ITCHY LEGS
Leg itch, which provokes a desire to scratch, is not the same as leg tingling.
Causes of itchy legs are listed below:
Poor Hygiene
Dried sweat and shed skin cells that were not washed off for prolonged period can irritate the skin and cause leg itch.
Keratosis Pilaris (Chicken Skin, “Leg Acne”)
In keratosis pilaris (<< picture), thickening of the hair follicles result in small, skin-colored, red, or brown bumps (also called goose bumps, chicken skin, leg acne) on the thighs, arms or other parts of the body. Heat and irritation by clothes can provoke itch. Bumps in this non-harmful, genetically predisposed condition can be rubbed off, but they usually recur.
Folliculitis
Picture 1. Staphylococcal folliculitis (source: Samuel Freire da Silva, M.D., atlasdermatologico)
In staphylococcal folliculitis (<< pictures and treatment), an infection of the hair follicles with bacterium Staphylococcus aureus, small red bumps with occasional white centers, resembling acne, appear on the thighs, upper trunk, face or other body parts. Bumps usually itch or cause burning pain. Staph folliculitis, even if not treated, usually heals on its own in few days/weeks.
Jock Itch
Picture 2. Jock itch (Tinea cruris) on the inner thigh (source: Samuel Freire da Silva, M.D., atlasdermatologico)
Jock refers to “a person trained to compete in sport”. Jock itch is a red or brown papular rash on the inner thighs, genitals, and buttocks, caused by Tinea fungi, commonly affecting athletes and others who often have moist skin in the groin. It can be treated with antifungal medications.
More pictures of jock itch (<< click and search for “Tinea cruris”)
Leg Itch During Running
1. Leg Itch in Unfit Runners
A person, starting to run after a prolonged period of inactivity can experience intense itch shortly after the start. 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, resulting in irritation of adjacent nerves and itch (1). The problem should resolve with training.
2. Cholinergic Urticaria (Physical Urticaria, Sweat Allergy, Heat Hives)
Cholinergic urticaria (hives) are red, swollen bumps or patches appearing on the skin as an allergic reactionin to physical stimuli, like pressure of the clothes, exercise, heat, sunlight, cold, vibration, water, spicy food, or emotional stress.
The term cholinergic is borrowed from tests in which some individuals have reacted with urticaria to injection of acetylcholine.
Picture 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 some of affected people have an allergy to their own sweat. Sweat triggers release of histamine causing itchiness in the legs or other parts of the body, warm skin, and small (up to 2-3 mm) bumpy hives, which usually persist from 30 minutes to 1-2 hours. Some of affected persons have positive patch test of their own sweat.
Treatment. In prominent itch, stopping exercising and removing some clothes is advised. A shower with lukewarm water can help you to cool down and remove irritant sweat. If itch does not stop, antihistamines, like hydroxyzine per mouth, may help. Additional read about using antihistamines in itchy conditions. Everyone has to find his own way to deal with cholinergic urticaria. People report their success stories, using different tecniques (4).
Tendency of the skin to develop an urticaria-like rash, when stroked, is called dermatographism – it is quite common; it mainly appears in young adults; worries can trigger it. Condition can last for several months. Continuous treatment with non-sedating antihistamines is usually effective.
Additional Pictures of Cholinergic Urticaria
Prevention
- Do not exercise in hot humid weather
- Take a shower before exercise to remove old sweat, use moisturizing creme after the shower to prevent drying the skin
- Wear light, airy, cotton-made sportswear
- Wash new underwear or sportswear before the first use to prevent reaction to fabric dyes
3. Exercise Induced Anaphylaxis (EIA)
Anaphylaxis (Greek ana = against, phylaxis= protection) is a severe allergic reaction to small amount of allergens (allergy triggering substances). Rarely, anaphylactic reaction can be triggered by an exercise. A person who has ingested a certain food (wheat, shellfish, nuts, alcohol, etc.) or medication (aspirin, ibuprofen, antibiotics, herbal supplements, diuretics, etc.), 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 (rarely) progress to shock or even death. Symptoms of EIA do not appear after eating alone or exercising alone, but only after eating certain foods followed by exercising . Symptoms also do not appear after hot shower or during stress. 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 intramuscular injection of adrenaline (epinephrine) as soon as possible (3).
Prevention of EIA is by determining triggering foods and medications with skin patch tests, and avoiding them on the day before and on the day of the planned exercise. Affected person should wear a medic-alert bracelet with description of a condition, and should never exercise alone. Taking antihistamines before an exercise can prevent anaphylactic reaction (2).
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 that may itch. Prevention is in wearing cotton-made pants, and washing new pants before the first use.
5. Other Causes of Itching During Exercise
- Dry skin irritated by sweat. Showering before exercising and using moisturizing cremes helps to prevent itch.
- Friction of tight clothes. Prevention is by using loose, light clothes.
Leg Itch After a Shower
Reasons for leg itch after (usually hot) shower:
- Frequent use of hot water and certain soaps removes protective oily layer from the skin, thus making skin dry and itchy
- Cholinergic urticaria (see above)
- Skin disorder like psoriasis or dermatitis
- Blood diseases like polycythemia vera (rare)
- Psychological reasons
Prevention. First, an exact cause have to be found. Using lukewarm water may help a bit. In dry skin, moisturizing creme used right after the shower may help. Allergy to shampoos or soap has to be considered, and patch tests made. In cholinergic urticaria, an antihistamine like Benadryl by mouth taken 30 minutes before shower usually helps.
Gravitational Eczema (Stasis Eczema, Venous Eczema)
Picture 4. Stasis (gravitational) eczema on the lower leg.(source: Samuel Freire da Silva atlasdermatologico)
In deep vein thrombosis or in varicose veins, blood can’t be pumped efficiently from leg veins, and resulting back-pressure causes fluid collection in tissues of the lower legs. Lower legs may be red, swollen, itchy, and cracks and scaling may appear.
Treatment. Underlying varicose veins or thrombosis has to be treated. Corticosteroid ointments help in marked inflammation.
Prevention:
- Avoid standing for long periods
- Legs should be kept clean and drying prevented with moisturizing cremes
Restless Leg Syndrome (RLS)
Restless legs syndrome (RLS) refers to strong urge to move your legs because of itching and tingling that develops during rest. Condition may severely affect sleeping. Symptoms partly or completely disappear with moving legs, like having a short walk. Disorder is of neurological origin; exact cause is not known.
There is no definite cure for RLS. Treating underlying disorders, or nutrient deficiency has to be considered. 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, infestations, infections, obstructive biliary disease, chronic renal failure, malignancy, medications, neurodermatitis, diabetes, peripheral nerve damage, emotional stress, psychological disorders, etc.
Further Reading:
Itchy Feet and Toes
Itchy Arms and Hands
Causes of Itchy Skin
Itch Diagnosis and Treatment
References:
- Leg itch in unfit runners (running.about.com)
- Cholinergic urticaria (allergies.about.com)
- Exercise induced anaphylaxis (EIA) (allergies.about.com)
- Reports about cholinergic urticaria by affected persons (heathives.com/forum)
Further Reading :
I am going crazy with my itchy legs. It started almost 2 weeks ago, with a slight itch on my thighs after taking my dog for a walk. By the following Friday, my slight itch and hives and had turned severe. I woke up the next Friday itching and scratching with hives. I was in tears. I ran to the store to get benedryl. I have been in agony for a week. I have been on benedryl and prednisone for a week. I am blowing up and still itching. I have been told that I might be allergic to my shiztzu puppy. I have hadn the dog for 6 months with absolutely no problems. This has come all of a sudden. It is baffling and seriously uncomfortable.