How Is Neurodermatitis Diagnosed
A dermatologist will exam the itchy area, possibly with a scope. The doctor will first rule out other skin conditions, like eczema and psoriasis. The doctor might take a complete medical history and then ask some questions, such as:
- When did the itch start?
- Is it constant or does it come and go?
- What home remedies have been tried?
What Causes Itchy Skin At Night
May 11, 2021
Medical Review By:
How many times has this happened to you: Youre in bed, trying to wind down and drift into sleep, and suddenly your skin starts itching maybe so much so that its hard to fall asleep or stay asleep.
Youre not alone. Itchy skin at night, which doctors call nocturnal pruritus, is fairly common. The causes are not completely understood, but these factors play a role.
Why Am I Itching At Night
Nighttime itching, also known as nocturnal pruritus, is a fairly common occurrence and can be caused by lifestyle factors as well as medical conditions.
Itchy skin during the night can often become an issue when you find yourself stuck in the itch-scratch cycle where the skin is broken and becomes inflamed and itchier, causing you to scratch more.
Carry on reading to find out more about the causes of nighttime itching and top tips for prevention.
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Things People With Eczema Want You To Know
What do you think when you imagine eczema? A red rash, dry skin?Or perhaps even an issue that mostly impacts kids? But what many people don’t realize is thateczema can be a painful, devastating condition. According to the National Eczema Association, 30 million people in the United States are currently living with some form of eczema. There are different types of eczema, so theres no one-size-fits-all treatment plan. The most common type is atopic dermatitis, which can occur in people from allergy-prone families, and is related to an underlying immune reaction that affects the skin.
People with the condition can experience flare-ups at any timesometimes for no reason at allalthough eating the wrong foods, coming into contact with an irritating substance, or experiencing a bit too much stress can increase the likelihood. What’s more, the symptoms often go beyond red, dry, itchy skin eczema can disturb your sleep, impact relationships, and wreak havoc on all parts of a persons life. Chances are, you already know someone with eczema. Heres what they want you to know about their day-to-day struggles.
How Is Neurodermatitis Treated
Neurodermatitis rarely heals without treatment. A dermatologist will write a treatment plan that is unique for each patient. The main goal is to stop the itching and scratching. Treatments can include medications like:
- Corticosteroids. These medicines can be applied to the itchy patch or injected into the patch. Corticosteroids help reduce redness, swelling, heat, itching and tenderness, and can soften thickened skin.
- Antihistamines. Taken before bedtime, an antihistamine can cut back on itching during sleep. It can also help prevent allergic reactions that would worsen the condition.
- Antibiotics. These are prescribed if the patchy area is infected. Antibiotics can be applied to the skin or taken orally in pill form.
- Moisturizers. These reduce dryness and itching.
- Coal tar preparations. This type of medicine causes the skin to shed dead cells and slows the growth of new cells. Patients can place it directly on their skin or add it to their bath.
- Capsaicin creams. These can relieve both pain and itching.
Your doctor might also suggest:
If none of these treatments are effective, nontraditional treatments include:
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Preventing An Itchy Scalp At Night
There are a few ways to reduce the likelihood of an itchy scalp at night. In addition to treating any skin conditions that are causing your scalp to itch, sleep experts recommend making certain adjustments to your sleeping area, including:
- Make sure your sheets and pillowcases are clean and made of material that wont trigger itching or irritation.
- Consider running a humidifier near your bed. This infuses the air with moisture, which may reduce itchiness.
- Keep your room at around 65 F. Cooler sleeping temperatures have been shown to help with the bodys own temperature regulation.
How To Stop Scratching Eczema At Night
Eczema can be quite a nuisance to our daily lives. Between the itchiness, cracking and redness, you may feel like you want to hide under the covers all day. Then in the stillness of the night, the itching just seems worse and scratching just happens without thought. So lets talk about how to stop scratching eczema at night.
Have you ever woken up from intense itching or have subconsciously scratched your skin raw during your sleep? Does your little one whimper through the night, scratching at their skin until it bleeds? If so, then youll want to check out our blog post this week that discusses tips and recommendations for soothing you or your little ones eczema scratching at night.
Please keep in mind that although these treatments can relieve eczema, we are in no way medical professionals. If youre experiencing severe eczema symptoms like an infection, it is best to seek medical advice immediately.
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Why Scalp Itchiness Increases At Night
Having an itchy scalp at night is also known as nocturnal pruritus. This condition can be acute or chronic .
Research shows there are many physiological reasons that skin irritation can become worse at night. Possible causes include:
- Changes in body temperature: During sleep, natural fluctuations in skin temperature may be associated with increased itch intensity.
- Hormone fluctuations: Circadian rhythms regulate levels of certain hormones. At night, the production of anti-inflammatory hormones called corticosteroids naturally falls, which may exacerbate feelings of itchiness.
- Sweating: In the evening, there is an increase in trans-epidermal water loss, where water passes through the outermost layer of skin and evaporates from the skins surface. This can increase skin dryness, which may also increase the sensation of itchiness.
Researchers note that there may also be a psychological component to the increased sense of itchiness. During the day, activities can offer some distraction from itchiness, but at night, the absence of other stimuli may intensify focus on the sensation of itch.
Shield Yourself From Uv Light
Yes, sunshine is glorious for your mood and vitamin D levels, but ultraviolet rays are rough on eczema. You can still exercise outside and soak up nature, just follow these tips, for your skins sake:
- Exercise outside in the early morning or evening to avoid the most intense UV rays of the day.
- Wear sunscreen.
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How To Reduce Eczema Itchiness
One way to reduce itchiness is to suppress the C-fiber nerve endings that give our brain the itch signal, and we can do this using different sensations.
Here are a few methods:
Ice, ice, baby.
Icing the area can numb the tiny C-fibers from transmitting itchy signals to the brain. If your eczema is itching at night, try holding an ice pack over the itchy area for 5-10 minutes or until its numb. You can also take an ice-bath or a really cold shower. This will make the fibers slow and they wont transmit itching signals as fast to the brain.
Get a massage.
Massages are a mix of pain and pleasure, which really distracts the brain. If the itchiness is bad at night, try massaging another body part to create a sensation away from the part that itches. If you have a child who scratches themselves for long periods at night, try to put them to sleep with a massage, away from the eczema-infected area.
Focus on another sensation.
If your leg is itching, try to create another sensation on a different part of your body: like your arm for example. Doing an exercise, going for a walk, or creating a kind of strain on another part of your body will take your brain off the itchiness.
Blow or pat the skin.
Blowing or patting the itchy part of your skin creates a sensation that can disrupt the itching signal. If you have a child who is itchy at night, you can have them try to pat or blow their skin instead of scratching.
Try the Itch-stopper.
Count to 10.
Fight fire with water
Bathroom Habits And Hygiene
Be sure to wipe correctly following the use of the toilet. You may notice that wiping too hard can cause irritation and over-dry the area around the anus. Alternatively, wiping too gently can leave some fecal residue, which might contribute to additional irritation and the potential for infection in any areas where the skin might be chapped or broken.
For the most success in the bathroom, consider using two-ply toilet paper and wiping gently from front to back. You also might also find a bidet useful, as water pressure can produce a better clean.
Read Also: Eczema On Lips How To Treat
Stress Anxiety And Depression Can Make Itchy Skin Worse At Night
There’s a strong association between psychological issues and nocturnal pruritus and itching at night, though it’s not clear how one leads to the other, says Dr. Hart.
One theory is that psychological drama can hyper-activate the body’s fight-or-flight response, flooding the body with hormones and activating the immune system as protection.
When stress happens in small doses, the body’s release of cortisol has an anti-inflammatory effect that may cancel out the stress-induced itchiness caused by the excess histamines. But chronic stress and anxiety can interfere with your body’s ability to produce enough cortisol to pick up the slack , says Dr. Hart, and this may be what makes the itchy skin at night that much more intense when you’re always stressed out.
Another possibility: Because our skin is a direct pathway to our nerves, and our nerve endings go into overdrive during psychological stress, this can also result in intense itching, says Michele Green, M.D., a New York-based dermatologist.
A cycle of sleep deprivation and itchiness may follow, since an out-of-whack sleep cycle can dysregulate the hormones necessary to keep nocturnal pruritus in check, resulting in a cascade effect that ultimately triggers you guessed it itchy skin at night only.
The Main Causes Of Skin Itching At Night
- Being too warm in bed: leaving the heating on, using a memory foam mattress and sleeping under synthetic bedding can all contribute to making your body overheat while you sleep. This in turn further irritates eczema, resulting in body itching at night and forcing you to stay awake.
- Dust mite allergens: while there are many different allergens that can cause eczema, from pet hair to pollen, one of the most common triggers is dust mites. If you frequently find your eczema symptoms are worse at night, then dust mite allergens may well be the cause. This is because most bedding provides the ideal environment for dust mites to thrive in one thats warm and moist exposing you to increased allergens while you sleep.
- Less distractions: children in particular can become more aware of their skin itching at night, simply because they have fewer distractions to keep them occupied.
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Eczema In Cold Dry Weather
Winter air can be hard on your skin, drying it out and triggering an eczema flare-up. Hereâs what you can do:
Keep showers tepid. Itâs especially hard in the winter, but you always need to use lukewarm water in the shower or bath. Hot water can trigger symptoms, especially if youâre changing temperatures quickly — like coming inside from shoveling snow and hopping into a hot bath.
Moisturize! You should already be doing it daily — ideally right after you bathe — year round. But itâs especially important when the weather is cold. Make sure you apply the lotion your doctor recommends on any body parts that might be exposed to cold air, like your face and hands. Think of lotion as an extra barrier you need to help lock in moisture and protect your skin.
Guard against itchy clothes. Your cozy wool sweater can be an eczema trigger. If you do wear wool, use a cotton shirt underneath to cover your skin. Wear cotton gloves under your winter gloves or mittens.
Donât overheat. When youâre bundled up in a heavy coat, itâs easy to break out in an itchy sweat. Wear layers, and take them off and put them on as needed to stay comfortable.
How Can I Sleep Better With Eczema
Though atopic dermatitis can make sleeping well difficult there are actions you can take to sleep better.
1. COOL BEDROOM
Overheating at night and sweating can really lead to a flare up and increase the impulse to scratch. Having a cool sleeping environment is key to alleviate the symptoms of eczema. Keep your bed room cool, this also improves on sleep quality in general. Our bedrooms should ideally be below 18°c / 64.5°F. If your bedroom gets hot during summer keep the blinds/ curtains as well as windows closed during the day and open to air out when it gets cooler at night. Use a fan or air conditioning to get a cooling air flow.
2. COOLING SLEEPWEAR
The best pajamas for eczema should help you keep the best micro climate, ensure you dont overheat and quickly wick moisture away from your skin. Look for natural, breathable and lightweight and soft fabrics. Your bed linen and bedding should also be breathable to avoid heat build-up during the night.
3. COOLING DIET
To avoid overheating at night have a light meal before going to bed, heavy meals keep our metabolism working at night and as a result our body temperature increases. Reduce your intake of alcohol and caffeine. As Dr med Lutz Graumann puts it: “A no-go for good sleep is alcohol. The moment we drink alcohol, there is absolutely no restorative sleep.”
4. REDUCE SCRATCHING
5. AVOID DRY SKIN
Apply moisturizer on the areas of your body prone to eczema before going to bed. This helps to counter any itching at night.
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What Causes An Eczema Flare
Triggers arenât the same for everyone, and there may be a lag between the trigger and the symptoms. Sweat, fabrics , pet dander, hot or cold weather, and harsh soaps are common triggers. Others include:
- Dry skin. It could get scaly, tight, and easy to crack, which can lead to a flare-up.
- Stress. For some people, emotional stress can trigger eczema symptoms. Doctors donât know exactly why this is, but there are ways to help lessen the stress in your life, from mind-body and meditation techniques, to lifestyle changes, to therapy approaches like cognitive behavioral therapy. Talk to your health care provider about how to reduce stress if itâs a trigger for your eczema.
- Irritants. These could include household items like hand and dish soap, laundry detergent, shampoo, body wash, or home cleaners and disinfectants. Juice from fruit, vegetables, and even meats can act as triggers in some people. Other common irritants include:
- Cigarette smoke
- Antibacterial ointment like neomycin and bacitracin
- Cocamidopropyl betaine
- Isothiazolinone (antibacterial in baby wipes and other personal products
Rinse Off Immediately After You Go Swimming
Chemicals found in chlorinated pools and salt found in the ocean could be a problem for those with sensitive skin. Just in case theres no shower in sight, bring along a spray bottle filled with water and use it to rinse off immediately afterward, according to the National Eczema Association. Follow up by reapplying moisturizer and sunscreen to protect the skin and keep it from drying out.
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Causes Of Nighttime Anal Itching
Anal itching, or pruritus ani, is a common condition that is typically worse at night. Accompanied by a strong urge to scratch the skin around the anus, this condition is caused by a variety of skin disorders, infections and an adverse environment that irritates the skin, according to the New York University Langone Medical Center 1.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Eczema Is An Emotional Burden
“This condition is chronic, and in addition to the external suffering, it can be taxing on your mental and physical stress levels. Ive gotten many looks of concern, or heard comments from people Ive attended school and worked with this does drag on your esteem every day. I also wish people would stop insisting I see a doctor. If I am having a bad skin day, I know about it. I really dont need the confirmation that my external appearance matches my internal agony.”Phil
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How Weather Affects Your Skin
Healthy skin acts as a barrier to protect you — the way a good coat of paint guards your house from the summer heat and winter snow.
But when you have eczema, that barrier just doesnât work as well. It leaks moisture, so your skin can get dried out and gets more irritated by heat, cold, humidity, wind, and more.
Weather also can affect your eczema indirectly. For example, a warm, windy day can blow pollen into the air and onto your skin. If youâre allergic, that means an itchy flare-up. The weather can change your own behavior as well. If youâre outside more in the warmer months and huddled under a blanket in the winter, youâll be exposed to different eczema triggers in different seasons.
The key is to notice the types of weather that stir up your eczema — and scratching.