Itchy Legs – Causes and Treatment

The human skin is not just a protective layer but also a highly sensitive sensory instrument which may be afflicted with a number of sensations that can cause discomfort. Itching is one of the more uncomfortable sensations, second only to pain. It can vary in intensity and duration, from a mild itch of a few minutes to the severe itch that can last for weeks.

Why do the legs itch?

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Itching of the legs is a common ailment that may arise without any underlying disease or obvious skin rash and often no cause can be found. It can nevertheless cause great discomfort and even affect a person’s daily functioning or sleep. Itching of the legs must be clearly differentiated from other sensations like leg pain or leg tingling.  Pain may be due to actual injury to the skin and underlying tissue, while tingling may be a sign of neurological conditions.

The itch receptors are intended to serve as a means of warning a person of some irritation on the skin. It usually elicits the scratching action which not only provides some relief from itching but is also intended to remove the surface irritant. However, itching may occur without any irritant triggering these receptors on the surface of the skin.

The various causes of itchy legs are listed below :

Poor Hygiene

Proper hygiene ensures that sweat, sebum (oil) and dead skin cells that have not fallen off as yet, do not collect on the skin surfaces. On the other hand, excessive cleaning can cause the skin to dry and therefore cause itching. It is important to strike a balance to ensure regular bathing with adequate moisturizing.

Keratosis Pilaris (Chicken Skin, “Leg Acne”)

In keratosis pilaris (link : pictures) thickening of the hair follicles result in small, skin-colored, red, or brown bumps (goose bumps, chicken skin, leg acne) on the thighs, arms or other parts of the body. Heat and irritation by clothes can provoke a bout of itching. Bumps in this harmless, genetically predisposed condition can be rubbed off but tend to recur.

Folliculitis

Folliculitis

In staphylococcal folliculitis (link : pictures and treatment), there is an infection of the hair follicles with Staphylococcus aureus (bacteria). It presents as small red bumps sometimes with white centers which resembles acne, and tends to appear on the thighs, upper trunk, face or other body parts. These small bumps are usually itchy or cause a burning pain. Staph folliculitis, even if not treated, usually heals on its own in few days/weeks.

Picture 1. Staphylococcal folliculitis (source: Samuel Freire da Silva, M.D., atlasdermatologico)

 

Jock Itch

Tinea cruris - jock itch

Jock itch is the common term for a fungal infection of the groin region and upper thigh. Jock itch is a red or brown papular rash on the inner thighs, genitals, and buttocks, caused by dermatophytes (tinea fungi), commonly affecting athletes and others who perspire excessively in the groin region. It can be treated with antifungal medication.

Picture 2. Jock itch (Tinea cruris)on the inner thigh (source: Samuel Freire da Silva, M.D., atlasdermatologico)

More pictures of jock itch (<< click and search for “Tinea cruris“)


Leg Itch During Running

1. Leg Itch in Unfit Runners

A person who starts vigorous exercise like running after a prolonged period of inactivity can experience intense itch a short while into the activity. In a fit runner, the small arteries in the muscles usually open rapidly in response to high demand to blood, but in an unfit runner arteries may not open properly leading to a low oxygen state. This may cause irritation of adjacent nerves and therefore the sensation of itching (1). The condition tends to ease after a few days to weeks of activity as the body adapts to the increased demands.

2.Cholinergic Urticaria (Physical Urticaria, Heat Rash)

Cholinergic urticaria (hives) are red, swollen bumps or patches appearing on the skin as an allergic reaction to physical stimuli, like pressure of the clothes, exercise, heat, sunlight, cold, vibration, water, spicy food, or emotional stress. Injection with acetylcholine tends to provide rapid relief of symptoms, hence the term cholinergic.

Cholinergic (physical) urticaria on the legPicture 3. Cholinergic (physical) urticaria on the lower leg (source: Flickr.com)

Some people experience intense leg itch during walking, running, after a hot shower or in a hot environment in general (3). The exact cause is not known, but could be related to an allergy to sweat itself. Sweat triggers the release of histamine causing itchiness in the legs or other parts of the body. It may also present with warm skin and small (up to 2-3 mm) bumps, which usually persist from 30 minutes to 2 hours. Some people may respond with a positive patch test to their own sweat.

Treatment. In severe itching, discontinuing exercise and removing tight clothing around the legs is advisable. A shower with lukewarm water can help to cool down the area and remove irritant sweat. If the itching does not stop, antihistamines like oral hydroxyzine may help with symptomatic relief. Read more about using antihistamines in itchy conditions.

Tendency of the skin to develop an urticaria-like rash, when stroked, is called dermatographism. It is quite common, mainly appears in young adults and often triggered by stress. The condition can last for several months and continuous treatment with non-sedative antihistamines is usually effective.

Additional Pictures of Cholinergic Urticaria

Prevention

  • Do not exercise in hot humid weather.
  • Take a shower before exercise to remove sweat, oil and any trapped dirt/dust.
  • Use a moisturizing cream after bathing to prevent the skin from drying.
  • Wear light, airy sportswear made from cotton.
  • Wash new underwear or sportswear before the first use to prevent reaction to fabric dyes

3. Exercise-Induced Anaphylaxis (EIA)

Anaphylaxis (Gk ana = against, phylaxis = protection) is a severe allergic reaction to certain, very specific allergens (allergy-triggering substances). Rarely, anaphylactic reaction can be triggered by exercise. A person who has ingested specific foods like shellfish or nuts; substances like alcohol; or medication like aspirin, ibuprofen, antibiotics, herbal supplements, diuretics, and started exercising up to 24 hours thereafter, may experience intense leg itch, warmth, fatigue, urticaria (hives) anywhere on the skin, facial swelling, difficulty breathing, nausea, vomiting, dizziness, or fainting within 30 minutes of exercising.

Symptoms can progress to shock or even death but this is rare. Symptoms of EIA do not appear after eating alone or exercising on its own, but only after a combination of eating certain foods followed by exercising. Symptoms also do not appear after hot shower or during stress as may be seen with hives. Exercising in cold weather or during menstruation can also trigger exercise-induced anaphylaxis in some individuals.

Treatment of severe allergic reaction in EIA is by an intramuscular injection of adrenaline (epinephrine) as soon as possible (3).

Prevention of EIA is by determining trigger foods and medication with skin patch tests and avoiding these triggers on the day of and immediately before the scheduled exercise program. An affected person should wear a medic-alert bracelet and never exercise alone.

4. Itchy Pants Syndrome (Pants Paresthesia Syndrome)

Wearing new pants or ones made by synthetic material may irritate the skin and cause contact or allergic dermatitis. Both these conditions cause severe itching. It can be prevented to some extent by using natural textiles like cotton and washing new clothing before first use. Friction of the pants against the skin may also cause itching.

Leg Itch After a Shower

Reasons for leg itch after a shower (usually hot shower) :

  • Frequent use of very hot water and certain soaps like antibacterial and strongly scented soaps, removes the protective oily layer lining the skin thereby making the skin dry and itchy.
  • Cholinergic urticaria (discussed above).
  • Skin diseases like psoriasis or dermatitis.
  • Blood diseases like polycythemia vera (rare).
  • Psychological reasons.

Prevention. First the cause should try to be isolated. Use lukewarm water, avoid strongly scented and antibacterial soaps and use a moisturizing cream immediately after bathing. If the itch eases with these measures then the cause may have been excessively dry skin. In cholinergic urticaria, an antihistamine like Benadryl by mouth taken 30 minutes before shower usually helps. Skin patch tests may be able to identify topical causes like an allergy to specific soaps or shampoos.

Gravitational Eczema (Stasis Eczema, Venous Eczema)

Stasis (gravitational) eczema

In deep vein thrombosis or in varicose veins, blood can not be pumped efficiently from the leg veins back to the heart. This results in blood pooling within the lower limbs.  The lower legs may be red, swollen, itchy, and cracks and scaling may appear.

Picture 4. Stasis (gravitational) eczema on the lower leg. (source: Samuel Freire da Silva atlasdermatologico)

Treatment. Underlying varicose veins or thrombosis has to be treated. Corticosteroid ointments help in severe inflammation.

Prevention:

  • Avoid standing for long periods,
  • Legs should be kept clean and drying prevented with moisturizing creams

Restless Leg Syndrome (RLS)

Restless legs syndrome (RLS) is the strong urge to move the legs because of itching and/or tingling that develops during a rest. The condition may severely affect sleeping. Symptoms partly or completely disappear with moving the legs or a short walk. This disorder is of neurological origin and the exact cause is not known.

There is no definite cure for RLS. Treating underlying disorders is integral in management of RLS. Alcohol and caffeine should be avoided. Medications to treat Parkinson’s disease or analgesics are sometimes effective.

Other Causes of Leg Itch

Leg itch may be a part of generalized itch caused by different disorders, such as xerotic eczema, senile pruritis, atopic dermatitis, contact dermatitis, parasites, infections, obstructive biliary disease, chronic renal failure, malignancy, medications, neurodermatitis, diabetes, peripheral nerve damage, emotional stress or psychological disorders. It is therefore not isolated to the legs.

Related Articles:

References:

About Jan Modric (249 Articles)
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Please note that any information or feedback on this website is not intended to replace a consultation with a health care professional and will not constitute a medical diagnosis. By using this website and the comment service you agree to abide by the comment terms and conditions as outlined on this page

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  • Hi Angela. Standing for long hours could be responsible. The itching may be associated with early stages of blood circulation disorders in the legs. Standing is known to cause these types of conditions. Also take note of swelling, coldness and discoloration of the skin on the legs. These symptoms would further support the possible diagnosis of circulatory disorders in the leg, particularly a problem with the veins. One would expect the legs to ache though after standing for so long. Speak to your doctor and have it assessed further. Investigations like a doppler ultrasound can be useful in identifying circulatory disturbances.

  • Sarah

    Hi!
    So for school I have to take a gym class. Lately in gym, it seems that when I have to run for more than about a quarter of a mile, I develop rashes on my thighs. Today I had to run a mile, pretty soon my legs began itching. I pulled my shorts up a bit to see that I’d, once again, developed large, red patches on my thighs that soon covered the entirety of both of my thighs. Scratching them caused pain, and when we went inside the gym, I sat down, and noticed that the rash seemed to be radiating heat almost. This has happened now around two or three times. It can’t be my detergent, since I use it for all of my clothes and never get rashes elsewhere, and I doubt it’s my shorts themselves, since I only get the rash from running. Am I having an allergic reaction? Is it safe to continue running for long periods?

  • Hi Sarah. It sound like this may be hives. Sometimes hives (urticaria) is triggered by certain activities although it may not be so much the physical exertion but the sweating that arises with physical activity. You may want to read up more on cholinergic urticaria. Of course this is just one possibility and it is difficult to say for sure through an online platform. It is advisable that you consult with a doctor.

  • Michael Durham

    70%. Isopropyl. Rubbing. Alcohol. It’ll wipe out whatever is causing the itch…and believe me, when applied to the offending area in question, that stinging pain feels so incredibly good.

  • Hi Michael. Thank you for your input. Rubbing alcohol may give momentary relief for some people but it also causes drying of the skin. This dryness can further exacerbate itching.

  • Michael Durham

    I’ve never had a problem with that. I never applied it to excess. But whatever it was that caused the itch, the 70% isopropyl wiped it out.

    Everything in moderation.

  • Hi Michael. That is true. Moderation is the key. However, if you have used it just once off or a few times then it may not cause much drying. The user above seems to be suffering with chronic itching and using it daily in her case would very likely lead to drying of the skin. Thank you again for your advice.

  • KeKeBrown

    When I stand for a short period of time less than 2 minutes, my lower legs from about the top of my feet to mid lower leg itch and tingle uncontrollably. I’m 32, and this has been a reoccurring problem for about the last 5 years or so and I can’t figure it out. I have asked doctors and they seem to have no answer. I did find out this year that I have hyperthyroidism. Could this be the cause? If so, why, and if not what could it be? Looking forward to a reply. Thanks so much!

  • Hi KeKeBrown. While hyperthyroidism may present with symptoms like itchy skin, your itching seems to be triggered specifically bu the action of standing and is isolated to the lower leg/feet. Two other possibilities that could account for it is a circulatory problem in the lower leg, or possibly nerve root compression which involves the lower leg.Disturbances in blood flow can cause itching as can irritation of the nerves. However, you should speak to your doctor again and possibly get a referral to a specialist physician who may be in a better position to isolate other causes.

  • keepitreal

    Have you ever tried taking a vitamin B supplement. I swear by that. I have been taking a complex B for years. Every now & then I will run out of it & if I don’t replace it right away sure enough the itchiness comes back…usually in my legs first. Of course this is just a suggestion to try. Check with a knowledgeable health food expert for their recommendation.

  • Hi Keepitreal. Thank you for your input. Yes, a deficiency of certain B-vitamins can cause a range of symptoms as mentioned by the user above.

  • Angela

    I have all over leg itching. I used to think I only got it when I had an uti or bv infection but now M6 husband has itchy legs too. Help.

  • jessica

    I am itchy all over small nude/pink bumps have formed. I don’t know why but I drank about 4 days ago then the next morning i felt fine so i excersised.

    I started to notice the bumps about 2 days ago. And it started with my next then moved to my arms.
    Now it is all over my upper back stomach legs arms and neck.
    I don’t want it to spread to my face help me!

  • Hi Angela. There are many possible causes of leg itching but if both you and your husband are experiencing it then it is most likely due to a common factor within the home. It could anywhere but the bed is a common site for triggers. You may want to look at bed bugs for a start. However, this itching could also be due to allergies and there may be a common allergen that both you and your husband are sensitive to. It would be advisable that both of you consult with the same doctor.

  • disqus_I6sbh6DGPm

    I finished chemo therapy at the end of December. A side effect of taxol that I had is neuropathy, which I am Experiencing In feet and lower legs and itchiness in lower legs and thighs. I am also on tamoxifen. I find my legs itchy and veins are varicosing. I have the muscle and joint pain too.

  • i Have a super bad itch after shaving the back of my thighs to the point that i break my nails scratching and it looks like a badger attacked my legs help please

  • jessika houghton

    I’m having am issues with my legs even time I get in bed my legs itch like no other I’m a waitress and I’m on my feet all day so when I get home and sit down the itching start up. It drives my fiance crazy I itch so bad to the point where it starts to bleed and I can’t fall asleep what can I do to help this it’s bugging me?!?!?!?

  • Hi Jessika. There are many possible cause for itching legs especially once in bed. Sometimes it may related to allergies with triggers being localized to the mattress or bedroom, for example house dust mite. However, the other possibility could be a circulatory disturbance which is more likely to occur in people who are on their feet all the day. The change in position once lying flat can alter the circulation and itching may be one of the symptoms that then arises. It would be advisable that you speak to a doctor.

  • A.Ram Reddy

    Hi

    For about 6-7 years in every summer atleast 2 months I suffer from itching on my lower legs accompanied by small red coloured spots. I use soap. My father had the same problem. This problem arises only in summer season. Pl.advice

  • Hi ARam. There are many possible causes but given that this is more common in summer, it is most likely due to environmental or climatic factors. Anything from grass and other plants, certain bugs or even the heat may be the problem. It is difficult to say through an online platform. A doctor would need to examine the spots and then reach a diagnosis.

  • A.Ram Reddy

    Dear Sir,
    Thank you very much for the suggestion
    RamReddy

  • John Nagle

    i have inching allover dont know what it is i cant get to sleep with it

  • Kevin Eames

    Hi Jessika what was your problem in the end, i think i have the same Kevin Eames

  • Axel

    Ah, so that’s why my legs it upon standing. I thought it was something to do with my blood, but infact it’s just my Keratosis Pilaris. Which is odd because it’s very mild on my legs :’)

  • christopher everett

    Hi. I hope this post helps fellow suffer`s. I have like many others suffered from itchy legs for many years. Looking up this problem on the net reveals that there are many causes which does not help when you are being driven mad. I have been able (at last) to stop this cursed annoyance. I have found in my case heat makes the problem far worse ie:- taking a bath etc. So a few weeks ago I thought I would try and experiment by putting up with cold legs. Rolling up my trousers while watching TV, Letting my legs be uncovered in bed. These two things gave me great relief. It did not cure my problem but it was far less intense and I was able to sleep. On awaking with cold limbs I covered up and in a short time I could feel the cursed itching returning. Uncovering again it subsided. Although I could feel the underlying problem remained at least I got relief albeit with cold legs. Two days ago my good lady needed some embrocation rubbed on her shoulder. She had some cream previously prescribed by her doctor. After her treatment I was left with a pair of very smelly hands. I rubbed them on my legs. No more itching. I put more on the next day. The itching has gone. No slight tingle. I am luving it. Fingers crossed it stays gone. Like I said at the beginning there are all sorts of reasons for this ailment and so with this in mind it may not work for you. The cream is called “Etoflam” It contains “5%Etofenamate amongst other stuff and is apparently a anti inflammatory treatment. Good Luck.

  • Harley

    Hi I’m Harley, I’m 15 and I’ve suffered from skin problems since I was very very young I’m allergic to insects (only when bitten) and that’s the main cause of irritation, like if I get bit by a mosquito the bite will swell and typically with mosquito bites on me it forms a knot kinda like a small mound about the size of a quarter underneath the bite and the bit istself is a small odd shaped welp, I may resist the erg to scratch but when I sleep I scratch no matter what there’s no way of stopping it I scratch and scratch and then I end up with big soars, missing patches of skin (few layers not like a chunk lol) so I’m left with raw stinging legs and big soars that won’t heal bc of my scratching. I have scars starting from the tops of my feet all the way up to the top of my thighs. Try growing up with that and trying to fit in being a girl wearing shorts and dresses or even shoes that show your feet it’s hard. I’m a teen now and it’s awful having to wear shorts in the Texas summer or a swim suit I get judged and weird looks. I’ve been to my doctor I’ve taken many many pills a day (only for a couple years) I’ve been diagnosed with many psychological problems and had been on medicine for that hoping that it would fix my skin problems. But the insects aren’t the only problem. I have itch flare-ups, they tend to happen in the evening trying to go to sleep or after a shower or just lounging around in my bed, It could be the dead of winter freezing cold inside and out so I’ll be like under all my blankets or something, and my legs (normally my thighs) them themselves will get hot like me myself won’t feel as if their hot but to the touch they are and they get over heated I break out into a heat rash and like an itch fit and sometimes it’s practically impossible not to scratch it’s not something you can tell yourself not to do, my mom doesn’t understand she yells at me all the time and tells me it’s my fault bc I scratch. At this point it’s uncontrollable and involuntary I try not to scratch I end up in tears, cracking my teeth, or leave bruises on my arms from gripping my wrists so tightly or I bite my arm and leave marks or make it bleed it’s so hard not to scratch and it’s painful not too although it’s painful to do it it’s less painful. I again end up with raw patches of skin and bruises and then later long strips of scabs from scratching but I don’t know what else to do, I’ve been to doctors I’ve taken meds (which just made me sick and depressed and lose weight) the only way I can diffuse the burning firey itchy sensation is with ice packs and sometimes I just can’t bc it’s winter or bc they make everything wet