6 Reasons Why You Might Itch After Taking a Shower

Itching after a hot bath or shower is not uncommon. It typically occurs during the winter months and only lasts a few minutes. However, itching after a shower can be chronic, severe, and even debilitating for some people. 

Several conditions can cause itching after a shower. Most are harmless, but some can be serious. Skin that is red, chapped, or irritated after showering should looked at by your healthcare provider. 

This article discusses common and uncommon causes of itching after a shower. It also explores different medications and home remedies to help to relieve the itch.

African American woman wash face in modern bathroom - stock photo

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Winter Itch

Xerosis, better known as winter itch, is common in cold, dry climates. It can affect people of any age, but older adults are particularly at risk. 

Symptoms of xerosis include skin that is: 

  • Dry
  • Itchy
  • Flaky
  • Red

Xerosis can also cause painful skin cracks on the hands and feet.

What Causes Xerosis?

Xerosis is caused by environmental conditions that decrease the amount of sebum in the skin. Sebum is an oily, waxy substance produced by the skin’s sebaceous glands. It forms a protective barrier that helps keep skin moisturized.

In the winter, dry, heated indoor air can strip the skin of sebum. Long, hot showers or baths compound the problem. Exposure to sun and wind can worsen it as well. Topical acne medications can also cause xerosis.

Though xerosis typically only occurs in winter, it can become chronic. This is known as asteatotic eczema.

Treating Winter Itch

Winter itch can typically be managed with home remedies. These steps can help:

  • Take short showers in warm water
  • Wash gently with a soft cloth
  • Use a soap that contains no perfume
  • Gently pat yourself dry and immediately apply an unscented moisturizer
  • Remember to wear sunscreen, even on cloudy days
  • Humidify the air in your home, if necessary
  • Reapply moisturizer often (especially right after bathing or showering)
  • Try a corticosteroid cream, calamine lotion, or creams with menthol 

Recap

Winter itch, or xerosis, is a common cause of itching after a shower. It is caused by dry, winter air stripping the skin of sebum. Long hot showers can further dry out the skin.

The itch of xerosis is often relieved by applying moisturizer. Taking shorter showers in warm, not hot, water can also help.

Polycythemia Vera

Polycythemia vera (PV) is a chronic bone marrow disease. It causes an overproduction of red blood cells. As a result, people with PV have thicker blood and are at increased risk for blood clots.

Symptoms of PV include:

  • Headaches
  • Excessive sweating
  • Dizziness
  • Visual changes
  • Bleeding
  • Shortness of breath
  • Enlarged liver and spleen
  • A “ruddy” complexion (redness of the face)
  • Itching, especially after hot showers or baths

PV can be diagnosed with a simple blood test called the hematocrit. This test measures the proportion of red blood cells in a volume of blood.

Treatment

PV cannot be cured, but its symptoms can usually be managed. Treatment focuses on lowering the risk of blood clots. This may include having blood drawn from a vein periodically and taking low-dose aspirin.

Prescription medications can reduce the number of red blood cells. These include:

  • Busulfan
  • Chlorambucil
  • Hydroxyurea
  • Interferon alpha
  • Ruxolitinib

In some cases, a bone marrow transplant may be needed. 

PV and Itching

Mild itching associated with PV can be managed by avoiding triggers. Common triggers are long hot showers and hot environments.

More severe itching or itching that does not respond to home remedies can be treated with medications. These include antihistamines, such as diphenhydramine, which are available over the counter.

Light therapy can be used for people with more severe or persistent itching. Also known as phototherapy, the treatment is used in combination with the medication psoralen.

Recap

A chronic bone marrow disease, polycythemia vera (PV) can cause itching after a shower. PV causes an overproduction of red blood cells, which increases the risk of blood clots. 

PV is managed with prescription medication to reduce red blood cell counts. The itching can be relieved by using a moisturizer after a shower. Over-the-counter antihistamines can help as well.

Hodgkin Lymphoma

Hodgkin lymphoma is a cancer of the lymph nodes. It causes enlarged lymph nodes in the neck, armpits, groin, or within the chest. It can also cause entire body symptoms, including weight loss, fever, night sweats, and itching.

Itching, often intense, is a prominent symptom of Hodgkin lymphoma. Alcohol and showering can trigger itching episodes. Medications used to treat the disease can also cause itching.

Other symptoms of Hodgkin lymphoma include:

  • Cough
  • Drenching night sweats
  • Fever
  • Persistent fatigue
  • Shortness of breath
  • Unexplained weight loss

Hodgkin lymphoma is screened for using X-rays to look for enlarged lymph nodes. A biopsy of an enlarged lymph node can also be used.

Hodgkin lymphoma is treated with a combination of chemotherapy, radiation, and stem cells. Clinical trials are also underway to test new therapies and approaches to stem cell transplantation.

Hodgkin Lymphoma and Itching

Home remedies can soothe the itching associated with Hodgkin lymphoma. The American Cancer Society recommends the following:

  • Add baking soda, oatmeal (enclosed in a cloth or mesh bag), or bath oil to your bathwater.
  • Use baking powder in place of deodorant.
  • Avoid products (e.g., powders, after-shaves) that are scented or alcohol-based
  • Wear clothes that fit loosely and are made of fabric that doesn't irritate your skin
  • Be sure to drink plenty of water and get enough rest.

Recap

Hodgkin lymphoma is a cancer of the lymph nodes. Itching is among its many symptoms. Taking a shower can trigger whole-body itching from Hodgkin lymphoma. Home remedies and keeping hydrated can help to relieve the itch.

Cholinergic Urticaria

This photo contains content that some people may find graphic or disturbing.

Urticaria
 DermNet / CC BY-NC-ND

Cholinergic urticaria is a form of hives that is caused by an increase in body temperature.

This can be due to hot showers, exercise, spicy foods, or too many blankets in bed at night.

Strong emotions may also cause hives to occur in people with cholinergic urticaria.

The hives in cholinergic urticaria are pinpoint-sized—smaller than a mosquito bite. The hives may group together, or coalesce, into larger hives.

Cholinergic urticaria can sometimes be associated with more severe symptoms. This includes asthma symptoms and low blood pressure.

Treating Cholinergic Urticaria

Cholinergic urticaria, like most other forms of urticaria, can often be treated easily with oral antihistamines.

Non-sedating second-generation antihistamines used to treat cholinergic urticaria include:

Corticosteroids, such as prednisone, may also be prescribed for short-term use.

Recap

Another possible cause of post-shower itching is cholinergic urticaria. This is a type of hives that are brought on by an increase in body temperature. 

Cholinergic urticaria is commonly treated with over-the-counter antihistamines, such as Allegra and Claritin. 

Aquagenic Urticaria

Aquagenic urticaria (AU) is a very rare form of hives. It’s caused by water coming into contact with the skin.

People with AU experience hives within a few minutes of water touching their skin. This occurs regardless of the water temperature.

What Causes Aquagenic Urticaria?

The cause of aquagenic urticaria is unknown. Some early researchers hypothesized that water reacts with sebum in the skin to form a substance that triggers an allergic reaction.

AU is diagnosed by placing a drop of room temperature water onto the skin. If a hive forms within a few minutes, the diagnosis is confirmed.

Treating Aquagenic Urticaria

Like most other forms of urticaria, AU can often be treated easily with non-sedating oral antihistamines. Other treatment options may include:

  • Creams or other ointments that help “waterproof” the skin, such as petrolatum-based products and baby oil
  • Ultraviolet light therapy (phototherapy)
  • Omalizumab, a drug usually used for severe asthma

Recap

Aquagenic urticaria is a rare type of hives caused by touching water. Its exact cause is unknown. It appears to be an allergic reaction to a protein in the skin that is dissolved by water. 

Aquagenic urticaria is treated with OTC antihistamines, moisturizers, and UV light therapy. 

Idiopathic Aquagenic Pruritus

Idiopathic aquagenic pruritus (IAP) is a rare condition. It causes itching without a rash after a person’s skin comes into contact with water.

IAP is likely caused by activation of the nervous system. Various chemicals are released by nerves located within the skin after contact with water.

Treating IAP

No one treatment has been shown to be most effective for aquagenic pruritus. Treatments for aquagenic urticaria may be helpful. Other possible treatments include:

For many people with IAP, it takes some trial and error to find the right treatment.

Recap

A rare condition, IAP causes itching when water touches the skin. Unlike aquagenic urticaria, IAP does not cause a rash. Treatments include oral antihistamines, topical corticosteroids, and electrical nerve stimulation.  

Summary

Itching after a shower or bath is a common phenomenon. It is usually caused by dry skin and is treated with moisturizer. Several conditions can cause itching after exposure to hot water.

If your skin is red, chapped, and irritated after showering, try lowering the water temperature, avoiding scented soaps and detergents, and moisturizing once or twice a day.

More severe itching or itching that persists despite home remedies can be a sign of a more serious condition.

If you experience unexplained itching after a shower, see a healthcare provider for a complete evaluation. Some conditions that cause itching can be dangerous and even life-threatening.

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10 Sources
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