The Itch Factor: Understanding Common and Serious Causes of Itchy Skin and When to See a Dermatologist

Almost everyone experiences itchy skin at some point. The uncomfortable sensation of itch that causes us to scratch for relief is one of the most common reasons individuals may visit a dermatologist. In fact, one study of patients 65 and older revealed that itch contributed to 11.5% of hospital admissions.

While the most common cause of itchy skin is xerosis (dry skin), there are many other causes that may be associated with more serious conditions. Systemic conditions such as hypothyroidism, chronic kidney disease, and liver problems may be associated with itch. Infestations with scabies or lice are other causes. Another very common cause of itch is certain medications such as opioids and aspirin.

Evaluating itch usually starts with a thorough skin examination and careful medical history. Some important questions may include if the itch disrupts your sleep, if anyone else at home is itching, and if you are experiencing any other symptoms. The physical examination will look for primary lesions (areas that are itchy but have not been scratched) as well as other clues to the diagnosis. Sometimes, the dermatologist may recommend blood tests or imaging.

For itchy dry skin, there are some basic steps you can try at home to obtain relief.

• Wash with fragrance free gentle soaps
• Take warm—not hot—showers
• Consider oatmeal baths
• After washing, while your skin is still wet, apply heavy moisturizers. The idea is to trap the water in your skin
• Avoid wool and rough fabrics that may further irritate your skin
• Consider trying an over the counter oral anti-histamine

If these do not provide adequate relief, you are having other symptoms, or your symptoms persist, consider reaching out to a dermatologist for a professional evaluation.