Itchiness is a hallmark symptom of many long- and short-term skin conditions, from eczema to psoriasis to hives. But this symptom has not historically been associated with acne. However, recent research demonstrates that itchiness is indeed relatively common with acne. If you've experienced this symptom, you are certainly not alone and there are potential remedies to relieve your discomfort.
A Common Experience
While pimples remain the primary focus with acne, itchiness frequently accompanies this common skin condition. A study conducted among 108 teenagers receiving acne treatment revealed that a full 50 percent experienced some itchiness associated with their skin condition, as reported in January 2008 in the journal "Acta Dermato-Venereologica." Another study published in November 2008 in the "Journal of the European Academy of Dermatology and Venereology" found 70 percent of the 120 study participants being treated for acne reported some associated itchiness.
Frequency and Intensity
Although acne-related itchiness has not been extensively researched to date, the aforementioned studies give some preliminary information on its frequency and intensity. In both the "Acta Dermato-Venereologica" and "Journal of the European Academy of Dermatology and Venereology" studies, the majority of participants reported that acne-related itchiness occurred only intermittently -- in some as infrequently as once per month. Only 7 percent of the "Acta Dermato-Venereologica" study participants reported daily itchiness.
In both studies, the intensity of itchiness was reported to be moderate, roughly 4 on a 10-point scale, with 10 being maximum intensity. A score of 4 is approximately equivalent to that of a mosquito bite. Interestingly, the severity of the acne did not appear to influence the frequency or intensity of the itchiness experienced.
Although acne-related itchiness is usually intermittent and of moderate intensity, the symptom still causes negative effects in those who experience it. In the "Acta Dermato-Venereologica" and "Journal of the European Academy of Dermatology and Venereology" studies, 15 percent and 21 percent of study participants reported their itchiness sometimes made it difficult to fall asleep. Other negative effects reported by the study participants included anxiety, agitation, mood changes and difficulty concentrating. Additionally, itchiness incites scratching of acne pimples. This can lead to secondary bacterial infection of the skin, with possible scarring and discoloration.
The cause of acne-related itchiness remains incompletely understood and more research is needed. However, several theories have been proposed. Some researchers speculate that people who experience acne-related itchiness might have a very mild form of another skin condition called dermatographism. With this condition, even gentle touching of the skin causes an inappropriate release of histamine that leads to itchiness. Other researchers have proposed that acne treatment leads to changes in the skin that trigger itchiness -- and that the symptom might actually signal treatment effectiveness. Another possibility is that acne itself triggers itchiness via unknown mechanisms. It's possible that these mechanisms or other undiscovered mechanisms act alone or in combination to cause acne-related itchiness.
Because the exact cause of acne-related itchiness remains unknown, the best treatment strategy also has yet to be determined. Approximately 20 percent of people in the "Acta Dermato-Venereologica" study reported that rinsing their face with cold water reduced short-term itchiness. Avoiding aggravating factors -- including hot conditions, sweating and stress -- might also reduce the frequency of acne-related itchiness. Oral antihistamines were reported to be effective by some study participants in both the "Acta Dermato-Venereologica" and "Journal of the European Academy of Dermatology and Venereology" studies. However, confirmatory research studies have not yet been conducted to determine the effectiveness of antihistamines for acne-related itchiness. Working with your doctor to be sure your skin does not become excessively dry -- which can lead to itchiness -- is also important.
You can try home treatments, such as rinsing your face in cold water and avoiding aggravating factors, if you experience relatively infrequent and nondisruptive acne-related itchiness. But if the symptom is more frequent or severe, or interferes with your everyday life, see your doctor. She can examine your skin and review your current skincare and acne treatment regimens to determine whether changes might help relieve your itchiness. Your doctor can also make recommendations regarding medications that might help relieve your discomfort.
Reviewed and revised by: Tina M. St. John, M.D.