Why Do My Ankles Itch & How Can I Treat Them?

Itchy skin, also called pruritus, usually occurs when the skin comes into contact with an irritant or an allergen. Most pruritus is harmless and goes away on its own. Sometimes, though, itchy skin, including itchy ankles, can be a sign of an underlying issue.

This article will provide an overview of the possible causes of itchy ankles, when to seek medical care, and how itchy ankles are treated.

Causes of Itchy Ankles

Conditions that can cause itchy ankles range from allergies to psoriasis to autoimmune conditions (when the immune system overreacts). Itchy ankles can also be the result of bacterial or viral infections.

When the skin reacts to an irritant or allergen, the immune system releases chemicals like histamine, causing itching, inflammation, and other symptoms.

Skin reactions like contact dermatitis, hives, allergic reactions, and psoriasis are all manifestations of the immune system responding to threats.

Contact Dermatitis

Contact dermatitis occurs when the immune system reacts to a substance with itching and redness. Contact dermatitis can happen because of an irritant, like a chemical or rubber gloves, or because of allergens like:

• Dyes and perfumes
• Poison ivy, oak, or sumac
• Fabrics
• Rubber
• Topical antibiotics
• Metals

If your ankles are itchy, it might be helpful to determine if a new sock, shoe, or lotion is to blame. To confirm an allergy, see your healthcare provider for testing.

Hives

Hives are red or pink bumps usually caused by allergens, irritants, or emotional stress. Some hives can occur because of heat or cold, water, sweat, and reactions to medications. Sometimes, hives can be itchy and swell as part of a condition called angioedema.

If your itchy ankle is red, bumpy, and swollen, hives might be the cause. Hives normally go away on their own. If they spread rapidly to the rest of the body, seek emergency care.

Allergies

Allergies can also cause skin reactions, whether they occur after physical contact with an allergen, an insect bite, or ingesting food or medications.

An allergic reaction could cause itchy ankles, along with redness and rash. Some allergic reactions appear as flakiness or scales, which can indicate the need to test for skin conditions like psoriasis or eczema.

Sunburn

If itchy ankles are accompanied by symptoms like warmth, pain, and redness, sunburn might be the cause. Sunburn can appear several hours after sun exposure. In extreme cases, a sunburned ankle might also blister, and it's possible to experience nausea, dizziness, and fever.

Liver Problems

Liver diseases can also lead to itchy skin and possibly itchy ankles. This itch is caused by bile in the bloodstream.

Bile is a liquid produced by the liver that helps with digestion. Bile is usually transported to and stored in the gallbladder, a sac under the liver. When the liver isn't functioning properly, bile can be left in the bloodstream. A 2021 study found that the outer layer of skin cells signal the brain about chemicals in the bloodstream, explaining why bile in the bloodstream may induce itching.

Itching caused by liver issues is most likely with autoimmune diseases like primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC), hepatitis C, and drug-induced liver disease. It is not as common in alcohol-induced liver disease and fatty liver disease.

Diabetes

Diabetes occurs when too much sugar (glucose) remains in the blood instead of being transported to organs and tissues for use. If your ankle is itchy and your skin is chronically dry, see about getting tested for diabetes.

Psoriasis

Psoriasis occurs when the immune system overreacts and produces skin cells too quickly. This results in scaly red skin that can burn and itch.

If your itchy ankles are also scaly and red, psoriasis could be a possibility. It's important to get a psoriasis diagnosis as early as possible since it can be a progressive condition. Unchecked psoriasis can lead to other disorders like psoriatic arthritis.

Eczema 

Eczema occurs when the skin reacts to irritants, stress, and allergens. Symptoms include redness, dryness, and itchy skin. Eczema can disappear over time or worsen. Minimizing stress and avoiding chemical irritants and allergens can help with healing eczema.

Cancer

Cancer, cancer treatments, and medicines for cancer symptoms (like antinausea treatments) can all cause itching. This may be a result of skin dryness or a reaction from certain substances released by tumors that cause itching.

Fungal Infections

Fungal infections like ringworm can irritate skin with redness, itchiness, and a rash. The legs and arms are the most common locations for ringworms. If your itchy ankles are caused by a fungal infection, a prescription antifungal cream or antibiotics could be necessary.

Circulation Issues

When blood doesn't circulate effectively, swelling can occur, such as when the legs become swollen after sitting for a long time. At times, this lack of circulation can become chronic, and blood can pool in one place, creating conditions like varicose veins. This leads to an inflammatory response from the body, also known as varicose eczema.

Varicose eczema, which includes dryness and itch, is most likely to occur in the lower body, farthest from the pumping heart.

Parasitic Infections

When the skin is infected by a parasite, like scabies, symptoms like a pimply rash, redness, and itching could occur. Scabies is more likely to occur in someone living or spending time in a crowded environment, like a care facility or school.

Scabies symptoms can take two to six weeks to appear for a first-time infection or one to four days for a second or subsequent infection.

If your itchy ankles are caused by a parasitic infection, get treated as soon as possible. Untreated parasitic infections could affect other organs or cause bacterial infections.

Autoimmune Conditions

Autoimmune conditions like multiple sclerosis, lupus, and human immunodeficiency virus (HIV) and their treatments can all increase the chance of itchy skin. Symptoms can include rashes, eczema, redness, and itch.

When to See a Healthcare Provider

See your healthcare professional if your itchy ankles:

• Do not improve on their own within a few weeks
• Do not respond to creams or antihistamines
• Blister, ooze liquid, or change colors
• Break or get infected by too much scratching
• Are accompanied by fever
• Spread beyond the ankles

How to Treat Itchy Ankles

Treating itchy ankles depends on the underlying cause. For most people, treatment might include:

• Cold compresses on the affected area
• Anti-itch cream
• Antihistamines
• Taking lukewarm instead of hot baths
• Oatmeal baths
• Wearing loose clothing or avoiding irritating fabrics
• Using fragrance-free lotions and bath products
• Avoiding heat
• Keeping the area dry
• Keeping the area free from allergens

Other ways to treat itchy skin could include:

• Antibiotic creams or medications for an infection
• Testing for and treating underlying issues or chronic disease
• Adjusting medications with help from a healthcare professional

Summary

Having itchy ankles is usually a harmless issue that heals on its own. Causes of itchy ankles can include reactions to irritants (like fabric, rubber, or chemicals) or allergens (like pollen, poison ivy, or metals), skin conditions like eczema and psoriasis, fungal infections, and immune system issues.

If itchy ankles show signs of infection, don't respond to at-home treatments like creams or antihistamines, or spread to other parts of the body, see your healthcare provider.

Treatment for itchy ankles can include antihistamines, anti-itch lotions, keeping the area dry, moisturizing, taking oatmeal baths, and avoiding perfumes and other chemicals. Testing for or treating an underlying health issue might also be necessary in the case of chronic, long-lasting itch.

A Word From Verywell

Having itchy ankles can be frustrating, but it's usually nothing to worry about for most people. Keeping the area dry and free from allergens and irritating fabrics should help your itch heal on its own. However, if itchy ankles don't go away on their own or don't respond to treatment, it's best to see a healthcare professional. Getting treated can be key to not only relieving itch but improving your health overall.