Help for Itchy Skin Without a Rash

Doctor’s answer:

With age, skin loses moisture. A dry skin barrier doesn’t work as well as it used to.

Things that may not have irritated you before may now be absorbed in the skin and cause itching. The skin also develops a somewhat impaired immune response, a reduction in fat and blood flow, and altered sensory perception, making it more prone to itching.

Here are some other reasons for generalized itching without obvious skin signs:

• Environment. A very hot, dry environment or lots of hot showers can make the skin dry and itchy, as can excessive exposure to sunlight.
• Medication. Itching may be a side effect of some drugs. Even if you’ve been taking a medication that didn’t bother you before, manufacturers can change the inactive ingredients, such as the dye coloring the pill, and that may cause the itch.
• Allergens. Detergents, fabrics, cosmetics, dust, and plant pollen can cause itching from irritation. A person can acquire an allergic reaction to anything that comes in contact with the skin, and may not notice a rash.
• Psychological conditions. High stress, anxiety, and obsessive-compulsive disorder are common causes of generalized itching. For people with these conditions, symptoms of any kind, including itching, can be amplified.
• Neuropathy. Nerve damage (neuropathy) that causes numbness, tingling, weakness, or pain can also cause itching.
• Underlying medical conditions. Itching may be a symptom of liver, kidney, or thyroid disease; iron deficiency anemia; or rarely some types of cancer, such as a lymphoma.

Reducing generalized itching starts with changing your lifestyle. Taking too many hot showers? Reduce the number to two to three per week. Make the water warm, not hot, and use bland soap.

Related: Six common age-related changes

If you’re not already moisturizing your skin, it’s time to start. Use an emollient (a mixture of water and oil) every day, especially after getting out of the bath or shower (to lock in moisture).

If your home is hot and dry, consider lowering the temperature and getting a humidifier. Aim for a goal of 40% humidity indoors.

When these measures don’t provide sufficient relief, it’s time to see your doctor. Your doctor will consider your medical history, medications or supplements you’re taking, and your lifestyle. It may be necessary to order blood work to check your blood sugar; red and white blood cell counts; and the function of your thyroid, kidney, and liver.

If you do have a rash or other skin changes, it can be difficult to tell whether scratching the itch was the cause rather than some underlying skin problem. Your doctor or a dermatologist might want to take a small sample of skin for examination under the microscope.

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