Itchy skin at night, called nocturnal pruritus, can be severe enough to disrupt sleep regularly. Why this happens can range from natural causes to more serious health concerns.
For most people, natural mechanisms could be behind nighttime itch. Your body’s natural circadian rhythms, or daily cycles, influence skin functions like temperature regulation, fluid balance, and barrier protection.
These functions change at night. For example, your body temperature and the blood flow to your skin both increase in the evening, warming your skin. A rise in skin temperature can make you feel itchy.
Your body’s release of certain substances also varies by time of day. At night, you release more cytokines, which increase inflammation. Meanwhile, production of corticosteroids — hormones that reduce inflammation — slows.
On top of these factors, your skin loses more water at night. As you might have noticed during the dry winter months, parched skin itches.
When itchiness hits during the day, work and other activities distract you from the annoying sensation. At night there are fewer distractions, which can make the itch feel even more intense.
Along with your body’s natural circadian rhythms, a number of different health conditions can cause itchy skin to become worse at night. These include:
- skin conditions such as atopic dermatitis (eczema), psoriasis, and hives
- bugs like scabies, lice, bed bugs, and pinworms
- kidney or liver disease
- iron deficiency anemia
- thyroid problems
- psychological conditions such as stress, depression, and schizophrenia
- restless legs syndrome (RLS)
- cancers such as leukemia and lymphoma
- nerve disorders, such as multiple sclerosis, shingles, and diabetes
- allergic reactions to substances like chemicals, drugs, foods, or cosmetics
Here are a few medicines and home remedies to relieve itchy skin at night.
Prescription and over-the-counter medications
If a condition like a nerve disorder or restless legs syndrome is causing the itch, see your doctor to get it treated. To treat nighttime itch yourself, you can try an over-the-counter or prescription medicine. Some of these medicines relieve just the itch. Others help you sleep. A few do both.
- Older antihistamines such as chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), hydroxyzine (Vistaril), and promethazine (Phenergan) relieve the itch and make you sleepy.
- Newer antihistamines, such as fexofenadine (Allegra) or cetirizine (Zyrtec), are also helpful and may be taken at night or during the day.
- Steroid creams stop the itch at the source.
- Antidepressants like mirtazapine (Remeron) and doxepin (Silenor) have an anti-itch and sedative effect.
To help you sleep, you could try melatonin. You can buy it at your local drugstore or online. This natural hormone helps regulate sleep. When you take it nightly, it has a sedative effect that can help you sleep through the itch.
Home remedies and lifestyle changes
You can also meet with a therapist for cognitive behavioral therapy (CBT). This program helps reverse some of the thoughts and actions that may aggravate your stress.
You can also try these home remedies:
- Apply a lubricating, alcohol-free moisturizer like CeraVe, Cetaphil, Vanicream, or Eucerin to your skin during the day and before bed.
- Apply cool, wet compresses to soothe the itch.
- Take a bath in lukewarm water and colloidal oatmeal or baking soda.
- Turn on a humidifier. It will add moisture to the air in your bedroom while you sleep.
If your skin itches at night, here are a few triggers to avoid:
- Don’t go to bed in anything itchy. Wear pajamas made from soft, natural fibers, like cotton or silk.
- Keep the temperature in your room cool, around 60 to 65°F. Overheating can make you itch.
- Avoid caffeine and alcohol before bed. They widen blood vessels and send more blood to warm your skin.
- Don’t use any cosmetics, perfumed creams, scented soaps, or other products that might irritate your skin.
- Don’t scratch! You’ll irritate your skin even more. Keep your fingernails short in case you do feel the urge to scratch at night.
See your primary care doctor or a dermatologist if:
- the itching doesn’t improve within two weeks
- you can’t sleep because the itch is so intense
- you have other symptoms, such as weight loss, fever, weakness, or a rash
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