Itchy skin is an inconvenience no matter what time of day. That nagging feeling can make you restless, and itchy legs at night can make it feel impossible to go to sleep.
Here, a dermatologist explains what itchy legs at night means and how to get relief.
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1. You Have Dry Skin
The reason behind your itchy legs at night could be as simple as having dry skin that needs to be moisturized. You may have dry skin on your legs if they are itchy, flaky, rough or scaly, per the Mayo Clinic. This is a common condition that affects all ages, but it can worsen as you get older.
"Skin gets drier with aging, so typically adults — especially senior citizens — will notice more itch, including on the legs at night," says Anna Kirkorian, MD, a dermatologist and chief of dermatology at Children's National Hospital.
What's more: Itching in general can ramp up at night. "Itching is more common at night in general because the chemical signals of itch (cytokines) have a circadian pattern, meaning they are more intense at night," Dr. Kirkorian says. "People are also less distracted by daily events and tasks at night, so they'll be more aware of itch."
You can stop skin irritation before it starts by applying moisturizer to your legs before you go to bed. Try these dermatologist-approved moisturizers:
2. It's Eczema
Eczema is a skin condition that causes itchy, inflamed skin, rashes, blisters and skin infections, per the National Eczema Association. According to Dr. Kirkorian, it's the most common cause of itching skin. And as we noted above, itching in general can be more noticeable at night.
A mild case of eczema typically causes small areas of dry, itchy skin, but in more severe cases, eczema can spread all over the body and cause constant itchiness, according to NHS.
Eczema occurs more often in young children, but it can also appear in young adulthood or after age 50.
Eczema is not a curable condition, but it can be treated to make it less disruptive in your daily life. The American Academy of Dermatology recommends consulting a board-certified dermatologist to create a treatment plan. The dermatologist may suggest over-the-counter eczema creams or ointments to help heal your skin, or prescribe medications if necessary.
3. You've Got Restless Legs Syndrome
Restless legs syndrome (RLS) is a neurological disorder marked by uncomfortable or unpleasant sensations in your legs and an irresistible urge to move them, according to the National Institute of Neurological Disorders and Stroke (NINDS). People with RLS sometimes describe the sensations in their legs as itching, or it may feel like aching, throbbing, pulling, creeping or crawling.
RLS symptoms are typically most intense at night, when you're resting, and they can disrupt sleep, per the NINDS.
The condition can affect anyone, but it's more common with age and people assigned female at birth are more commonly affected.
Moving the legs often relieves symptoms temporarily, per the NINDS. Other home remedies for restless legs syndrome relief include taking a warm bath before bed, getting moderate exercise during the day, doing regular stretching and getting leg massages.
If at-home remedies aren't cutting it, talk to your doctor about medication options for RLS.
4. You Have Hypothyroidism
Hypothyroidism is a condition caused by an underactive thyroid gland that is failing to produce enough necessary hormones, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Some signs of hypothyroidism include:
- Dry, itchy skin
- Weight gain
- Joint pain
- Irregular menstrual cycles
- Slowed heart rate
Underproduction of thyroid hormones can cause seemingly unexplained itching all over body, per Dr. Kirkorian, including on the legs. Skin will likely become dry, itchy and scaly.
Hypothyroidism should be formally diagnosed by a doctor. A blood test can detect if there are problems with your thyroid, per the Mayo Clinic. Your doctor then may prescribe thyroid hormone replacement medication.
In the meantime, find relief for your dry skin by applying an anti-itch cream before going to bed.
5. You Have Liver Disease
Itchiness and liver problems may seem like a weird connection, but itchy legs are a possible symptom of liver disease, according to Baton Rouge General.
Liver disease is a condition that can affect or severely damage the function of your liver. About 1 in 10 Americans have some type of liver disease, per the Cleveland Clinic.
There are several different causes for liver disease, including cancer, a compromised immune system, viral infections and alcohol abuse.
When itching is associated with liver disease, it's usually because of bile salt in the body. Bile salts are produced by the liver to help with digestion, according to the U.S. National Library of Medicine. People with liver disease may have higher levels of bile salt building up under the skin, which can cause itching, per Baton Rouge General.
Liver disease is a serious condition that should be diagnosed by a doctor, per the Cleveland Clinic. An accurate diagnosis can be found through blood tests, a biopsy or imaging tests. If liver disease is found, a doctor will recommend appropriate treatment depending on the type of liver disease and the severity. Treatment can include medication, lifestyle changes or — in severe cases — a liver transplant.
6. You Have Another Underlying Health Condition
Although rare, skin irritation and leg itching that worsens at night can be a sign of several underlying health conditions. According to the Mayo Clinic, other conditions related to itchy skin include:
- Certain cancers
- Nerve disorders
- Anxiety or depression
- Allergic reactions
"Other medical issues can cause a sensation of itching in the absence of a rash, but this is a rare cause of itching skin," Dr. Kirkorian says. "Most of the time, itching skin is either related to the skin being dry or a skin rash like eczema."
If you suspect your itchy legs at night are caused by an underlying condition, see your doctor. They can run tests to reach a diagnosis and work with you to come up with a treatment plan.
How to Prevent Itchy Legs at Night
While having itchy legs at night may have different causes, it typically can be treated and prevented by practicing skin care for dry skin, Dr. Kirkorian says. She suggests using a fragrance-free gentle cleanser and limiting its use to the "stink zones" (armpits, private area, feet) and not using soap all over the body.
Her other tips to stop legs from itching at night include:
- Avoid using loofahs, sponges or washcloths.
- Use warm (not hot) water to bathe.
- Limit showers to less than 10 minutes.
- Immediately after bathing, apply a thick, fragrance-free moisturizer of your choice.
- Try hot and cold therapy: After a warm bath or shower, apply a cold compress to your legs.
When to See a Doctor About Itchy Legs at Night
Itchy legs at night can be aggravating and disrupting to your sleep routine. You can try to relieve your skin with home remedies or incorporate foods that relieve itching into your diet, but if these don't help, consult your doctor.
You should be concerned about itchy legs if the itching is persistent despite implementing dry skin care or if there is a visible rash, Dr. Kirkorian says: "That's when it is time to seek help from a primary care physician or board-certified dermatologist."
- American Academy of Dermatology Association: "Eczema Types: Atopic Dermatitis Diagnosis and Treatment
- National Institute of Diabetes and Digestive and Kidney Diseases: "Hypothyroidism (Underactive Thyroid)"
- Mayo Clinic: "Hypothyroidism (underactive thyroid)"
- U.S. National Library of Medicine: "Bile"
- Baton Rouge General: "Itching: An Unknown but Not Uncommon Sign of Liver Disease"
- Cleveland Clinic: "Liver Disease"
- Mayo Clinic: "Itchy skin (Pruritus)"
- National Institute of Neurological Disorders and Stroke: "Restless Legs Syndrome"
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.