LYME DISEASE & CO-INFECTIONS EXPERT. LOOK CLOSER AT YOUR ITCHING

100 possible causes of itching

The most useful clue is what the skin looked like before you scratched. A rash that appeared first points toward causes such as eczema, hives, infection, or a reaction to something that touched the skin. Itching that began on normal-looking skin can still come from dryness or a subtle skin condition, but medicines, iron deficiency, liver disease, kidney disease, and nerve problems also deserve consideration. Scratch marks and open sores can develop afterward with either pattern. AFP (opens in new tab)

The list includes common causes, less common diagnoses, and specific triggers. The numbers are for counting.

1–10. Dry skin, eczema, and irritation

1. Age-related dry skin — often affects the shins, arms, and back.
2. Dry winter air or indoor heating — can dry the skin and trigger itching.
3. Frequent hot showers or baths — can strip oils from the skin.
4. Atopic dermatitis — eczema that often affects the hands, neck, or folds of the elbows and knees.
5. Irritant contact dermatitis — from harsh soaps, cleaners, solvents, or repeated wet work.
6. Allergic contact dermatitis — from things such as nickel, fragrances, preservatives, or hair dye.
7. Poison ivy, oak, or sumac — often causes itchy blisters or streaks where the plant touched the skin.
8. Nummular eczema — itchy, coin-shaped patches.
9. Dyshidrotic eczema — tiny, intensely itchy blisters on the fingers, palms, or soles.
10. Seborrheic dermatitis — itchy, flaky skin on the scalp, eyebrows, or around the nose and ears. AFP (opens in new tab)

11–20. Other skin disorders

11. Stasis dermatitis — itching and discoloration around swollen ankles or lower legs when leg veins drain poorly.
12. Psoriasis — raised, scaly patches that can itch, often on the scalp, elbows, or knees.
13. Lichen planus — often causes flat-topped, itchy purple bumps.
14. Lichen sclerosus — can cause intense genital or anal itching with pale, fragile skin.
15. Lichen simplex chronicus — repeated rubbing or scratching creates a thick patch that keeps itching.
16. Prurigo nodularis — firm, intensely itchy bumps that can break open when scratched.
17. Bullous pemphigoid — in older adults, intense itch can start weeks or months before large, tense blisters appear.
18. Dermatitis herpetiformis — a celiac-related rash with very itchy bumps or blisters, often on the elbows, knees, or buttocks.
19. Linear IgA bullous disease — a rare immune disorder that can cause itchy rings of blisters.
20. Dermatomyositis — an autoimmune disease that can cause an intensely itchy scalp or rash, sometimes with muscle weakness. AFP (opens in new tab)

21–30. Hives, allergy, and physical triggers

21. Acute hives after a viral infection — raised, itchy welts that come and go.
22. Chronic spontaneous urticaria — recurring hives for more than six weeks without a consistent external trigger.
23. Immediate food allergy — can cause itching or hives soon after eating the trigger food.
24. Bee or wasp venom allergy — can cause widespread itching or hives after a sting.
25. Immediate latex allergy — can cause itchy hives after contact with latex.
26. Dermatographism — itchy, raised lines form after scratching or rubbing the skin.
27. Cholinergic urticaria — tiny itchy welts triggered by exercise, sweating, or a hot shower.
28. Cold urticaria — itchy welts after exposure to cold air or water.
29. Delayed pressure urticaria — raised swelling that can itch or hurt hours after sustained pressure, such as from a strap.
30. Heat rash — prickly itching from blocked sweat ducts in hot or humid conditions. AFP (opens in new tab)

31–40. Fungal, bacterial, and viral infections

31. Ringworm of the body — often an itchy, scaly patch that expands outward.
32. Athlete’s foot — itching and peeling between the toes or on the soles.
33. Jock itch — an itchy, scaly rash in the groin.
34. Scalp ringworm — scalp itching, scaling, and sometimes patchy hair loss.
35. Candida in skin folds — a red, itchy or burning rash beneath the breasts, under the belly, or in the groin.
36. Vaginal yeast infection — can cause intense itching around the vaginal opening.
37. Bacterial folliculitis — itchy or tender bumps around hair follicles.
38. Impetigo — a superficial infection that may itch and leave honey-colored crusts.
39. Chickenpox — crops of very itchy spots and blisters.
40. Shingles — itching, burning, or pain in a strip on one side of the body. AFP (opens in new tab)

41–50. Parasites, bites, and outdoor exposures

41. Scabies — often causes intense nighttime itch at the finger webs, wrists, waist, or genitals. Close contacts may itch too.
42. Head lice — scalp itching, often behind the ears or at the back of the neck.
43. Body lice — itchy bites where clothing seams sit against the skin.
44. Pubic lice — itching in areas with coarse body hair, especially the pubic region.
45. Pinworms — anal itching that is often worst at night.
46. Bedbug bites — itchy bumps after sleeping, sometimes grouped together.
47. Flea bites — often clustered around the ankles or lower legs.
48. Mosquito bites — localized, itchy bumps at bite sites.
49. Swimmer’s itch — an itchy rash after swimming in water containing certain microscopic parasites.
50. Cutaneous larva migrans — a very itchy, winding skin track after contact with sand or soil contaminated by animal hookworm larvae. AFP (opens in new tab)

51–60. Liver, bile duct, and kidney disease

Several of these can cause widespread itch before an obvious rash appears. Reduced bile flow is called cholestasis. PMC (opens in new tab)

51. Primary biliary cholangitis — an autoimmune disease that damages small bile ducts in the liver.
52. Primary sclerosing cholangitis — inflammation and scarring narrow the bile ducts.
53. A gallstone lodged in the common bile duct — can block bile flow.
54. Bile duct scarring after surgery or injury — can narrow the duct and slow bile flow.
55. Bile duct cancer — can cause itching if it blocks bile drainage.
56. Pancreatic head cancer — can compress the bile duct and cause itching, sometimes with jaundice.
57. Chronic hepatitis C — can be associated with itching through liver disease or related skin conditions.
58. Alcohol-associated hepatitis with cholestasis — itching can occur when bile flow is impaired.
59. Intrahepatic cholestasis of pregnancy — new itching, especially on the palms or soles, warrants a prompt call to the maternity care team.
60. Advanced chronic kidney disease — can cause persistent itching, including in people on dialysis. AFP (opens in new tab)

61–70. Blood, hormone, and metabolic disorders

61. Iron-deficiency anemia — a recognized cause of widespread itch.
62. Polycythemia vera — a blood disorder that can cause intense itching after bathing, with normal-looking skin.
63. Hodgkin lymphoma — persistent generalized itching can occur, sometimes with swollen lymph nodes, night sweats, or unexplained weight loss.
64. Non-Hodgkin lymphoma — can also cause generalized itching in some people.
65. Cutaneous T-cell lymphoma — an uncommon lymphoma that can resemble eczema or cause persistent itchy patches.
66. Mastocytosis — excess mast cells can cause itching, flushing, or hives.
67. Hypothyroidism — an underactive thyroid can contribute to dry, itchy skin.
68. Hyperthyroidism — an overactive thyroid can sometimes cause widespread itching.
69. Diabetes mellitus — itching may come from dry skin, yeast infections, or nerve damage.
70. Hyperparathyroidism — an uncommon association with itch, particularly in the setting of chronic kidney disease. AFP (opens in new tab)

71–80. Medicines and medication withdrawal

71. Opioids such as morphine — can cause itching without an allergic rash, especially when given near the spinal cord.
72. Penicillin or amoxicillin reactions — can cause itchy hives or a more widespread rash.
73. Sulfonamide antibiotic reactions — medicines such as trimethoprim-sulfamethoxazole can cause an itchy drug eruption.
74. Aspirin or other NSAIDs — can trigger or worsen hives in susceptible people.
75. Vancomycin infusion reaction — can cause flushing and itching during or shortly after an IV infusion.
76. Chloroquine — can cause marked itching without a visible rash.
77. Hydrochlorothiazide — can cause a sun-sensitive, itchy rash in some people.
78. Immune checkpoint inhibitors — cancer treatments such as pembrolizumab can cause itching with or without a rash.
79. Amoxicillin-clavulanate–related liver injury — can cause delayed itching if it interferes with bile flow.
80. Stopping long-term cetirizine or levocetirizine — the FDA warns that rare, severe itching can start within days after stopping. PMC (opens in new tab)

81–90. Nerve-related itching

Nerve itch may come with burning, tingling, or a crawling sensation. The skin can look normal at first. PubMed (opens in new tab)

81. Brachioradial pruritus — itching or burning along the outer forearm, sometimes linked to neck nerve problems or sun exposure.
82. Notalgia paresthetica — a stubborn itchy patch near one shoulder blade.
83. Small-fiber neuropathy — damage to tiny sensory nerves can produce itching, burning, or tingling.
84. Postherpetic itch — itch that persists in the same area after a shingles rash clears.
85. Nerve injury after surgery — can cause persistent itch around an incision or in the area served by the affected nerve.
86. Healing burns or burn scars — damaged skin and nerves can cause long-lasting itch.
87. Nerve compression in the lower spine — can occasionally cause persistent genital or anal itching.
88. Stroke — rarely causes localized or one-sided itching from damage to sensory pathways.
89. Multiple sclerosis — can cause short attacks of intense itching.
90. A spinal cord lesion — a tumor or other lesion can rarely cause itch in a specific band or region. PubMed (opens in new tab)

91–100. Other causes and less common diagnoses

91. Polymorphous light eruption — itchy bumps or patches after sun exposure, often in spring or early summer.
92. Friction and moisture in skin folds — can cause itchy, inflamed skin even before an infection develops.
93. Stool leakage or persistent moisture around the anus — can irritate the skin and cause itching.
94. Genitourinary syndrome of menopause — lower estrogen can lead to vulvar dryness, irritation, and itching.
95. Polymorphic eruption of pregnancy (PUPPP) — an itchy rash that often starts in abdominal stretch marks late in pregnancy.
96. Pemphigoid gestationis — a rare pregnancy-related condition that can begin with severe itching around the belly button and progress to blisters.
97. HIV-associated itching — may come from dry skin, an itchy skin eruption, infection, or a medication reaction.
98. Onchocerciasis — a parasitic disease that can cause severe chronic itching after exposure in affected regions.
99. Aquagenic pruritus without an identified underlying disease — water contact triggers itch without hives or a visible rash. Polycythemia vera is one condition clinicians may check for.
100. Functional itch disorder — psychological factors can drive persistent itch in some people. Clinicians consider this after evaluating skin, medication, nerve, and internal causes. AFP (opens in new tab)

When itching needs medical attention

• Call 911 if sudden itching or hives come with trouble breathing, throat or tongue swelling, or faintness. Use an epinephrine auto-injector immediately if one is available. ACAAI Patient (opens in new tab)
• Arrange an exam if itching is widespread, keeps returning, disrupts sleep, or leaves recurring open sores. If there was little or no rash before scratching, common initial tests include a complete blood count, iron studies, kidney and liver tests, blood sugar or A1c, and TSH. The history and exam guide which tests are needed. AFP (opens in new tab)

10 full references

1. Rupert J, Honeycutt JD. Pruritus: Diagnosis and Management. American Family Physician. 2022;105(1):55–64. Full article (opens in new tab)
2. Weisshaar E, et al. European Guideline on Chronic Pruritus. Acta Dermato-Venereologica. 2025;105:44220. DOI 10.2340/actadv.v105.44220. Full guideline (opens in new tab)
3. Millington GWM, Collins A, Lovell CR, et al. British Association of Dermatologists’ guidelines for the investigation and management of generalized pruritus in adults without an underlying dermatosis, 2018. British Journal of Dermatology. 2018;178(1):34–60. DOI 10.1111/bjd.16117. PubMed (opens in new tab)
4. Merck Manual Professional Edition. Pruritus. Clinical review (opens in new tab)
5. Centers for Disease Control and Prevention. Symptoms of Scabies. CDC guidance (opens in new tab)
6. DermNet. Drug-induced pruritus. 2019. Clinical review (opens in new tab)
7. U.S. Food and Drug Administration. FDA requires warning about rare but severe itching after stopping long-term use of oral allergy medicines cetirizine or levocetirizine. 2025. Drug safety communication (opens in new tab)
8. Pereira MP, Wiegmann H, Agelopoulos K, Ständer S. Neuropathic Itch: Routes to Clinical Diagnosis. Frontiers in Medicine. 2021;8:641746. DOI 10.3389/fmed.2021.641746. PubMed (opens in new tab)
9. Society for Maternal-Fetal Medicine, Lee RH, Greenberg M, Metz TD, Pettker CM. Society for Maternal-Fetal Medicine Consult Series #53 (opens in new tab): Intrahepatic cholestasis of pregnancy. 2021. Clinical guideline (opens in new tab)
10. American College of Allergy, Asthma & Immunology. If I use epinephrine for an allergic reaction, do I have to call 911? Patient guidance (opens in new tab)