“Why does my skin get itchy when I’m stressed?”

Itchy skin when stressed: why your skin feels so itchy when you are experiencing stress or anxiety

Dr Alia Ahmed explains how stress and anxiety can cause your skin to itch, as well as how to combat it (without scratching).

Sweaty palms, pounding heart, churning stomach – these are all common symptoms of stress. For me, though, my stress manifests itself in a different way: maddeningly itchy skin.

It’s something that has happened a lot more during the past few months (thanks a lot, Covid) while working from home. At first, I barely even realise that I’m scratching lightly at the skin on my forearms, scalp, and stomach. 

As the pressure mounts and deadlines loom ever larger, though, I’ll find myself clawing at my skin in a desperate attempt to relieve the itch. Which, naturally, results in ugly red streaks up and down my arms, chest, and torso.

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Considering I don’t have a known skin condition, this has all proven very alarming. Especially as itching, of course, comes with a lot of negative connotations.

For a little while, I worried relentlessly that I might have some sort of skin disorder – or, worse, fleas. (Top tip? Never type the words ‘why is my skin so itchy?’ into Google: the results will give you nightmares!).

Itchy skin when stressed: the stress hormone (cortisol) is known to cause or exacerbate existing skin disease.
Itchy skin when stressed: the stress hormone (cortisol) is known to cause or exacerbate existing skin disease.

When it suddenly dawned upon me that my itching was always triggered by stress, though, my worry gave way to intrigue. And so I reached out to global psychodermatologist Dr Alia Ahmed to learn more.

Why does my skin feel so itchy whenever I get stressed?

“The brain has a stress-activated pathway that causes release of various chemicals and hormones that drive inflammation both in the body and the skin,” explains Ahmed. 

“Feelings of emotional distress, like anxiety, lead to the release of a stress hormone (cortisol), which is known to cause or exacerbate existing skin disease. Itch is one of the outcomes of this process, probably through the stress-mediated effects of disruption of the skin’s natural barrier, lack of production of protective factors in the skin (e.g. lipids) and changes in blood flow to and from the skin.

“Effects on the skin include erythema (redness), dryness and scale, all of these factors can predispose an individual to feel itchy.”

Is it normal for stress to make you feel itchy?

“This is a normal response, but it does not mean that everyone who is stressed will feel itchy,” says Ahmed. 

“As a dermatologist, I hear from my patients with conditions such as eczema and psoriasis that stress can make them feel more itchy than usual. Once the skin is scratched (to relieve the itch) individuals can get into an itch-scratch cycle, which then propagates the feeling of itch and can result in skin-damaging behaviour (e.g. aggressive scratching) and further stress. 

“Both acute and chronic psychological stress are implicated in the perception of itch.”

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What should I do to soothe itching skin?

Ahmed suggests the following methods for relieving itchy skin:

  1. If skin is dry, then apply emollients regularly. Look for ingredients like ceramides, glycerin, hyaluronic acid. Use occlusive formulations (those containing paraffin for example) for very dry skin.
  2. Cool creams in the fridge before applying.
  3. Apply cool gel packs to itchy skin to soothe the feeling of itch and reduce the impulse to scratch.
  4. Menthol-containing creams can reduce the feeling of itch.
  5. Wear loose fitting comfortable clothing.
  6. Use tepid rather than hot water to wash.
  7. Consider a soap substitute to wash rather than soap. If you must use soap to wash hands then apply a moisturiser afterwards
  8. Apply moisturisers to damp skin to lock in moisture and reduce itch in dry skin.
  9. Avoid skin-damaging behaviours like scratching and rubbing – try tapping or gently pinching the skin instead.
  10. Take an antihistamine if the itch is secondary to allergy.
  11. A good way to train your mind not to scratch is to try habit reversal therapy (a four-step programme, which is mainly for those people who suffer from chronic itch).
  12. If stress or anxiety if driving the itch, try breathing exercises or muscle relaxation or any form of meditation that works for you (you may have to experiment!) to control the triggers.
  13. Drink at least two litres of fluid a day to reduce the effects of dehydrating on the skin and body.
  14. Eat a well-balanced diet including protein, carbohydrates, good fats and natural sugars where able. The interaction between the gut, brain and skin should not be forgotten when assessing skin health. The natural balance of the gut can be skewed by lifestyle factors and stress, this in turn can promote inflammation, which is implicated in itch. Take some time to consider if your diet is working well for your body, incorporate some healthy choices and consider a probiotic supplement.
  15. Sleep at least eight hours a night to allow the skin time to repair itself.
  16. Scalps can also itch! Consider a targeted shampoo for issues with dry itchy scalps.

“If none of these work, or there is a dermatological condition that is causing the itch (e.g. eczema, psoriasis, hives), then it is important to have this treated by a qualified healthcare professional,” adds Ahmed. 

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Are there any specific products I can use to ease itching?

If you’re hoping to ease itching skin, then Ahmed recommends adding the following products to your shopping trolley:

  • Dermol 500 lotion, E45 emollient wash cream (soap substitutes).
  • Balneum plus cream (contains lauromacrogols to relieve itch).
  • Dermacool cream (contains menthol).
  • Adex gel (contains niacinamide).
  • Eucerin Calming range (contains colloidal oatmeal and menthol).
  • Head and Shoulders Supreme range (for dry itchy scalps, infused with oils to protect and nourish hair).

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How can I prevent stress itching from happening in the future?

“Sometimes itch can occur for no clear reason at all,” says Ahmed. “If you are prone to some of the triggers of itch, then you should try to minimise them as much as possible.”

To do this, Ahmed suggests the following:

  1. Identify triggers for itch and work on controlling them. Examples of triggers are stress, anxiety, and skin conditions (you will need to see a healthcare professional for treatment).
  2. Treating anxiety is extremely important, optimal results are achieved when both emotional issues and the skin are treated at the same time. Options for treatment of anxiety include psychological interventions (e.g. talking therapies), mood or anxiety managing medications.
  3. Stress management is very important and can be addressed in several ways. Everyone is different and not all therapies will be suitable for all. The key is to find a stress management strategy that suits you and practice that regularly (e.g. meditation, mindfulness, exercise, talking to someone close to you). Ways to facilitate this have become easier, and there are even apps that can be used (e.g. Headspace), as well as online habit reversal and self-help websites. If you are not sure which approach is right for you, speak to a healthcare professional.

You can learn more from Dr Alia Ahmed via her website.

If working from home is taking its toll on your mental health, you’re not alone. From the isolation of being separated from colleagues to the stress of trying to communicate with one another over Zoom, there is a myriad of reasons why you might find this time particularly challenging.

So, what can we do about it? We’ve got a plan.

Our new Work It Out campaign, supported by Mind, aims to give you the tools and resources you need to take care of your mental health while you’re stuck at home. From completing your Work 5 A Day to dealing with issues including anxiety, loneliness, and stress, we’ll be exploring all aspects of WFH wellbeing.

For more information, including how to complete your Work 5 A Day, you can check out our guide to getting started.

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