Morning Itch – Causes of Scratching When Waking Up

Waking up in the morning and scratching our head, buttocks or other areas is a common practice among most people but the reason why we do this is unclear. It could be to attend to itching that we did not notice while we were asleep, or there may be an even more complex evolutionary reason where we attempted to remove any insects or toxic plant material that may have adhered to the body while sleeping.

Irrespective of the cause, scratching a few areas of the body for a few seconds is not uncommon or abnormal. However, when there is significant itching upon waking in the morning then it needs to be investigate from a medical perspective. It may be isolated to one part of the body or there may be itching throughout the body which is known as generalized pruritus.

Why do we scratch?

We scratch an area when we feel it itchy. Sometimes a burning sensation or even pain may prompt us to scratch but usually we rub an area when these sensations are experienced. Itching signifies discomfort in an area that is different from pain. It arises with stimulation of itch receptors which can detect the presence of a substance or organism that may pose a threat, for example ants crawling on the skin causes an itchy sensation.

Scratching may therefore be a means of removing the offending agent. However, itching has a more complex origin. It is associated with inflammatory reactions where chemicals like histamine are secreted in large quantities at a site. This explains symptoms like itching in certain skin conditions such as contact dermatitis. While scratching may help in removing any agent that trigger the itch, it can at times worsen the inflammation and exacerbate itching.

Causes of Morning Itch

Our senses are significantly dulled when sleeping so minor pain, itching and so on are not perceived as the brain is in a sleep state. We may even scratch minor itches while asleep without being disturbed from the sleep. While we all experience the odd itch somewhere in our body throughout the day, waking up and scratching for long periods or uncontrollably may indicate a problem.

One of the most common causes of itching is dry skin which is often overlooked as a possible problem. Other conditions like circulatory problems particularly in the legs can also lead to morning itching as the blood pools in the leg during sleep and inactivity.

Personal Hygiene

Dust, sweat, skin oils, dead skin cells and bacteria are constantly present on the skin and cannot be avoided. In small quantities it does not pose a problem but if it is not frequently removed with bathing then it can irritant the skin, lead to itching and even result in a skin condition known as irritant contact dermatitis. It is further exacerbated by sleeping on a bed or using linen and blankets that are not clean even if there are no bed bugs.

House Dust Mite

House dust mite are tiny bugs that live in human habitats. It is more concentrated in areas where people spend long hours and the mites find refuge in couches and mattresses. The mites emerge to feed on dead skin cells that are shed and the bed is therefore the ideal environment. House dust mite allergies are common and to some extent even people without allergies react to these mites. It is not the mite itself but its droppings that are the allergen.

Bed Bugs

Bed bugs are not as common as house dust mite and is usually associated with poor hygiene although it can even infest clean homes if the opportunity arises. These wingless insects feed on humans (blood meal). Although it very often lives in mattresses, hence the term bed bugs, it can find a suitable habitat just about anywhere in a house. They can be carried on clothing but do not reside on humans.

Contact Dermatitis

Contact dermatitis is a common and broad skin condition that is caused by the skin making contact with certain substances. These substances can then irritate the skin or cause an allergic reaction. Sweat, water, soap, dust, soil, food and just about any substance can irritate the skin if it makes contact for long enough periods and in large enough quantities. Only specific substances trigger an allergic reaction, like certain textiles, and only in people who are hypersensitive to it.

Atopic Dermatitis

Atopic dermatitis is a common skin condition in children. It arises from hypersensitivity to certain substances (allergens) and is closely linked to asthma and hay fever. The condition is very itchy and the itching tends to peak at certain times like the evening and mornings in most people. While some people may be unable to sleep due to the itching, for others the itching may seem to subside when asleep.

Psoriasis

Psoriasis is another itchy skin condition and the itching is usually constant. Certain factors like heat or hot water may cause the itching to worsen. As with other itchy skin conditions, the itching may be ignored or even reduce while asleep. However, upon returning to a waking state the itching may appear to return and this can be the cause of itching in the morning. Just about any itchy skin condition may present in a similar manner.

Psychogenic

Some people do have itching that is due to psychological factors rather than physical factors. In fact we all tend tend to scratch parts of our body when nervous or anxious. Sleep shifts the conscious mind from focusing on the perceived itching but it usually returns upon waking.

Medication

Drugs used to ease itching like antihistamines or even corticosteroids may wear off by the morning, after sleeping for a long period of time. The itching that appears to occur in the morning is therefore not due to the daytime but rather due to the medication having worn off. Morning itching may resolve upon using the drug again. However, there are various drugs that may cause itching as a side effect. It could also be an adverse drug reaction.

Remedies for Morning Scratching

Itchy skin conditions should be treated and managed by a medical professional and may require the use of medication. For non-specific morning itch that does not occur due to any clearly identifiable cause, the following measures may prove helpful.

• Bathe before bedtime. Do not use very hot water or strong smelling and antibacterial soaps that may dry the skin.
• Moisturize the skin with a hypoallergenic, fragrance-free moisturizer.
• Use light clothing made of natural fibers and the same applies to bed lined. Avoid wool.
• Cool down a room prior to bedtime and maintain it at a comfortably cool temperature.
• Change bed linen at least every second or third day and turn the mattress over once a week. Waterproof mattress protectors may also help.

Last updated on September 6, 2018.