Itchy legs at night: 22 Causes, 4+Treatments and Prevention

Itchy legs at night, have you suffered from this problem anytime. Then you know how annoying it is. Let us explore its causes and remedies.

‘Itchy legs at night is a petty form of suffering,’ wrote Andre´ Gide in 1931. Skin itchiness that continues more than 2 weeks is referred to as chronic pruritus, and during sleep is specifically called Nocturnal Pruritus.

Severe cases often cause difficulty in sleeping and make it impossible to get a deep relaxing sleep. By the time, this will influence your well-being health and put you in a lot of stress affecting your work, emotional health and your everyday activities.

Why does itchy rash on legs worse at night?

itchy legs at night
Image source: verywellfit.com

Itchy legs at night during sleep period can present as a symptom of the dermatological or systemic disease. Scratching during sleep can be mild or severe, sometimes patients report to suffer from no obvious sleep or skin injury to bleeding and scars formation. Itching eventually causes skin damage and makes you susceptible to infection.

Why does itch increase at night?

Certain hormones, and chemicals that occur in the body as a natural cycle increase itchy leg skin at night. The skin may only feel itchier during the night because of a lack of outside distractions.

It may also be a sign of more serious medical conditions. If itchy legs at night is long-term more than two weeks or accompanied by a rash or scales, it might be due to an illness which has not been diagnosed yet, and a dermatologist has to be considered.

Why do my leg itch at night?

Circadian rhythm:

The circadian rhythm causes some changes and most of the time they aggravate nighttime skin itchiness. These include:

  • Blood flow is more directed towards the skin, causing itchy legs at night.
  • Elevated body temperature.
  • Increased immunological responses which in turn increase the inflammation.
  • Decreased corticosteroid, therefore there is an increase in inflammation.
  • Increase widening of vessels through prostaglandin release.
  • Increased sweat
Menopause:

Hormonal fluctuation and changes cause itchy leg sensation along with dry skin, crawling under the leg sensation.

Pregnancy:

Women with pregnancy‐related intrahepatic cholestasis should be evaluated as early as possible to minimize any risk for the unborn child. Itchy legs at night is usually apparent on thighs, causing itchy thighs.

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Xerosis (Dry skin):

It is mostly seen in the winter when there is little air moisture. Usually, it is not something serious, and moisturizers will be more than enough to prevent them. You must check with a dermatologist if this itchy legs at night persist for more than two weeks or didn’t improve after regular remedies.

Allergic Dermatitis:

Contact dermatitis, this is due to touching anything allergic as soap or irritating chemicals and even some plants. This will cause the itchy legs at night with the possibility of the appearance of some bumps.

Try to minimize or do not add any cloth cleaning detergent or bleaching agent, and if you added them, then double wash is mandatory. Sometimes, you can show allergic signs to the same chemical you have been using before many times in the past.

Kidney Failure leg itching:

Another type of itching and it is common to show in legs, it is referred to as Uremic pruritus which occurs due to the hemodialysis of kidney failure patients, it is usually accompanied by low life quality and severe depression.

Hodgkin’s lymphoma:

It is a serious condition that causes itchy legs at night

Liver failure:

A patient with a poorly functioning liver will suffer from the itchy legs at night and Tommy scratching at night because bile acids accumulate and precipitate under the skin causing itchy legs at night sensation.

 Systemic mastocytosis:

Present with multiple symptoms involving various systems in your body including skin (pruritus, and flushing), neurologic (depression, and sleep disturbance).

Bed bugs:

Bedbugs are small, blood-feeding insects. Mattresses are where you should start searching for bugs; they usually hide inside it.

These bugs and small insects feed on the blood of the humans or even animals and pets, causing itching sensation that really disturbs regular life pattern and mostly sleep.

Mosquito, insects bites:

It is one of the most common causes of developing itchy skin at night.

Chickenpox:

Chickenpox is a very common condition which develops in people exposed to the people affected by chickenpox and those who are not vaccinated against it. These people develop itchy vesicles all over the body.

Fungal infections:

Fungal infections as candida sometimes affect the feet causing itching sensation that is worse during the night and sometimes it appears between thighs; it could be mild or severe depending on the degree of atrophy occurring. Anti-fungal creams and warm water bath is the mode of treatment.

Sunburn:

If your skin is exposed to excessive heat, you can develop sunburn. This can lead to red rash over skin which is very itchy.

Allergy:

Allergy-causing reactions are not from contact with allergenic things sometimes. But maybe because of food or plant seeds or dust allergy. This allergy could spread through the whole body affecting mainly the extremities (Hand and legs).

Increased sweating:

You might sweat a lot due to your body nature, hot environment, excess physical activity, etc. Excess sweating is also one of the causes of itchy legs at night.

Restless leg syndrome:

In this disorder, we can notice the affected person changing the position of his leg continuously with an itching sensation.

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Excessive thyroid hormone secretion:

Generalize itching all over their body makes the physician consider thyroid disorders especially in patients presenting with pruritus who do not respond to conventional anti-pruritic agents.

Skin cancer:

Skin cancer, there are a lot of types, each type shows different signs and symptoms, Itchy legs at night is one of the common ones that usually is found in skin cancer patients. Usually, itching is accompanied by tingling, starts with no pain, and eventually, there will be the pain, all skin cancer patients say that it feels like ants crawling under the skin.

Lymphoma (para-neoplastic pruritus):

If itching is combined with weight loss, unjustified excessive night sweating then this is due to the lymphoma. Itchy legs at night in lymphoma disease ends with scaling rash.

Auto-immune diseases:

Examples to it Graves’ disease and Hashimoto’s Thyroiditis, patients with autoimmune thyroid conditions show skin conditions, which can lead to the itchy legs at night.

Other conditions causing itchy legs at night:
  • Skin Eczema
  • Inflammatory skin diseases associated with lichen.
  • Lupus erythematosus
  • Neuropathic pruritus

Treatment of itchy legs at night:

Different modalities in treatment in leg skin itchiness in night

Start with Prevention and lifestyle changing ways:
  • Hydration and the use of moisturizers are very important for smooth, prevention of dry skin and its complications.
  • Do not take long time showers and don’t overheat the water temperature.
  • Cotton clothes in summer especially are the best to reduce itchy legs at night. Loose fitting cotton pyjamas are to be worn at night.
  • Remember that Caffeine and alcohol-containing drinks, increase blood flow, increasing itching sensation, PLEASE avoid or at least limit them.
  • Adjust the room temperature before sleeping, as sweating causes itchy legs at night.
  • Bed sheets are to be replaced regularly.
  • If you have any pets, regular visits to their vet are very important, and their good hygiene is mandatory.
  • Use moisturizers preferably glycerin-based, but use oil free one, before bedtime especially between your thighs and feet area, will play a great role in limiting the itchy legs at night sensation.
  • Aloe-Vera cream for soothing is great at night time.
  • Remember that scratching will worsen your itching feeling and increase the inflammation causing more leg itching. (Trim your nails regularly and smooth them).
  • Regular inspection of bed bugs and insects and spraying of the room is mandatory every day.
  • Open the windows every morning in your bedroom for better room ventilation.
  • Hear music or play yoga before going to sleep, sometimes stress can worsen itchy legs at night.
Prescribed medications:

They are needed if nothing of the home-made natural remedies decreased the itchy legs at night for better treating and the symptoms and the causes as well.

These medications as mentioned is prescribed, meaning that your dermatologist or doctor is the responsible for choosing the best treatment for you, this after reaching the diagnosis and the cause of itchy legs at night, this is very important to avoid any complications or interferences with another drug prescriptions.

  • Creams containing steroids have great influence in reducing inflammation, therefore decreasing the itchy legs at night feeling.
  • Medications for Allergy reduction, will decrease the inflammation and soothe the leg area.
  • Natural hormone Supplements at night will help you to sleep and also have a sedative effect example to it is melatonin, good deep sleep won’t make you feel the itchy legs at night which will impact the amount of scratching at night.
  • Antidepressants, but, as previously mentioned, never to go for this type of medication without your physician approval. It helps reduce itching caused by stress and anxiety.
  • Immune-suppressants, also act on inflammation by reducing it.
  • Anti-histaminic drugs that perfectly reduce any itching and relieve scratching effect.
  • Phototherapy, type of treatment that targets the immune response of skin and therefore decreasing inflammation.
  • Estrogen hormone is replaced in the body; this will reduce dry skin and itchiness.
  • Steroid creams.
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Chronic long-term itchy legs at night requires interdisciplinary cooperation:

Symptoms and the Specialist required:

  • Generalized pruritus: Neurologist, psychosomatic medicine specialist
  • Psychological cofactors: Psychiatrist, psychosomatic medicine specialist
  • Localized neuropathic pruritus in legs: A radiologist (MRI), orthopaedic surgeon, neurologist
  • Pruritus during pregnancy: Gynaecologist, an internist
What should not be done if you have itchy legs at night:
  • Don’t wear tight pyjamas or clothes during sleeping, avoid synthetic clothes and always go for cotton clothes.
  • Before sleeping, don’t spray any perfumes or sprays over your body, if it is essential to spray the outside of the clothes.
  • Always adjust the room temperature that you either don’t feel hot or cold during sleep for a deep relaxing sleep.
  • A humidifier could always be used to improve itchy legs at night.
  • Scratching is your worst enemy; it will increase the itching and irritate more.
  • Caffeine and any alcohol containing drinks are to be avoided as they cause vasodilation of the vessels causing more inflammation and pruritic itch.
Reference article:
  1. https://www.healthline.com/health/itchy-skin-at-night
  2. https://www.medicalnewstoday.com/articles/319387.php
  3. https://www.livestrong.com/article/212650-what-causes-itchy-skin-at-night/
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  5. Liu Q, Sikand P, Ma C, Tang Z, Han L, Li Z, Sun S, LaMotte RH, Dong X. Mechanisms of itch evoked by beta-alanine. J Neurosci. 2012;32(42):14532–7.
  6. Pardanani A. Systemic mastocytosis in adults: 2012 update on diagnosis, risk stratification, and management. Am J Hematol. 2012;87:401–411.
  7. Ständer, S. , Zeidler, C. , Magnolo, N. , Raap, U. , Mettang, T. , Kremer, A. E., Weisshaar, E. and Augustin, M. (2015), Clinical management of pruritus. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 13: 101-114. doi:10.1111/ddg.12522

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