What Causes Your Skin To Itch Without Having A Rash?

Pruritis is the medical term for itchy skin, which is quite a common condition in which, depending on the intensity, you just want to scratch the bejesus out of your skin. ⁽¹⁾ Many times, the itchy skin subsides on its own without treatment.

The common cause of itchy skin without a rash can be some type of irritation to the skin. There can be appearance of bumps, rash or another sign of skin irritation.

However, in this article we are talking about itchy skin without any rash.

The cause of itchy skin without any rash or other signs of irritation can be difficult to diagnose and often is a sign of some underlying health condition that needs treatment. Some of the potential causes of suffering from an itchy skin without the appearance of a rash are:

Dry skin is one of the common causes of skin itchiness without a rash.⁽¹⁾ The intensity of the dry skin is often mild and can be a result of environmental conditions, like cold/hot weather or low humidity. Dry skin can also occur by certain things, which reduce the moisture from the skin, such as taking hot showers or hot bath. In such cases, treatment and prevention of itchy skin without a rash can be done with using a moisturizer daily and using a humidifier when the weather is dry. To prevent dry skin and its resulting itchiness, one should also stay away from harsh cleansers or soaps which further dry out the skin.

There can be more severe causes of dry skin, such as genetic or due to some underlying disease and in such cases treatment must be sought accordingly.

The skin becomes dry as one ages.⁽⁴⁾ Certain skin conditions, like eczema also causes dry skin and itching.

Bug Bites: Insect bites often cause itchy skin. However, insect bites may not be easy to detect. A tick bite is pretty small and often needs a full-body scan to locate the tick after going into a tick-infested area.⁽²⁾

Some of the other insects whose bite causes itchiness of the skin are: Wasps, mosquitoes, hornets, ticks, mites, bedbugs, fleas, red ants, gnats, spiders and flower bugs. Bug bites are often not a thing of concern. According to The American Academy of Dermatology, after a bug bite, one should use hydrocortisone cream or an ice pack to relieve the itch or one can also take an oral antihistamine.⁽³⁾

However, if someone is experiencing serious symptoms along with the itching of the skin, then it is time to visit an emergency room ASAP. Some of the serious symptoms, which warrant immediate medical attention are: Fever, rash and body pains.

Use of Medications: The use of certain drugs can also cause itching of the skin without having a rash.^{(5, 6)} Treatment for this consists of stopping the use of the drug completely and using a lower dose or replacing it with another medicine. All of this should be done upon consulting your doctor.

Some of the medications which can cause itchy skin without a rash are:

Statins and Niacin: These are cholesterol-lowering medications and cause itchiness all over the body and face.^{(7, 8)} Liver damage can occur in some people who are using statins, which causes organ stress resulting in itching sensation. If your skin is becoming scratchy after taking a statin, then consult your doctor immediately to change the dose or change the medication altogether.

Itchy skin without a rash upon taking niacin is the side effect of this medicine and can be relieved with the use of aspirin beforehand.

Certain blood pressure medications can also cause itchy skin as a side effect. These medicines include amlodipine.⁽⁹⁾ The itchiness can occur as a result of liver disease or can be an allergic reaction to the medicine. Consult your doctor regarding stopping the use of this medicine to relieve the itching.

Stopping use of a medication that causes itchiness can quickly resolve the issue in most people.

Opioids: Opioids can cause itchy skin as a common side effect. Medications which can help to relieve this are nalfurafine hydrochloride and nalbuphine.⁽¹⁰⁾

There are other medications which cause your skin to itch by damaging the body systems and organs. This occurs when the wrong medication is prescribed or when it is used in the wrong way.

Other medications which can cause itchy skin are: Antimalarial drugs, blood thinners, antibiotics and diabetes medication.

Thyroid Disorders: Suffering from a thyroid disorder may produce itching of the skin without any rash.⁽¹¹⁾ Thyroid disorders are commonly associated with the autoimmune disease Graves’ disease.^{(12, 13)} To relieve itching in such cases, taking antihistamines with thyroid medicines help a lot.

Pancreatic Disease: Patients with pancreatic diseases, such as pancreatic cancer, can also experience itchy skin without a rash occurring as a result of jaundice and cholestasis.⁽¹⁴⁾ Treating the cause, which is the pancreatic disease, helps in alleviating itching with medicines, such as rifampicin, colesevelam and cholestyramine.

Kidney disease can also cause itchy skin without any rash and needs treatment.^{(16, 17)}

Kidney disease causes poor metabolism, dry skin, decreased ability to sweat and cool off; re-growth of a new nerve; toxins accumulating in the blood; inflammation and diabetes.

Liver Disease: Just like kidney disease, having a liver disease also can cause itchy skin without a rash.⁽¹⁷⁾ Certain liver disorders such as cholestasis, where there is a hindrance to the flow of the bile can cause jaundice with the following symptoms: itchy skin, yellow eyes, light-colored stool and dark urine.^{(17, 18)}

People having alcohol-related liver diseases will have itchy skin less commonly. This condition is more common in individuals with hepatitis or autoimmune liver diseases. To prevent itchy skin caused by liver disease, the best way is to follow your treatment plan according to the doctor. According to some experts, the use of certain medications help in relieving the symptoms and these are: rifampicin, colesevelam and cholestyramine.⁽¹⁸⁾

Iron Deficiency Anemia: Iron deficiency anemia is a condition where a person’s body does not have sufficient iron to remain healthy.⁽¹⁹⁾ This kind of anemia commonly occurs in:

• People following vegetarian or vegan diets.
• Women who are menstruating.
• Loss of blood from injuries or accidents.

In case of iron deficiency anemia, having itchy skin without a rash is not a common symptom and it can occur from lack of iron in the blood, which puts a strain on the skin as well as other organs.⁽²⁰⁾ Treatment for iron deficiency anemia is consuming iron-rich foods and the use of iron supplements.

In severe cases of iron deficiency anemia, intravenous iron can be given which can cause increase in itching; however, this side effect is rare in many people.

Nervous System Disorders: Nervous system problems can also cause itching sensation. Nerve disorders which cause pain can also cause itching without a rash and these are:

Stroke: Neuropathic itch is caused by stroke and the cause of this is not clear and it is thought to do something with changes in signals of the brain.⁽²¹⁾ Nerve damage from the stroke can also cause itching of the skin without having a rash. Diagnosis of neuropathic itch occurring as a result of stroke can be made through physical exam and different types of tests.

Diabetes: Diabetes is a condition where the body is not able to produce sufficient insulin, which is a hormone that helps in regulation of the blood sugar.⁽²⁾ People suffering from diabetes often suffer from itchy skin without a rash and it commonly involves the lower limbs.⁽²³⁾ This occurs due to persistent levels of increased blood sugar, which further results in complications like kidney disease and nerve damage.

People suffering from diabetes can get rid of their itching by keeping their levels of blood sugar within the normal range by following a healthy lifestyle and taking medications as prescribed by the doctor. Other things, such as using anti-itch creams and moisturizers and lotions also help with itchy skin.

Pinched Nerve: A compressed or pinched nerve occurring as a result of osteoporosis, injuries or being overweight will caused displacement of muscles or bones onto the nerve. Pinched nerves are not able to properly function and cause erratic sensations of weakness, numbness, pain and sometimes itching without any rash.⁽²⁴⁾ Treatment using lifestyle changes, physical therapy or surgery of the underlying cause of the pinched nerve helps in releasing the pressure on the pinched nerve and also gets rid of the itchiness. Some of the medications prescribed for this type of itching are the same group of medications used for treating seizures, neuropathic pain and depression that include antidepressants and a few classes of opioids.

Hodgkin’s Lymphoma: Hodgkin’s lymphoma is lymphatic system cancer and can cause skin itchiness.⁽²⁵⁾ The symptoms of Hodgkin’s lymphoma are lymph nodes swelling commonly around the armpit, neck and groin. Additional symptoms of Hodgkin’s lymphoma consist of: unexpected weight loss; fatigue; abdominal pain; reduced appetite; breathlessness; continuous cough; night sweats and fever.

Hodgkin’s lymphoma can cause persistent itching all over the body, which can increase after consuming alcohol or bathing,

Other Cancers: Rarely, itchy skin without a rash can be an indication of other type of cancers.⁽²⁶⁾ The cause is not clear but it is thought to occur as a result of a reaction to the matter present within the tumors. Melanoma is also a form of skin cancer which causes itching; often on the chest and legs. This kind of itching is also often associated with treatment of cancer, such as chemotherapy.

Cancer Treatments: Treatments for cancer can also cause itchiness without a rash and medicines like erlotinib causes itching when they are being effective. Itchiness along with cancer treatments can also be an indication of an allergy to a certain drug. When going through cancer treatment and experiencing itching, one should consult your doctor immediately.

Mental Health Disease: There are some mental health diseases, which can cause itchy skin without the presence of rash.⁽²⁷⁾ The exact cause is not clear, but it is thought to be associated with chemical imbalances within the brain.

Depression and anxiety are usually associated with itching and random pain without the presence of a rash. Patients suffering from obsessive compulsive disorder and psychosis feel as if their skin is itching. To treat this itching, the underlying mental health disease should be treated first. Treatment consists of lifestyle changes, medication and talk therapy.

HIV Causing Itching:⁽²⁸⁾ Patients with HIV can also experience itching without a rash. HIV is a medical condition where the patient’s immunity decreases and the skin becomes susceptible to skin conditions resulting in itching without a rash.

Complications causing itchiness in patients with HIV are: psoriasis, eczema, dermatitis and dry skin. Sometimes, the medications used for treatment of HIV can result in itchiness. To resolve this itchiness, it’s important to diligently follow the treatment plan for HIV. Taking antihistamines and treating other skin conditions can help in reducing the itching. Phototherapy can also help some patients in reducing the itchiness.

When suffering from itching of skin without any apparent rash one should always consult your doctor and they will help in diagnosing the cause of itching.

The doctor will conduct a physical exam and ask the patient’s medical history. Tests to diagnose the cause of itching without a rash are: blood tests, urine analysis and imaging tests such as x-ray and ultrasound. The results of these tests can help your doctor understand if there’s an underlying health condition causing itchy skin. According to the results of these tests, the doctor will devise the proper treatment plan to relieve itching.

If the cause of your skin to itch without having a rash is a nerve problem, then a neurologist needs to be consulted; in case of tumor or cancer, the expertise of an oncologist is needed; and a psychiatrist or psychologist is consulted if the patient is having some mental health condition.

If the cause of why your skin is itching without a rash is not found then the patient is referred to a dermatologist who can come to the diagnosis by performing the following: visual exam of the skin; skin biopsy; and medical history.

There are certain home remedies which help in giving quick short-term relief from itching.  Some of the home remedies one can try to relieve itching are:

• Use of topical anesthetics.
• The application of unscented and hypoallergenic lotions and moisturizers daily to relieve dry skin and itching.
• The use of over-the-counter creams to combat itching which include: nonprescription corticosteroid creams; calamine lotion and capsaicin or menthol cream.^{(29, 30)}
• OTC allergy medication, such as antihistamines also help in relieving itching.⁽³¹⁾
• Avoid hot baths, as they strip your skin of natural oils and make it dry. Always bathe in cold or lukewarm bath using baking soda, Epsom salt or colloidal oatmeal; all of which soothe the itchy skin. Avoid daily bathing if your itching gets worse with bathing.
• Place a humidifier in your house to combat dry air and to add moisture in the air.
• Try not to scratch your skin. It is better to wear gloves and cover areas that scratch. It is highly advisable to keep your nails trimmed short to avoid worsening of the itch and to prevent any potential infection.
• Always wear lightweight and loose clothing to prevent exacerbation of the itchy skin. Tight clothes can cause excessive sweating, which worsens the itching.

Seek medical attention for your itchiness without a rash if:

You experience itching on sensitive areas of the body or over the entire body.

If itching is accompanied with symptoms, such as change in bowel habits; weight loss; fatigue; develops suddenly; persists for more than 2 weeks; and if it becomes so severe that you are unable to perform your daily activities of living.

Itchy skin is not a serious cause for concern and is seen commonly in many people. Skin itching usually with a rash has an identifiable cause, such as sunburn etc. However, if there is itching of the skin without a rash, the underlying cause can be difficult to diagnose. It can be as simple as skin dryness or something worrying like cancer. Always talk to your doctor for the right diagnosis and treatment to get rid of your skin itching without a rash.

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