disease where progressive inflammation and destruction of the small bile ducts within the liver occurs.

One of the early symptoms of PBC is itching, but it’s not the only one – there is also bone and joint ache, fatigue, tummy pain and a dry eyes and mouth. If you are worried, speak to your GP.

How can I get rid of itchy skin at night?

1. Antihistamines

That 2016 study mentioned earlier? It outlined the possible causes, but also looks at the best treatments.

It notes that antihistamines can help with nocturnal itching – but that it has to be first-generation antihistamines, i.e. the ones that make you drowsy. If you do want to go down this route, then Piriton is a good choice.

2. Hydrate your skin

This is all about protecting your skin barrier, which, as mentioned before, is key for preventing itching. 'For general itching, having hydrated skin can ease the itching, so have a bath with moistening and calming colloidal oatmeal, as will using an oil-, alcohol- and scent-free hydrator like Cerave,' says Dr Williams.

3. Use a humidifier

'A humidifier in your room will keep skin hydrated while you sleep and finally, try and keep the room temperature constant and cool to stop extra heat,’ she adds.

4. Don't over exfoliate

Robinson notes that avoiding over-exfoliation of the skin’ may help too. Again, this can protect your skin barrier.

5. Visit your GP

If you are at all concerned, do go and see your GP and explain your symptoms.

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