Chronic itching in the evening and at night: what exactly is itching?

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Chronic itching, called pruritus, can be the result of various diseases. What are they and how can itching be treated?

Do you scratch and scratch and scratch until your skin hurts? And does that feel like non-stop, even at night? Then you may suffer from what is known as pruritus. If severe itching occurs only occasionally, home remedies such as yogurt and black tea can relieve symptoms and make your daily life easier. But if the skin itches, tightens and burns continuously for more than six weeks, doctors speak of chronic itching. Sufferers are often under a huge psychological burden: the skin itches, but the skin itself is not the cause. As university professor Sonja Stehr, head of the Pruritus Competence Center in Münster, knows, the cause of persistent itching is often found elsewhere in the body.

Chronic itching in the evening and at night: what is behind the itching?

Patients with neurodermatitis often suffer from other skin diseases (picture of the symbol). © imago images / Panthermedia

Essentially, the skin starts to itch when certain nerve fibers are stimulated by the messengers histamine and serotonin. Mechanical stimuli, food, toxins or temperature fluctuations can also lead to itching if the tissue hormone histamine is released in excess.

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In Germany, millions of people suffer from itching. In many cases, the cause of chronic itching is recognized very late or not at all.

Chronic itching: Diseases can be the cause

First of all, it is important to describe exactly where and when the itching occurs to the attending physician. This can help get to the bottom of the cause. The causes can be as varied as the itching experienced by the sufferer.

Inflammation, medications, allergies, parasites, neurodermatitis, diabetes, tumors, liver, gallbladder or kidney disease and neurological disorders, even a herniated disc can cause severe and long-lasting itching.

  • Itching on the head may pass dry scalp, fungal infection or simply intolerance to shampoo.
  • Excretory itching of the skin at night can indicate a parasitic skin disease, scabies.
  • Itching in the crook of the neck, groin, and underarms may indicate Hodgkin’s lymphoma.
  • Severe itching of the skin on the feet could be the cause of liver problems.
  • Itching after contact with water can be a symptom of a rare disease of blood-forming cells in the bone marrow. In this case, excessive reproduction of red blood cells (erythrocytes) occurs.
  • An itchy nose or nose is a sign of eczema, and in very rare cases, it can also be caused by a brain tumor.
  • Non-specific itching in different parts of the body can be caused by kidney disorders or be a side effect of diabetes, HIV infection or even multiple sclerosis.
  • The so-called cholestatic itching may indicate a disease of the liver or gallbladder, such as jaundice (icterus). This itching is especially noticeable in the early evening and at night, often on the soles of the feet and palms. Scratching the itchy areas often provides little relief in cholestatic pruritus, but often leads to skin changes such as abrasions, sore and bloody areas, crusts, and itchy nodules (prurigo nodularis). And these secondary manifestations will trigger the itch again. Cholestatic itching is very stressful for sufferers and in the medium term leads to sleep disturbances and even depression in the long term.

The fact that these diseases and accompanying circumstances can be the cause of itching should definitely be included in the diagnosis, says Prof. Standard

This article contains only general information on the relevant health topic and is therefore not intended for self-diagnosis, treatment or medication. In no case does it replace a doctor’s visit. Unfortunately, our editors are not authorized to answer individual questions regarding clinical images.

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