Itchy Skin at Night? Causes and Treatments You need to know about

In Diagnosis & Treatment by Dr. Clinton Osborn

Itchy skin at night is also known as nocturnal pruritus. It’s a common symptom that results in the natural body processes of constant scratching and itching throughout the night. It can be very aggravating because it ruins your sleep cycle, and the symptoms are challenging to control. 


Fortunately, there are over the counter medication, prescription drugs, and various home remedies to help reduce the symptoms. However, in rare cases, nocturnal pruritus could be something serious such as organ failure or cancer. 


Either way, by understanding the mechanism of action and treatment modalities, you will be able to take control and have a good night’s sleep. Learn more about the symptoms so you can decide if you should contact your online doctor and see your physician in person.


Related: Flu vs Cold: Understanding the Differences

Why does your skin itch at night?

According to research studies in 2016, 90% of people with chronic pruritus would develop nocturnal itching. Severe cases of nighttime itching can disrupt the sleep cycle, making it challenging to have a full night’s rest. If you leave this symptom unmanaged, it can impact your work performance, mental health, and overall well-being.


There are various reasons as to why your skin would itch at night, and it’s best to examine multiple causes to find the one that matches your symptoms.


Causes of nocturnal itching

There are different reasons why your skin will itch at night. It can range from a chemical imbalance, hormone problems, molecular changes, and various other causes. 


Here are some of the ones that you can look at:

Circadian rhythm

The body often regulates chemicals and hormones by utilizing the circadian rhythm. The circadian rhythm causes nighttime skin itching by increasing blood flow to the epidermal layer, increase cytokine, increase skin temperature, decrease prostaglandin, decreased corticosteroid levels, and increased water loss from the skin.


Pregnancy and menopause

Low levels of estrogen can cause itchy skin, flushing, and dryness. Sometimes, a menopausal woman will experience a sensation like ants crawling under the skin.


Other causes

  • Insect bites
  • Hives 
  • Allergic reaction
  • Chickenpox
  • Sunburn
  • Sweating
  • Stress
  • Medication side effects
  • Nervous habits
  • Psoriasis
  • Eczema
  • Fungal infection
  • Skin cancer
  • Thyroid problems
  • Diabetes
  • Multiple sclerosis
  • Shingles
  • Lymphoma/leukemia
  • Kidney/liver failure
  • HIV
  • Depression/anxiety
  • Iron deficiency


Related: Online Physicians Offer Family Subscription Healthcare


Treat itchy skin at night with medication

Different types of treatment can reduce pruritus, and here are some of them that you can check out:

Over-the-counter medication

There are medications that you can order online to be delivered to your local drugstore, such as corticosteroid cream to reduce inflammation, allergy medication to inhibit histamine release, and supplements like melatonin that promote drowsiness. When you are looking at corticosteroid cream, it’s best to look for products that range between 1 to 2.5% active ingredient. When it comes to allergy medications, the best one to get for nocturnal itching would be Benadryl, Zyrtec, and Allegra.

Prescription medication

Prescription medication often requires a doctor’s visit for an examination. These types of drugs are usually stronger and more potent than over-the-counter meds. The most common prescription medication would be corticosteroid cream or pills to reduce the inflammatory process.


 If the nocturnal itching is due to depression and anxiety, your doctor may prescribe you antidepressants such as mirtazapine. If the chronic itching is caused by a constant immune attack, then immunosuppressants like a calcineurin inhibitor can reduce inflammation. 


Phototherapy utilizes a UVB wave link to decrease inflammation and discontinue response. Gabapentin can treat anxiety and insomnia, while Gabapentin can get rid of the sensation of itchiness.


If you have menopause, then hormone replacement therapy, especially estrogen medication, can help alleviate dry and itchy skin.

Alternative medications and lifestyle modifications

If you don’t want to use medications, you can try these alternative home remedies.

Bathing and moisturizing

You can take a warm bath, and when you’re finished, dab yourself dry. The warm sensation from the water would dilate the pores on your skin to allow the moisture to be trapped inside. Afterward, apply moisturizer onto your skin, where it can seep through the pores efficiently. Keep in mind that when you take a bath, you can use scent-free soap, oatmeal, or baking soda.

Types of moisturizer to use

You can apply a closer mean oil base in an alcohol-free moisturizer before bedtime. The best example would be Eucerin, Cerave, and Cetaphil.

Natural ointment

If you prefer something natural, you can try vitamin E and Aloe vera. Aloe vera comes from a cactus-like plant where you cut up the leaves to obtain the gel-like substance from them. The jelly substance contains anti-inflammatory and soothing properties that can help trap moisture and alleviate any pruritus symptoms.


A common culprit for itchy skin at night is dry skin. If you run a humidifier in your bedroom, it provides moisture in the air that can replenish your skin.

Cool cloth

You can apply a cool, damp cloth on your skin before bedtime. The cloth can lower the temperature of your skin to reduce itching.

Background noise

Sometimes having some background noise can act as a mental distraction, so you don’t keep scratching. You can turn on some music or use a fan to create airflow.

Wear gloves

If you keep scratching at night, it can make the symptoms worse. The best thing to do would be to wear mittens or gloves to avoid scratching.


Keep in mind that stress and anxiety can increase itching. Fortunately, meditation before you fall asleep can help reduce stress and decrease nocturnal pruritus. You can also practice relaxation techniques such as visualization to help you with meditation.


If you have long fingernails, it can make you want to scratch more. If you trim them down, you can reduce the chance of further skin irritation.

Loose clothes 

Wearing comfortable, loose-fitting clothes can get skin plenty of ventilation, therefore reducing nocturnal pruritus.

No pets in the bedroom

The problem with dogs and cats is that they love to play outside in the backyard. When they are outside, they tend to bring home dirt, debris, and possibly fleas. If you are prone to nighttime itching, it’s best to keep the pets away from the bedroom.

Check for infestations

Bed bugs are the primary culprit for nocturnal itching. It’s vital to check the bedroom, furniture, shelves, or anything nearby for insects. If you see red or bloody streaks or little linear dots, then that might be a sign of bed bug infestation.

Chamomile tea

The significant part about chamomile tea is that it relaxes you and helps you fall asleep. When you are at the maximal level of peacefulness and relaxation, you are less likely to be scratching throughout the night. In fact, it might decrease that tingling sensation and the urge to scratch.

Lavender oil

2 to 3 drops of lavender essential oil on the pillow can do wonders for your sleep. This type of oil provides a relaxing effect that can help decrease the need to scratch.

Related: Why Should I Use an Online Doctor?


How to Prevent Nocturnal pruritus?

If nighttime itching is causing you some issue, here are some lifestyle changes that you can partake to reduce the symptoms.

Stay hydrated

It’s important to drink plenty of water to replenish your body system. Drinking water can alleviate dry skin, therefore, decrease scratching and improve the pruritis.

Avoid the heat

It’s important to avoid anything that has high heat. This is mainly because it can increase the body temperature, therefore, cause loss of moisture, which can lead to severe itchiness. It’s best to avoid sauna and a long hot bath before bedtime.

Wearing the right clothes

You want to wear clothes made from natural fibers like cotton. This can decrease skin irritation and feel more comfortable on your skin.

Scented beauty products

Some cosmetic products are scented to provide an alluring smell to attract customers. However, scented or dyed products can be irritating for the skin. It’s best to avoid that and consider natural and unscented cream.

Avoid elevated blood flow

It’s best to avoid taking in drinks that contain an elevated amount of caffeine, which can cause anxiety. You should also avoid drinking alcohol because it can dilate blood vessels in the skin to promote blood flow to the epidermal layer. In addition to that, you should avoid activities that can elevate body temperature, which will, in turn, increases blood flow to the skin.

Change your bedding

It’s vital to change your bedding every week. This is to keep all the dirt, debris, and insects out of your bed. It’s essential to check if those bed bugs are responsible for those nighttime itching marathons.

Check your pets

If you notice that your dog or cat is constantly scratching, you should bring them to the vet for medications to get rid of those nasty fleas and ticks. There are sprays, oral medication, and liquid form that you can apply on your pet’s neck.


What to avoid with itchy skin?

Sometimes, we develop bad habits that we take home to our bed. These habits can lead to restless nights due to constant itching. Here are some things to avoid so you can stop nocturnal pruritus:

Horrible pajamas

If your pajamas are made of rough and irritating material, it can cause an uncomfortable night of non stop itching. It’s vital to wear pajamas that are light, soft, and made of silk or cotton.

Avoid sleeping in high temperature

The best thing to do is to keep your room around 60 to 65 Fahrenheit. It’s best to avoid overheating the room, or else it can stimulate a sensation to scratch throughout the night.


Avoid certain drinks

Caffeine and alcohol can dilate your blood vessels to send more blood to your skin. This can cause a warm and itching sensation in your skin that can be very annoying at night.

Avoid anything with a scent

Don’t use any cosmetic products with a scent such as perfume, scented soap, or any product that has a higher chance of irritating your skin or causing the hypersensitive reaction.

Don’t scratch

The more you scratch, the worse it gets. Scratching will only cause the symptoms to get worse, and it will irritate your skin even more. It’s best to keep your fingernails short in case you feel the urge to scratch throughout the night.

When to see a doctor?

If the itching does not improve in two weeks, your sleep is disrupted from the pruritis, or you have additional symptoms of fever, weight loss, rash, and weakness, then it’s time to see the doctor. There might be some underlying malignant cause to the nighttime itching that will require a blood test and physical examination to find the cause of this madness. Keep in mind that constant scratching can lead to a cut and penetration of the skin barrier. This will make you vulnerable to secondary bacterial infections that will require antibiotic medications from the doctor.


If you are unsure about your symptoms and don’t want to deal with the hassle and wait time at the urgent clinic or emergency room, you can visit an online physician. Telemedicine is a unique way of getting access to a health care provider through the chat room or video camera, where you can show them your rash and explain to them your symptoms. Through this method of diagnosis, the doctor can send your prescription to the nearest pharmacist. That way, you can get your antibiotic or corticosteroid cream without having to wait hours in the ER with everyone coughing and sneezing near you.


Related: Online Physicians Offer Family Subscription Healthcare

Take home message

Chronic nighttime itching is no fun at all. It can leave you tossing and turning at night. When you wake up, it can affect your concentration and work life. Fortunately, there are over-the-counter medication, prescription drugs, and lifestyle modification that you can partake in to reduce the itching. If the symptoms don’t go away, then it’s time for a trip to the doctor’s office to find other causes to the nocturnal pruritus. If you don’t have time to visit a doctor, you can go online and see a provider at the comfort of your home.


 Through a thorough physical examination and interview, your doctor will be able to prescribe you the proper medication to help you through the night.

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