Itching can drive you a little crazy—messing with your sleep, stealing your concentration, and leaving you wishing you could step out of your skin.
A bit of gentle scratching to tame the uncomfortable sensation is fine. But if you find yourself scratching to the point of distraction or so much that you're damaging your skin—which can allow bacteria in—you may be on the lookout for strategies to stop the itch.
Many people turn to one of the over-the-counter topical anti-itch products on drugstore shelves.
These creams, gels, and lotions can be very effective, says Gil Yosipovitch, MD, professor of dermatology and Stiefel chair of medical dermatology at the University of Miami Miller School of Medicine—provided you choose the right product for your particular itching problem and follow label directions.
Figure Out What's Triggering Your Itch
"Summer brings out poison ivy and other itch-inducing plants, lots of bugs, and, of course, sunburn," says Jessica Krant, MD, MPH, assistant clinical professor of dermatology at SUNY Downstate Medical Center in New York City and a dermatologist in private practice in Manhattan. With these, it's easy to pinpoint the problem.
But other causes of itching may not be so obvious. Fungal infections and contact allergies (the usually short-lived rashy reactions some people have from substances such as cosmetics or certain fabrics or metals) are common in warmer weather. And though dry skin is a far more frequent problem in the winter months, it can crop up now as well.
If you're unsure why you're itching or you're extremely uncomfortable—unable to sleep through the night because of the need to scratch, for instance—check in with your doctor.
"Itching is one of the most common complaints in visits to a dermatologist, but itching is caused by so many different things it's hard to have one set protocol or method for addressing it," Krant says. "A careful history and physical exam by the dermatologist can go a long way in identifying the true cause and fixing it as fast as possible."
Try a Couple of Simple Steps First
It's fine to try an OTC itch reliever right away for bug bites and rashes. For other problems, keeping itchy skin cool could ease the urge to scratch a little, Yosipovitch says. Turn on a fan or air conditioning in hot weather or sleep with your itchy body part outside the covers at night, for instance. "Sometimes ice water compresses can help soothe itchy skin, and sometimes cold plain yogurt or cold cow's milk compresses can relieve mild itch without needing any over-the-counter or prescription medications," Krant says.
And no matter what's behind the itch, using a gentle, fragrance-free moisturizer (look for lanolin, or glycerin, petrolatum, or a combination of these on the label) two to three times a day could help.
If it's simple dryness causing your itch, use soaps and body washes that are mild, unscented, and free of alcohol. Because soap and water can wash away protective skin-surface oils, keep baths and showers short, and use tepid water. Moisturize afterward, while skin is still slightly damp. Skip long, hot showers and large amounts of soap. Both can dry your skin, leading to itching, Krant says.
"If gentle skin care and plenty of moisturizer are not helping your itch, it may be time to try an OTC anti-itch product," Krant says.
Pick the Right Product
Here, the active ingredients you're likely to see on labels and how to choose wisely.
Hydrocortisone: The 1 percent strength of this steroid cream, which eases itch by reducing inflammation, is in a slew of OTC itch products, such as Aveeno 1% Hydrocortisone Anti-Itch Cream, Cortizone 10 Maximum Strength Ointment, and generics.
"If clearing up dry skin doesn't reduce the need to scratch in a few days, hydrocortisone is a good choice," says Ethan Lerner, MD, PhD, and associate professor of dermatology at Harvard Medical School, whose lab at Massachusetts General Hospital studies skin itching. "It's also good for itchy rashes—such as skin reactions due to nickel in jewelry, buckles and snaps on clothing, and to irritants in laundry products." Drugstore hydrocortisone can help to soothe anal itching and discomfort from psoriasis and eczema as well.
Skip hydrocortisone for itching around your toes or in your vaginal area or groin, which might be caused by a fungal infection. "Corticosteroids can actually make these infections worse by reducing immunity, so the fungus can thrive," Lerner says. "Choose an antifungal product designed for your itching problem instead."
Calamine: Old-fashioned calamine lotion, found in products such as Caladryl Skin Protectant Lotion and generics, is less ubiquitous than hydrocortisone. But this mixture of zinc oxide and ferric oxide is very effective for relieving itch and drying out blistery rashes such as poison ivy, oak, and sumac, Lerner says. It can also help with insect bites and stings.
Diphenhydramine: Itch creams, gels, and sprays containing this antihistamine, such as Benadryl Extra Strength Itch Stopping Cream and generics, work by blocking the itchy effects of histamine, a compound produced in the skin during an allergic reaction.
Topical diphenhydramine is sometimes recommended for short-term relief from itches related to bug bite or hives, but both Lerner and Yosipovitch caution that it can irritate skin and that some people are allergic to it.
"An OTC hydrocortisone cream will work just as well for bug bites and contact allergies," Lerner says. If you use a diphenhydramine skin product, don't do so for more than seven days. And don't use other diphenhydramine products, including pills, while using a skin product containing this anti-itch ingredient.
Diphenhydramine is not a good choice for chronic itching, such as that caused by psoriasis, eczema, shingles, nerve damage (neuropathy), or other medical conditions. "Diphenhydramine is not a good choice for chronic itch," Yosipovitch says. "It turns out that histamine is not an important factor in long-term skin-itching problems the way it can be in short-term cases."
Pramoxine: This mild anesthetic is often added to anti-itch products that also contain hydrocortisone or other active ingredients, such as Aveeno Anti-Itch Concentrated Lotion (which also contains calamine), CeraVe Itch Relief Moisturizing Lotion, Gold Bond Medicated Anti-Itch Lotion (which also contains menthol), and generics. It's often found in products for anal itching, as well as in general-use anti-itch creams. "It's effective for relieving pain and itching; you may find it in products for insect bites, poison ivy, oak, or sumac, and for hemorrhoids," Yosipovitch says.
Menthol: This minty ingredient, found in products such as Eucerin Calming Itch-Relief Treatment and generics, activates nerve fibers that send cool, icy sensations to the brain, distracting you from the itch, Yosipovitch says.
"Menthol can be very effective for itchy skin, but it's not for everybody," he says. "If standing in a cold shower relieves your itch, menthol may work for you. Products with eucalyptus or camphor have similar effects, but I'm more hesitant with these. They may aggravate itching."
Capsaicin: If your itching is caused by neuropathy—nerve damage often related to diabetes—then this chili-pepper ingredient could help, Yosipovitch says. Be patient and be careful, he advises. Follow label directions carefully, and don't use near your eyes, mouth, or genitals—"it can really burn," he says. It may take several days to notice an improvement. You'll find a variety of generics and brand-name products containing 0.025 percent capsaicin on the market, such as Capzasin.
When to See the Doctor
Make an appointment if your discomfort hasn't resolved with home treatments after several days, you need a drugstore itch cream for more than two weeks, you have severe itching and can't pinpoint the cause, or if your skin is red, warm, swollen, or leaking fluid, or if itching is generalized or covers large areas of skin.
"Also, keep in mind that some itchy rashes may contain bacterial or fungal infections, which are not cured by topical steroids, and may in fact be partially masked, confusing the picture," says Krant. "For this reason, anything that does not fully get better in a few days should be seen by a dermatologist for safety."
