Itchy Legs: Causes and Treatment

Itchy legs can be caused by dry skin, but it may also be a sign of more serious conditions such as poor circulation, nerve damage, and diabetes.

It's important to avoid scratching your itchy legs, as this may cause further damage to the skin and can make the area feel even more sensitive. Itchy skin (pruritus) on the legs may be treated with home remedies, over-the-counter (OTC) products, or prescription medications depending on the underlying cause.

Causes of Itchy Legs

The causes of itchy legs can be divided into four categories:

• Neurogenic: This type of itch involves the nervous system, which is the body’s communication pathway.
• Psychogenic: This feeling of itchiness is caused by a psychological disorder.
• Neuropathic: Nerve damage in the body causes this itch.
• Pruriceptive: Itchiness is generated in the skin itself. For instance, the skin may become itchy and irritated in reaction to an insect bite. 

The following causes of itchy legs fall into one of these four categories. 

Dry Skin

Dry skin is the most common cause of itchy skin. Known medically as xerosis, dry skin belongs to the pruriceptive category of itching.

Dry skin occurs when the skin lacks moisture and becomes dehydrated. It can occur for many reasons, including:

• Middle age and older: With age, our skin produces less sebum, an oil that keeps skin soft and moist.
• Climate: When outdoor temperatures fall, the air holds less moisture.
• Exposure to dehydrating chemicals (such as chlorinated water)
• Taking long, hot showers

Signs of dry skin include:

• Cracks in the skin, which may hurt or bleed
• Stinging or burning
• Flake or scales on the skin 
• Itching 
• Wrinkled skin with a rough, loose texture

Dry skin is sometimes an indication of dermatitis, a type of inflammation of the skin that may indicate another skin condition. Dermatitis often also causes a rash or discolored (a change in skin tone), irritated skin. 

Allergic Reactions

Certain allergens can lead to extremely itchy legs. The most common allergen that people come into contact with is nickel, but other irritating substances found in hygiene products, nail polish, and latex are also common. When an allergic reaction occurs, the skin will feel intensely itchy, and a rash will develop.

Diabetes

Diabetes is associated with several skin issues that can cause itching, such as:  

• Necrobiosis lipodica diabeticorum (NLD): causes reddish-brown areas on the skin
• Granuloma annulare (GA): causes raised bumps or a rash in a ring pattern
• Scleroderma-like skin changes: causes inflammation and thickening of the skin

People with diabetes often have poor blood circulation. Although itching isn’t a typical symptom of poor circulation, it can be.

People with diabetes are also more likely to have dry skin due to high blood sugar levels that, over time, can damage the nerves in the legs. This, in turn, can cause the legs to become itchy.   

Related Health Conditions

Various other types of disease can also cause itchy legs to occur. Some include:

• Skin cancer
• Blood diseases or diseases that affect the blood, such as Hodgkin’s lymphoma or cutaneous T-cell lymphoma
• Kidney disease
• Liver diseases such as hepatitis C or cirrhosis
• HIV
• Hyperthyroidism (overactive thyroid grand) or hypothyroidism (underactive thyroid gland)
• Hand, foot, and mouth disease, a type of viral infection that can cause severe itching on the legs
• Multiple sclerosis
• Stroke
• Restless leg syndrome, which can cause nighttime itchiness

Skin Conditions

Skin conditions are another likely culprit behind the itchy sensation in your legs. There are several types of skin conditions that lead to itch. The symptom itself may be mild or severe and can be accompanied by a rash. Skin conditions that lead to itchy legs include:

• Various types of eczema
• Contact dermatitis, a skin reaction to an irritant
• Chickenpox and shingles, which are both caused by the same virus
• Folliculitis, which develops because of inflammation of hair follicles on the skin
• Hives
• Psoriasis
• Neurodermatitis, a skin condition that causes intense and chronic itchy skin that worsens when it is scratched
• Ringworm, a type of fungal infection that affects the skin and causes a ring-like rash
• Scabies, a skin rash caused by a contagious mite

Medications

Certain medications can cause your legs to become itchy, such as:

• Prescription-strength painkillers like opioids
• Antimalarials, which are designed to treat or prevent malaria
• Hydroxyethyl starch, which is a drug that is used to help prevent shock after a person loses a significant amount of blood
• Some blood pressure drugs
• Aspirin
• Anticancer drugs

Insect Bites

There are many insects that bite and leave behind a feeling of itchiness. For example, mosquito bites typically cause an itchy sensation, but this feeling tends to fade once the bite heals.

The itchy feeling can be intense and may become chronic if the culprit is not identified, which can sometimes be the case with bed bugs, mites, or lice. Sometimes the itchiness gets worse during the nighttime hours.

If you suspect that you have been bitten or infected with any of these insects, it's best to seek out immediate treatment to remove the bugs from your skin, scalp, and home.

Nutrient Deficiency

A vitamin or mineral deficiency could result in excessively dry skin on your legs and other parts of the body. Skin needs nutrients to keep it healthy. If you’re not getting enough vitamins A or D or minerals such as niacin, zinc, or iron, you may develop dry skin that leads to itching.

Diagnosis

Your healthcare provider will examine your skin and look for bumps, hives, irritation, rash, or discoloration. They will also ask questions that may provide clues to the cause of itching, such as: 

• Changes to your skincare routine, laundry detergent, or diet
• Duration (how long you’ve had symptoms)
• Frequency (how often your legs itch)
• Other preexisting medical conditions, such as diabetes
• Triggers, such as shaving or spending time outdoors 

If your primary healthcare provider is unable to diagnose the cause of your itchy legs, they may refer you to a dermatologist (a doctor who specializes in skin conditions).

How to Treat Itchy Legs

Treating itchy legs depends highly on the cause. If your itchy legs are caused by dry skin, restoring moisture and hydration can help to relieve the symptom.

Home Remedies

Itchy legs can often be relieved using items you have on hand. Try these common home remedies for itchy legs:

• Apply aloe vera: It has anti-inflammatory properties that can soothe itchy skin.
• Ditch hot showers: Hot water dries out the skin. Use lukewarm or cool water instead.
• Moisturize skin twice daily: Apply lotion to your legs twice daily, preferably after a shower or before bed.
• Take an oatmeal bath: Colloidal oatmeal is an anti-inflammatory. Epsom salts or baking soda baths may also help soothe itchy legs, but may cause irritation if there are areas of open, raw skin.
• Try a cold compress: Apply ice for 10 to 20 minutes, using a towel or other cloth between your legs and the ice pack to prevent ice burns. 

Over-the-Counter Treatments

If at-home treatments and moisturizers fail to bring relief for itchy legs, over-the-counter (OTC) treatments may help. These include:

• Benedryl (diphenhydramine), an antihistamine, for night-time itching
• Hydrocortisone cream, a steroid itch-reliever
• Lotions that contain ceramides, a wax-like substance that hydrates skin
• Pramoxine, a topical anesthetic that relieves itching
• Second-generation antihistamines—like Allegra (fexofenadine), Claritin (loratadine), or Zyrtec (cetirizine)—for daytime itchiness
  

Prescription Medications

If home remedies and OTC treatment do not bring relief, you may have a more serious skin condition or underlying health issue.

Treatment may include a topical prescription to help manage and control itching flare-ups. Your healthcare provider will recommend treatment if the itch stems from a systemic (whole-body) condition. 

Prevention

Some causes of itchy legs are preventable. For example, itchy skin caused by an allergic reaction can be prevented by avoiding allergens. Razor burn and ingrown hairs can be prevented by using proper shaving techniques.

Other tips for preventing itchy legs include the following:

• Avoid scented soaps, lotions, and laundry detergents. 
• Check package labels for known allergens, such as nickel in a copper compression brace.
  
• Do not use expired sunscreen, sprays, or lotions.
• Exfoliate your legs before shaving, use a sharp razor, and shave in the direction of hair growth.
• Moisturize your skin after bathing and shaving.
• Use insect repellant and keep your legs covered when spending time outdoors.
• Wear loose clothes and breathable fabrics to prevent chaffing, heat rash, and irritation.

When to See a Healthcare Provider

Many cases of itchy legs can improve significantly with over-the-counter products and at-home remedies. However, there are some cases where you will need to see a healthcare professional:

• Intense itching that does not go away with the use of moisturizers or other at-home treatment methods
• Itchiness that is accompanied by a rash that continues to get worse
• Itching that interferes with your ability to get a good night’s sleep

Any symptoms of another type of disease, along with itchy legs, could be indicative of an underlying health condition. In this case, you should schedule an appointment with your healthcare provider. 

Summary

Since dry or irritated skin is the most common reason for itchy legs, it's typically not a cause for concern. However, underlying medical conditions, such as diabetes and skin conditions, can sometimes be a cause of itchy legs.

You'll likely be able to treat the itch at home using moisturizing agents to help heal dry skin. However, if you are experiencing other symptoms, like a rash or an itch that does not resolve over time, this warrants seeing your healthcare provider.