VERIFIED CONTENTAuthor: lek. Katarzyna Banaszczyk
Itchy skin at night significantly reduces the quality of sleep, and thus also the functioning of the patient during the day. Not only dermatological diseases, but also systemic diseases may be responsible for itching of the skin. What conditions can cause itchy skin at night? What to do if this symptom occurs?
Itchy skin at night can have many causes. Most of the causes of pruritus are relatively harmless, but in rarer cases, itching may indicate serious systemic diseases. If the itching of the skin continues and does not decrease after changing the used cosmetics or mouthwash, it is definitely worth visiting your family doctor who, after taking an interview and examining it, will decide on the next diagnostic steps.
Itchy skin at night and allergies and hypersensitivity
The frequent cause of itching at night is an allergic reaction to ingredients in washing powders or liquids in which we wash, for example, our bedding or pajamas. In addition, large amounts of mites, i.e. arachnids, that feed on e.g. exfoliated skin.
House dust mite allergy is a condition that can also appear as itchy skin at night.
Other symptoms of a house dust mite allergy include:
- sneezing,
- Qatar,
- nasal obstruction,
- cough.
These symptoms typically worsen, for example, during cleaning or just after going to bed, when our contact with mites increases. In order to reduce symptoms, it is worth washing bedding often, and also give up the use of carpets, which are a significant habitat of these arachnids.
It is also worth taking a look at the cosmetics we use in the evening. Ingredients in cleansing products, creams and lotions can also sensitize and cause itchy skin.
Itchy skin at night and arthropod bites
The cause of night skin itching can also be arthropods such as:
- head and pubic lice - their bites, in addition to itching, lead to the appearance of scabs, scratches, and in the case of pubic liceblue spots on the thighs, abdomen and chest,
- bedbug - bedbugs that feed on human blood attack at night, their bites are not painful, but leave numerous erythematous-papular lesions on the skin and are the cause of persistent itching.
Itchy skin at night and pinworms
The cause of itching around the anus, which intensifies at night, may also be pinworm, a parasitic disease caused by the nematode - human pinworm. It is a disease that very often appears in school, kindergarten and nursery children.
Interestingly, in many cases the disease proceeds without typical clinical symptoms.
Other symptoms, apart from anal pruritus, characteristic of pinworms include:
- nervousness,
- anxiety,
- irritability and even disturbance of concentration,
- sleep disorders,
- loss of appetite,
- sometimes anemia, which is a decrease in the concentration of hemoglobin in the blood.
Itchy skin at night - when should scabies be suspected?
A characteristic feature of the parasitic disease called scabies is itching of the skin, which intensifies at night. The pruritus in this disease is intensified mainly by the warming up of the body under the bedding, which leads to the activation of scabies, which are located in scabies burrows, i.e. corridors formed in the epidermis of the female parasite (more precisely in the stratum corneum).
In addition to itching, the course of scabies includes scratches of the skin (i.e., eczema), as well as eczema-like lesions, which are most often located in the area of:
- fingers,
- wrists,
- navel,
- skin folds,
- buttocks,
- genital area,
- nipples in women.
Świerzbowiec is a mite parasite that is most often transmitted from person to person by direct contact, but it is also possible to become infected by using the same items (for example, bedding, clothes or towels).
Itchy skin at night in Hodgkin's disease
Hodgkin's disease (Hodgkin's lymphoma) is a neoplastic disease that originates in B lymphocytes, i.e. cells belonging to the immune system. This disease is typically treated in hematology departments. People between the ages of 20 and 40, as well as patients over 50, suffer most often from the disease.
As shown by scientific reports, pruritus increasing at night may be the first symptom of this disease and, importantly, may precede diagnosis by up to 5 years.The pruritus in Hodgkin's disease initially appears in the lower extremities and then spreads over the entire body. Patients often describe their sensation as "burning" the skin.
Skin pruritus occurs in approximately 30% of patients with Hodgkin's disease. Other symptoms typical of this disease include:
- weight loss - at least 10% in the last six months,
- sweating,
- fever above 38 degrees Celsius, typically lasting more than one month,
- weakness, increased fatigue,
- lymphadenopathy - the most commonly involved are the cervical and mediastinal nodes. The knots are not painful when palpated, but interestingly, they can be painful after drinking alcohol, which is quite a characteristic feature of this disease,
- spleen enlargement
- and enlargement of the liver.
Itchy skin at night and polycythemia
Polycythemia of the skin is another hematological neoplastic disease, the essence of which is to increase the number of produced erythrocytes, i.e. red blood cells. One of the symptoms reported by patients with polycythemia is itching of the skin, which increases after a hot bath, i.e. typically in the evening hours. Other symptoms of polycythemia include:
- dizziness, visual disturbances, tinnitus - which results from excessive blood viscosity caused by an increased number of red blood cells,
- enlargement of the spleen - the spleen is a so-called cemetery of erythrocytes, this is where they are broken down,
- enlarged liver,
- reddish discoloration of the facial skin,
- erythema of hands and feet (painful),
- congestion of mucous membranes incl. oral cavity,
- conjunctival redness.
Itchy skin at night and atopic dermatitis (AD)
A chronic skin disease called atopic dermatitis is another condition characterized by itching. The pruritus in AD is typically worsening in the evening and at night, which leads to sleep disturbances and, consequently, reduced well-being during the day.
Other characteristic symptoms of atopic dermatitis that are worth mentioning are:
- the appearance of eczema-like changes in the area of elbow and knee bends, as well as on the skin of the face and neck,
- skin lesions are characterized by thickening of the epidermis,
- numerous cuts (scratches on the skin),
- nails that look as if they were varnished - which is due to the increased scratching of the skin.
When suffering from AD, it is worth remembering, first of all, about the use of emollients - it is the basis of treatment and prevention alsoitchy skin.
Itchy skin at night and liver and kidney diseases
Itching of the skin, also the one that occurs at night, may be part of the clinical picture of some kidney and liver diseases. They mainly include:
- chronic kidney failure - most often it is caused by poorly controlled diabetes, complicated by diabetic nephropathy, as well as arterial hypertension, or a genetic disease - polycystic kidney disease. Chronic renal failure, in addition to pruritus, is characterized by, among other things, loss of appetite, lowered immunity, or a tendency to bruise. You should be aware that the clinical picture of renal failure can be very diverse and affect many body systems,
- extrahepatic cholestasis - the essence of this disease is to block the secretion of bile from the liver to the duodenum (for example through a gallstone). The main symptoms of cholestasis are yellowing of the skin and its itching, discoloration of the stools, and dark urine,
- pregnant cholestasis - a disease characteristic of pregnancy, increasing the risk of complications for both the mother and the child. The cause of this ailment is the response to high levels of progesterone and estrogen, which are typical of pregnancy. The pruritus in cholestasis of pregnant women intensifies at night and most often affects the hands and feet,
- primary biliary cirrhosis - this is an autoimmune disease, the essence of which is the above-discussed cholestasis, but not extrahepatic, but concerning the small bile ducts inside the liver. A common symptom of this condition, in addition to itchy skin, is chronic fatigue, dry mouth and conjunctiva, as well as pain in the right subcostal area.
Itchy skin at night in endocrine diseases
Itchy skin, including nocturnal itching, may also be part of the clinical picture of endocrine diseases, including thyroid diseases. One should mention Greves-Basedov's disease, an autoimmune disease of the thyroid gland characterized by an overactive thyroid gland.
In the course of this ailment, urticaria may also appear, i.e. the presence of hives on the skin accompanied by itching. There are also reports of possible pruritus in the course of diabetes.