While nocturnal pruritus, aka “nocturnal itch,” is a great name for a band, it hardly “rocks,” and may cost you beauty rest.

If left unchecked, it can hijack your quality of life. The possible culprits behind it range from the creepy-crawly (we’re talking legit bugs), to possible health concerns, to mental or emotional overload.

But take heart — you should be able to scratch that itch off your list with over-the-counter (OTC), prescribed meds, alternative treatments, or a calming dose of zen.

Why would skin itch worsen at night?

It’s likely that the itch only strikes at night due to your natural cycles. Put simply, it could be that it’s just harder to ignore itchiness when there aren’t other distractions competing for your attention.

But there’s also a number of health-related conditions that can intensify the need to scratch when you crawl between the sheets.

Irregular circadian rhythm

This is the body’s natural 24-hour cycle that tells the body when to wake and sleep, but its influence doesn’t stop there.

It affects your body temperature, hormone levels, and so-called itch mediators. Irregular circadian rhythm has been linked to several underlying health conditions.

An irregular circadian rhythm is not a commonly recognized cause of itch at night.

Sunburn, aka “Hell’s Itch”

Hell hath no fury like a skin scorched! Hell’s itch is a deep, painful itching resulting from an overdose of ultraviolet radiation.

Hormonal fluctuation

This is mainly experienced with menopause or pregnancy due to fluctuating levels of the hormone estrogen, which can cause the skin to become dry, flushed and itchy.

Skin disorders

Eczema

Eczema causes patches of skin to become inflamed. Continued scratching can result in red, cracked, and rough, dry skin.

Hives

Hives is a non-contagious rash sometimes triggered by an allergic reaction. It causes inflammation and fluid to accumulate under the skin, giving the skin a red, raised, itchy rash.

Triggers can include certain foods, medications, infections, insect bites, and scratching. Some other possible causes behind allergic reactions that often result in itchy skin include:

  • chemicals
  • cosmetics
  • pollen

Allergies are triggered when certain cells in the body perceive a threat and release a substance in response called histamine, which triggers inflammation as a protection mechanism.

Psoriasis

Psoriasis develops most commonly on elbows and knees and is marked by inflamed, red, raised plaques of skin. It’s a result of the skin production process on fast forward, leading to a buildup of skin cells that resemble scales, which can sometimes crack and bleed.

Bugs

Scabies

These microscopic mites are carried on infested clothing, bedding, or furniture and they make themselves at home by burrowing into the skin and laying eggs.

It is most often transmitted by prolonged skin to skin contact, however. So make sure that whoever you share your bed with also gets treated.

This causes skin infection and itchy red rashes, not to mention a serious case of the heebie jeebies!

Lice

Lice are wingless parasites that feed on human blood, dance on scalps, and lay eggs on hair shafts. If these activities alone didn’t make them bad tenants, they can make a scalp itch like crazy!

Bedbugs

These small, wingless insects feed on warm-blooded animals like us. They enjoy loafing around on sofas, mattresses, and clothing. They prefer to dine between midnight and 5 a.m., causing wicked nighttime itching.

Pinworms

Talk about a pain in the butt! These parasitic worms take up residence in their victim’s colon, and while they sleep the worms poke out through the anus to lay their eggs in the surrounding skin.

This, as you probably can’t prevent yourself from imagining, causes the worst kind of itch.

Kidney or liver disease

Itchy skin is a common experience for those with end-stage renal disease or chronic liver disease.

Thyroid problems

Hyperthyroidism and its cousin, hypothyroidism, have long been known to cause itchiness.

Consult a doctor if your itchiness is accompanied by unintentional weight loss, quickened pulse, puffy eyes, or an enlarged thyroid (signs of hyperthyroidism) — or weight gain, worsening fatigue, constipation, or dry skin (signs of hypothyroidism).

Psychological conditions

Stress, anxiety, depression, or chronic stress can make your skin crawl even without a physical cause, making you feel an overwhelming urge to scratch.

Restless leg syndrome

Women are twice as likely to experience this neurological disorder that causes an itchy “creepy crawly” feeling in the legs. Symptoms tend to be worse at night when resting or trying to sleep.

Iron deficiency anemia may be also be related to this disorder.

If low on iron, the body can’t produce enough healthy red blood cells to meet its needs. Symptoms can include fatigue, shortness of breath, or a tingling feeling in the legs, like that of an itch.

Cancer

A chronic itch could be an early sign of some cancers. If your itch has been bothering you for a while and has no obvious cause, it could be worth it to consult a doctor.

This is a rare cause of itching and is more likely to concern those with night sweats, fevers, chills, and unintentional weight loss.

Nerve disorders

Itch-sensing nerves can malfunction, causing a phantom itch that has no physical trigger.

This can be a result of an underlying disease, including:

  • multiple sclerosis
  • shingles
  • diabetes

With luck, these remedies will have the Sandman taking your itch off to never-never land before returning for you. Choose them according to the likeliest cause, or consult a doctor to remove the guesswork.

Natural remedies to try:

Melatonin supplements

Melatonin is a hormone that naturally exists in the body to help induce sleep.

It’s considered generally safe to take as a supplement, and science supports its power to help you doze off. You can’t itch if you’re already asleep, right? You can shop for some here.

Moisturizers

If dry skin is doing you in, lotion up before bedtime. Or better yet, have a friend do it for you. Overwhelmed by the selection of body butters and creams and not sure where to start? Try this trusted favorite.

Bathing with baking soda or colloidal oatmeal

These are cheap, effective, and luxurious methods for relieving itchy skin, and the side benefits are numerous as long as the water isn’t too hot. Also, the baking soda shouldn’t be used more than two to three times per week.

You can find baking soda in any grocery store, but the oatmeal in the cereal aisle is not going to work in the tub — instead, try this one.

Cool compress

Start the night off on the cool side and reduce itching related to elevated skin temperature. These are available in so many styles that one exists for nearly every body part.

Humidifiers

Humidifiers put moisture into the air, creating a great environment for supple, itch-resistant skin. Some even have trays for diffusing essential oils, adding aromatherapy into the bargain.

Cognitive-behavioral therapy

If your nighttime itching is triggered by stress, anxiety, or depression, cognitive-behavioral therapy (CBT) may be just what the doctor ordered.

CBT is a form of psychotherapy designed to help manage emotions and to redirect unhealthy thought patterns. It’s been recognized as an effective treatment for skin conditions that are influenced by the psyche.

OTC itch relief

Antihistamines

As their name suggests, antihistamines stifle or block the release of histamine, thus calming itchiness brought on by hives. Benadryl is a well-known branded version of the generic antihistamine diphenhydramine.

Note that although non-drowsy options are available, some can knock you right out. Just a fair warning so you don’t take them at an inopportune time, like before driving or while being pursued by Freddy Krueger.

Hydrocortisone cream

While not an antihistamine, hydrocortisone cream performs a similar action — blocking the release of chemicals in the skin that cause inflammation.

Antidepressants

Antidepressants called selective serotonin reuptake inhibitors (SSRIs) are prescribed to combat chronic itch.

However, one possible side effect of SSRIs is reduced sexual desire, so for some this could be an overcorrection — nights could end up too peaceful!

It’s also important to note that some antidepressants can actually worsen the quality of sleep in some individuals and cause insomnia.

Other tips for itch prevention

Avoid itchy fabrics

There’s a reason most of us don’t recycle our old potato sacks into pajamas — bedtime calls for gentle clothes made from natural fabrics. Try organic cotton, or for a splurge — silk.

Temperature control

As described above, overheated skin can bring on the itch. Setting your thermostat down a notch or two may also lessen your skin irritation.

Avoid other skin irritants

Cosmetics, scented soaps, and perfumes can make your skin more appealing to other people, but some of them can take a toll on your comfort. Especially those loaded with artificial fragrance.

If you find that’s the case with anything in your makeup bag, it could be a perfect holiday gift for your best frenemy!

Keep nails short and resist the itch

Itchiness makes you scratch, but scratching irritates your skin, so you scratch more, and itch more… where does it end?!

One way out of this infinite feedback loop is to keep your nails short to protect the skin from scratching. Another is simply to master the urge to itch — easier said than done, for sure.

It may feel silly to visit a doctor just for an itch, but if you’ve tried home remedies and still can’t find relief, you owe it to yourself to get help.

If your itching lasts more than a couple weeks or is preventing you from sleeping, why put up with it? And if your itch is accompanied by other concerning symptoms, it’s better to be safe than sorry.