Itchy skin and tiredness are common symptoms that can be caused by a variety of underlying conditions. In this article, we will explore some of the most common causes of itchy skin and fatigue and provide an overview of treatment options.
Allergies
Allergic reactions are a common cause of itchy skin (pruritus). When you come into contact with an allergen such as pollen, pet dander, or a food you are allergic to, your immune system overreacts and releases histamine. This causes inflammation and itching.
Common allergy symptoms include:
- Itchy, red, and sometimes scaly skin
- Hives or skin welts
- Itchy eyes, nose, or throat
- Sneezing and coughing
Allergies may also contribute to fatigue by disrupting sleep and just generally making you feel unwell.
Treatment for allergies
Allergy treatment focuses on avoiding triggers and using medications to reduce symptoms, such as:
- Oral antihistamines like loratadine (Claritin) or diphenhydramine (Benadryl) to relieve itching
- Nasal corticosteroid sprays for allergy symptoms affecting the nose
- Immunotherapy or “allergy shots” to help desensitize you to allergens
Skin Conditions
Many common skin conditions like eczema, psoriasis, hives, and dermatitis can cause itchy skin. These conditions cause inflammation, irritation, and discomfort. Constant itching can certainly lead to increased fatigue as well.
Atopic Dermatitis (Eczema)
Eczema is an inflammatory condition that makes skin become itchy, red, dry and cracked. The itchiness of eczema is often worst at night, which can interfere with sleep and cause daytime tiredness.
Psoriasis
Psoriasis speeds up the growth cycle of skin cells, causing a buildup of cells that manifests as thick, scaly patches. These areas are often itchy and painful. The itch-scratch cycle can prevent good sleep.
Hives
Hives (urticaria) are very itchy, raised welts that can appear on the skin. They often come and go. Severe hives can be extremely uncomfortable and make it difficult to sleep.
Dermatitis
Dermatitis refers to skin inflammation, which often includes itchy, dry skin. There are different types of dermatitis with different causes, but all can disrupt sleep.
Treatment for skin conditions
Treatment focuses on healing the skin barrier, reducing inflammation, and relieving itching. Medications may include:
- Corticosteroid creams and ointments
- Oral antihistamines
- Oral immunosuppressants for severe cases
- Light therapy
- Moisturizers and bath oils to hydrate the skin
Kidney Disease
Itchy skin and fatigue can both be signs of an underlying kidney problem. When the kidneys are not working properly, waste builds up in the bloodstream. This causes severe itching without a rash.
Kidney disease itching is often worst at night. The buildup of toxins can also make you feel generally unwell and fatigued.
Treatment for kidney disease
Treatment focuses on the underlying kidney condition. For end stage kidney failure, dialysis is needed to filter the blood. Medications, diet changes, and hydration can help reduce waste buildup and relieve itching.
Liver Disease
Liver conditions like hepatitis and cirrhosis can cause itching without a rash. When the liver is damaged, it is unable to process bilirubin normally. This causes bile and bilirubin to build up in the blood and tissues.
Pruritus due to liver disease tends to be most severe on the palms, soles of feet, and in areas with thicker skin. Fatigue is also common as the liver loses its ability to regulate energy.
Treatment for liver disease
Treatment focuses on managing the underlying liver condition. Medications that help remove bilirubin from the blood can relieve itching. In severe liver failure, a liver transplant may be necessary.
Thyroid Problems
Both hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) can cause skin itching. When thyroid hormone levels are too high or too low, it disrupts the normal turnover of skin cells.
Hypothyroidism often causes fatigue, lethargy, and an overall feeling of tiredness. Meanwhile, hyperthyroidism can cause anxiety, insomnia, and restlessness which also lead to exhaustion.
Treatment for thyroid problems
Treatment involves getting the thyroid hormone levels back into the normal range, which relieves symptoms. Medications that regulate thyroid hormone production include:
- Levothyroxine for hypothyroidism
- Methimazole for hyperthyroidism
Diabetes
Itching is a common symptom of diabetes. When blood glucose levels are high, it causes dryness and damage to nerve fibers in the skin. This type of itching is called diabetic dermopathy.
Diabetes can also cause chronic fatigue, as cells are unable to access glucose for energy properly. Fatigue tends to set in after meals when blood sugar is at its peak.
Treatment for diabetes
Keeping blood sugar levels controlled is key. This is achieved through medications (insulin injections or oral medications), diet, exercise, and blood sugar monitoring. Good diabetic management helps resolve the itching and fatigue.
Iron Deficiency Anemia
A lack of iron in the bloodstream can cause iron deficiency anemia. This reduces the blood’s ability to carry oxygen throughout the body, leading to exhaustion, weakness, and fatigue.
In some cases, iron deficiency also causes itchy skin. Researchers believe this is related to iron’s role in proper immune system functioning and skin cell metabolism.
Treatment for iron deficiency anemia
Treatment involves iron supplementation, either through diet changes or direct iron tablet supplementation. Raising iron levels resolves fatigue and itching.
Cancer and Chemotherapy
Itching is a common side effect of some cancers like leukemia, lymphoma, and multiple myeloma. Cancer treatments like chemotherapy and radiation therapy can also cause severe itchy skin.
Cancer-related fatigue is thought to be caused by multiple factors like anemia, hormone changes, side effects of medications, poor nutrition, and more.
Treatment for cancer itching and fatigue
Anti-itch creams, medications, and light therapy may help provide some relief. Low dose sedating antihistamines are often used at night. Managing side effects and maintaining nutrition and activity can improve fatigue.
Autoimmune Diseases
Autoimmune diseases like lupus, rheumatoid arthritis, and multiple sclerosis where the immune system attacks the body’s own tissues can cause widespread inflammation and skin changes leading to itching.
These diseases also commonly produce feelings of chronic fatigue. Researchers believe this fatigue is likely due to chronic widespread inflammation putting stress on the body.
Treatment for autoimmune issues
Treatment focuses on managing the underlying disease through medications to suppress the overactive immune response. Steroid creams, anti-itch medications, pain medications, and lifestyle changes help control symptoms.
Anemia
Anemia refers to having a below normal number of red blood cells or hemoglobin. This reduces oxygen delivery throughout the body, resulting in fatigue, weakness, and tiredness.
While not a direct symptom of anemia, some research indicates that low hemoglobin levels negatively impact skin barrier function, leading to increased dryness and itching.
Treatment for anemia
Treatment depends on the cause but may include iron supplementation, medications to stimulate red blood cell production, or treatment of underlying conditions contributing to anemia.
Lyme Disease
Lyme disease is caused by a bacterial infection transmitted through tick bites. It causes a characteristic “bulls-eye” circular rash at the site of the bite. However, lyme disease can progress to cause fatigue, joint pain, and peripheral neuropathy.
Late stage lyme disease often includes intense itching and crawling/burning skin sensations. Fatigue from lyme disease is thought to be related to immune system activation and inflammation.
Treatment for Lyme disease
Antibiotics like doxycycline and amoxicillin are used to treat Lyme disease. These help resolve the infection and associated skin irritation and fatigue symptoms.
Medications
Certain medications can list itching and fatigue as potential side effects. Examples include:
- Opiate pain medications
- Blood pressure medications
- Antidepressants
- Antibiotics
- Anti-seizure drugs
- Heart medications
- Chemotherapy
If symptoms arise after starting a new medication, talk to your doctor about potential side effects and alternatives.
Stress and Anxiety
While not a direct cause of itching, stress and anxiety can worsen symptoms of skin conditions. Itching can also increase feelings of stress and anxiety, creating a vicious cycle.
Anxiety and chronic stress take a toll on the body, leaving you mentally and physically drained. This constant state of high alert leads to fatigue build up.
Treatment for stress and anxiety
Counseling, medications, meditation, sufficient sleep, exercise, and social support help keep stress and anxiety in check. Anti-itch creams can help break the cycle of itching and worry.
Diagnosing the Cause
As you can see, many conditions can cause fatigue and itchy skin. To determine the underlying cause, your doctor will likely:
- Ask about your medical history
- Conduct a physical exam
- Order blood tests (complete blood count, metabolic panel, thyroid tests)
- Consider skin biopsies or allergy testing if needed
Keeping track of any other associated symptoms and being able to describe the fatigue and itching in detail helps your doctor narrow down the list of possibilities.
When to See a Doctor
Make an appointment with your healthcare provider if:
- Itching is severe, widespread, or persists beyond a few days
- Fatigue is making it difficult to function normally
- You have additional symptoms like weight changes or fever
- Skin changes like a rash, hives, or swelling develop
- There is no obvious cause like seasonal allergies
While mild itching and temporary fatigue are common annoyances, pronounced symptoms may signal an underlying health issue needing evaluation.
Treatment Overview
Treatment focuses on identifying and addressing the root cause of itching and fatigue. Some general treatment approaches include:
- Avoiding triggers like allergens, irritants, stress, and anxiety
- Topical steroid creams, antihistamines, immunosuppressants
- Oral medications tailored to the condition
- Light therapy for some skin diseases
- Treating underlying health conditions
- Staying hydrated and moisturizing skin
- Getting adequate sleep
Lifestyle measures like diet, exercise, and stress management also help improve symptoms. Severe, debilitating itch and fatigue may require specialized treatment plans.
Coping with Itch and Fatigue
Dealing with constant itchiness and exhaustion can impact your quality of life. Along with medical treatment, tips for coping include:
- Moisturize skin after bathing while still damp
- Apply cool compresses to itchy areas
- Keep nails trimmed to minimize damage from scratching
- Wear comfortable, smooth fabrics like cotton
- Avoid getting overheated or sweating
- Take antihistamines as needed for relief from itching
- Use calamine lotion on irritated areas
- Try relaxation techniques, massage, and meditation
- Take breaks to rest when tired
- Engage in gentle exercise like walking, swimming, or yoga
- Don’t push yourself beyond your limits
Joining a support group can also help you cope and share advice. Talk to your doctor if itching and fatigue are impacting your ability to work, socialize, or complete daily tasks.
When to Seek Emergency Treatment
Seek prompt medical attention if you experience:
- Widespread itching with no rash that comes on suddenly
- Swelling of the lips, face or throat
- Difficulty breathing
- Chest pain
- Sudden dizziness, weakness or fatigue
- New rash with fever and blisters
These can signal a potentially life-threatening allergic reaction or other medical emergency requiring immediate treatment.
Conclusion
Both itchy skin and persistent tiredness are frustrating and often mystifying symptoms. But they usually indicate an underlying medical condition that needs evaluation. Common causes include allergies, thyroid disorders, kidney/liver disease, skin conditions, cancers, autoimmune disease, and side effects of medications.
Diagnostic tests along with tracking your symptoms helps pinpoint the root cause so appropriate treatment can be initiated. While mild itch and fatigue occur at times when you are unwell, significant or debilitating symptoms warrant medical assessment for management and relief.