6 Reasons Why You Itch After Taking a Shower

We’ve all experienced it. After taking a long, hot shower during the cold winter months, your skin gets a little itchy after you dry off and get dressed. For most of us, this symptom is mild, only lasts a few minutes, and is related to dry skin caused by cold, dry air and long, hot showers.

But for some people, itching after taking a shower can be chronic, severe, and even debilitating. There are a number of different conditions that can cause itching after exposure to hot showers or baths. Most are benign, but some can be dangerous.

The underlying cause needs to be addressed before itching can be effectively managed. If your skin is red, chapped, and irritated after showering, there are a number of home remedies, described below, that can help soothe the irritation. These can be as simple as lowering the temperature of the water you bathe in, and treating your skin gently with unscented soap and patting dry.

More severe itching or itching that persists despite home remedies can sometimes be a symptom of a serious underlying disorder. Be sure to see your doctor.

Any person with unexplained itching, especially after taking a hot shower, should see their doctor for a complete evaluation, given that some conditions causing this symptom can be dangerous and even life-threatening.

Xerosis

Dry skin plagues people of all ages but is particularly common in older people. Dry, irritated, itchy skin characterizes a number of skin diseases that are collectively referred to as eczema.

Xerosis, also known as winter itch, occurs most often during the dry, cold winter months as a result of repeated wetting and drying without the use of moisturizer. Symptoms include dry, itchy, flaky, red skin, with painful cracking on the hands and feet.

Winter itch is very common, and it can affect people of all ages. It is usually caused by environmental conditions that decrease the amount of sebum in skin. Produced by glands in the skin, sebum forms a protective barrier that helps keep the skin moisturized. Long showers and baths, dry heated indoor air, frequent exposure to sun and wind, and sometimes use of topical medicines to the skin (for acne, for example), can strip the skin of sebum, leading to excessive water evaporation. The result is dry, cracked, and itchy skin.

Tips for Treating Winter Itch

In most cases, winter itch can be managed with simple measures that prevent water evaporation. 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
  • Try a corticosteroid cream (you can buy these without a prescription) or calamine lotion or creams with menthol 

Polycythemia Vera

Polycythemia vera (PV) is a disease of the bone marrow in which there is an overproduction of red blood cells. People with PV have “thicker” blood as a result of this disease process and are at increased risk for blood clots that block blood flow through arteries and veins.

In addition to blood clots, symptoms of PV include headaches, excessive sweating, dizziness, visual changes, bleeding, shortness of breath, enlarged liver and spleen, and a “ruddy” complexion (redness of the face). Itching, especially after hot showers or baths, can be a prominent symptom.

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.

PV is a chronic disease. It cannot be cured, but its symptoms can usually be controlled effectively.

Treatment of PV is focused on lowering the risk of blood clots. This may include having blood drawn from a vein periodically and taking low-dose aspirin.

Medications that reduce the number of red blood cells may also be prescribed. Your doctor may prescribe one or a combination of drugs, such as hydroxyurea, interferon alpha, ruxolitinib, busulfan, and chlorambucil. For selected patients, a bone marrow transplant may be an option. 

Mild itching associated with PV can be managed by avoiding things that trigger the symptom, such as long hot showers and hot environments. Several medications can be used for more severe itching or itching that does not respond to home remedies. These include antihistamines, such as diphenhydramine, which can be purchased without a prescription.

Light therapy (also called phototherapy) can be used for people who have more severe or persistent itching. This treatment is used in combination with the medication psoralen.

Hodgkin Lymphoma

Hodgkin lymphoma is a cancer of the lymph nodes. People with this cancer have enlarged lymph nodes in the neck, armpits, groin, or within the chest. In addition to enlarged lymph nodes, Hodgkin lymphoma may cause entire body symptoms including weight loss, fever, night sweats, and itching.

Hodgkin lymphoma can be screened for by performing X-rays to look for enlarged lymph nodes, or performing a biopsy on an enlarged lymph node.

Itching, often intense, is a prominent symptom of Hodgkin lymphoma. Alcohol and showering can trigger itching episodes, as can some medications used to treat the disease itself. Other symptoms include drenching night sweats, unexplained weight loss and fever, and persistent fatigue or cough or shortness of breath.

People with Hodgkin lymphoma are treated with chemotherapy, radiation therapy, and stem cell therapy--or a combination of these. Clinical trials are also underway to test new drugs, new drug combinations, and novel approaches to stem cell transplantation.

To soothe the itching associated with Hodgkin lymphoma (and other cancers), the American Cancer Society recommends these measures, in addition to those discussed above:

  • Add baking soda, oatmeal (enclosed in a cloth or mesh bag), or bath oil to your bath water
  • 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

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. The increase in body temperature may be due to hot showers, exercise, spicy foods, or being under too many covers in bed at night. Strong emotions may also cause hives to occur in people with cholinergic urticaria.

The hives in cholinergic urticaria are classically pinpoint in size, smaller than a mosquito bite. These may group together, or coalesce, into larger hives over time. Occasionally, cholinergic urticaria can be associated with more severe symptoms, including asthma symptoms and low blood pressure.

Cholinergic urticaria, like most other forms of urticaria, can often be treated easily with oral antihistamines. Non-sedating second generation agents such as fexofenadine, desloratadine, and loratadine are a mainstay of treatment. Corticosteroids, such as prednisone, may also be prescribed for short-term use.

Aquagenic Urticaria

Aquagenic urticaria is a very rare form of hives caused by water coming into contact with the skin. Affected people experience hives within a few minutes of exposure of water to skin, regardless of the water temperature.

Why this occurs isn't known, although some researchers think that water allows for a certain protein in the skin to be dissolved in the water, and that dissolved protein is then able to reach deeper layers of the skin where an allergic reaction will occur.

The diagnosis of aquagenic urticaria involves placing a drop of room temperature water onto the skin and observing for the formation of a hive within a few minutes. Aquagenic urticaria, like most other forms of urticaria, 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

Idiopathic Aquagenic Pruritus

Idiopathic aquagenic pruritus (IAP) is a rare condition that 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, with the release of various chemicals by nerves located within the skin after contact with water.

No one treatment has been shown to be most effective for aquagenic pruritus. The following treatments, in addition to those for aquagenic urticaria, have been tried to varying degrees of success. It can be a matter of trial and error before you find a treatment that works best.

  • A corticosteroid, such as triamcinolone
  • Non-sedating antihistamines
  • Topical capsaicin cream
  • Sodium bicarbonate added to bath water
  • Alpha interferon
  • Transcutaneous electrical nerve stimulation
  • B-alanine supplements
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  2. Leukemia & Lymphoma Society. Polycythemia vera.

  3. Ansell SM. Hodgkin Lymphoma: Diagnosis and Treatment. Mayo Clin Proc. 2015;90(11):1574-83. doi:10.1016/j.mayocp.2015.07.005

  4. Leukemia & Lymphoma Society. Hodgkin lymphoma.

  5. American Cancer Society. Itching. Updated February 1, 2021.

  6. Altrichter S, Wosny K, Maurer M. Successful treatment of cholinergic urticaria with methantheliniumbromide. J Dermatol. 2015;42(4):422-4. doi:10.1111/1346-8138.12765

  7. National Institutes of Health. Aquagenic urticaria. Updated January 24, 2019.

  8. National Institutes of Health. Aquagenic pruritus. Updated February 2, 2021.

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