Got an itch that won’t quit? Itchy skin is one of the most frustrating feelings, especially when it feels like nothing will help. Worse, itchy skin can happen for many reasons, including your average mosquito bite and dryness to hives and psoriasis. While for some of these, an over-the-counter cream or ointment may do the trick, other factors behind itchy skin can be trickier to figure out.
Dermatologist Hassan Galadari, MD breaks down ten reasons you might have itchy skin—and what you can do about it.
1. Dry Skin
What Causes It: Dry skin is missing essential components in the skin barrier, like lipids and oils. “This exposes and allows for the increase in nerve endings known as C nerve fibers, which transmit an itch-like sensation,” explains Dr. Galadari. They’re the same nerves behind sensations of warmth, like burning.
How to Treat It: How to defeat dry skin? Try the magic of moisturizer. “It increases the lipid barrier on the upper part of the skin, decreasing the exposure of these nerve fibers,” explains Galadari.
Related Reading: Here’s How to Identify and Care for Your Skin Type
What Causes It: A number of things can cause itchy rashes, but the most common are hives and atopic dermatitis. Oftentimes, “there’s a release of histamine that activates the C nerve fibers,” says Galadari.
How to Treat It: It depends largely on the cause, according to Galadari. Most of the time, an antihistamine or just proper hygiene—like washing the area with a gentle cleanser and applying emollients and over-the-counter corticosteroid creams—can help. But if your rash doesn’t improve within several days, see your doctor to get a specific diagnosis and treatment plan.
Related Reading: Inflammation of the Skin: Risk Factors, Triggers and Symptoms
3. Bug Bite
What Causes It: Odds are that you’ve been plagued by summertime mosquito bites. While a mosquito won’t cover a large area, it does leave behind its saliva, which provokes a skin reaction. On the bright side, “The itch of a bite is pretty localized, and it looks like a bump,” says Galadari, making it easy to identify.
How to Treat It: First, prevent bites by wearing creams or lotions that contain DEET, says Galadari, especially if you’re going to be outside or in warm, humid weather. If a bug gets you anyway, Galadari recommends taking an antihistamine and applying an over-the-counter hydrocortisone cream to the area. If the swelling is more painful than itchy—or you have trouble breathing, which can indicate an allergy—see a doctor ASAP.
4. Eczema or Psoriasis
What Causes It: Both eczema and psoriasis can cause an itchy feeling, but they look completely different on your skin. “Eczema starts as dry skin that’s itchy,” says Galadari. “The repeated scratching may cause possible infection and the area appears oozing and rough.” Psorasis, on the other hand, appears as silvery, scaly plaque on the skin, and, unlike eczema, doesn’t always itch.
How to Treat It: If you suspect you have either skin disease, visit your derm for a definitive diagnosis. Only then will you be able to get the proper treatment—and relief from the itchiness.
Related Reading: Differences Between Psoriasis and Eczema
5. Contact Dermatitis
What Causes It: Ugh, allergies. “Contact dermatitis occurs when a patient encounters an allergen,” explains Galadari. “This can be anything from metals, such as nickel, to everyday materials such as hair dye or even leather.”
How to Treat It: If you know what substance may have caused it, then take care to avoid that in the future. If you’re still not sure, go to your doctor. “The doctor may use a method called patch-testing to learn exactly what it is you’re allergic to,” says Galadari.
Related Reading: 10 moisturizers for sensitive skin that go beyond hydrating
What Causes It: Those itchy, red or white splotches that seem to appear out of nowhere occur when your skin is angry and instigates a reaction from your immune system. Anything from certain foods, medications, infections and even sudden changes in temperature can trigger a flare of hives.
How to Treat It: Since hives are an immune reaction, over-the-counter antihistamines are your best bet. But if you notice any swelling of the lips and throat or your hives last longer than a week, see your derm.
Related Reading: Why Ceramides Are a Must in Your Skin Care Routine
7. Certain Medications
What Causes It: “Any medication that causes dryness may cause itchiness,” says Galadari. That could involve anything from statins, which lower cholesterol, to isotretinoin, an anti-acne ingredient that can have a drying effect on skin.
How to Treat It: Be wise and moisturize. Make sure you’re doing so regularly, says Galadari. If the itchiness is unbearable, see your doctor, who may need to adjust the dosage of your medications.
What Causes It: “Changes in the hormones cause itchiness, as does the stretching of the skin,” says Galadari. Sometimes, internal changes during pregnancy (like those in the liver) may exacerbate it, too.
How to Treat It: Certain medications may help with itchiness during pregnancy, but they depend on what, exactly, is causing it. Visit your doctor to get a confirmed diagnosis.
Related Reading: What to Expect (From Your Skin) When You’re Expecting
9. Nervous System Issues
What Causes It: Since itchiness is mediated by the C nerve fibers—which are part of your nervous system—anything that messes with your nervous system can lead to itchy skin.
How to Treat It: A topical capsaicin cream can help, according to Galadari. If it’s more severe, “Other medications may also be used to help decrease nerve activity,” he says.
10. Psychological Causes
What Causes It: Just thinking about how itchy your skin is can definitely make it worse, since the brain is connected to those nerve fibers that cause itchiness. Plus, “There are also conditions such as OCD, in which a patient has an unexplained compulsion to scratch,” says Galadari. “That can exacerbate itchiness and make matters worse.”
How to Treat It: Breaking the itch-scratch cycle—whether by covering the itchy area so it’s difficult to scratch or even keeping your nails super short—is key. Cognitive behavioral therapy may also help, as can medications, in the case of mental health causes like OCD.
Related Reading: Skin Picking Disorder & the Mind-Skin Relationship