Itchy skin: why you itch and what to do

Itching (pruritus) is an irritation of the skin that makes you want to scratch. It can be in one spot or all over the body, and it can come with hives, bumps or patches, or with nothing you can see.

This page is about the itch itself, especially when there is no clear rash. If you have spots, bumps or welts, see also skin rash.

According to MedlinePlus, the most frequent causes are:

• Dry skin, one of the most common causes, especially in older adults
• Insect bites, such as mosquitoes and sand flies: see bug bites
• Irritants: harsh soaps, chemicals, wool or rough fabrics
• Dermatitis (eczema or contact dermatitis): see dermatitis
• Hives that come and go: see hives
• Parasites, such as scabies or lice: see scabies and head lice
• Itching around the anus, especially at night: it can come from pinworms, very common in children, or from hemorrhoids
• Fungal infections of the skin, groin or feet
• Sunburn and minor skin infections

When the whole body itches and there is no visible cause, MedlinePlus lists possible causes such as allergic reactions, some medicines (for example certain antibiotics or opioids), pregnancy, iron deficiency anemia, hepatitis, and liver or kidney disease.

That is why itching that keeps coming back with no clear cause, itching all over, or hives that keep returning should be checked soon. Most of the time the cause is simple, but unexplained itching can be a sign of another condition.

MedlinePlus recommends:

• Don’t scratch or rub; keep your nails short
• Take lukewarm baths with little soap, and rinse well
• Apply a moisturizing cream or lotion after bathing
• Wear cool, loose, soft clothing; avoid wool
• Put cold compresses on the itchy area
• Avoid long exposure to heat and humidity
• An over-the-counter antihistamine or hydrocortisone cream may help; some antihistamines cause drowsiness

You see Dr. Diana Nieves Castro, a Puerto Rico-licensed general practice physician with several years of emergency-department experience, in English or Spanish. She asks how long you have itched, where, whether it is constant or at certain times, which medicines you take, whether you have allergies and whether you have been sick. Through the secure link you can show her your skin on camera.

We evaluate, diagnose and treat. If the itch has lasted weeks with no explanation, we give you a lab order for a lab near you: for example a blood count, iron, and liver and kidney tests. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. For skin problems that keep coming back, see also skin and acne care.

An online doctor visit costs US$79, the same price for every age. We see adults and children; if the patient is under 21, a parent or legal guardian stays on camera for the whole visit and shows ID.

If itching or hives come with swelling of the lips, tongue or face, or with trouble breathing, it may be a severe allergic reaction (anaphylaxis). According to MedlinePlus, this is an emergency: call 911 right away. If the person has a prescribed epinephrine auto-injector, use it.