How to reduce night time pruritis mainly in lower extremities - #11183

Hello, There can be multiple causes of this as it is from a long time…there can be issues like Scabies,fungal infection, dryness of skin, Diabetes etc You need to get a proper evaluation done for this… Get a in person consultation for this,mean while get few tests done like cbc,kft,fbs,thyroid profile,lipid profile

Dermatological (skin-related)

Xerosis (very dry skin) – worsens in cold/dry weather.

Eczema (atopic, asteatotic) – can be subtle.

Systemic / Internal causes

Liver disease / bile flow issues → itching worse at night, often without rash.

Kidney disease (uremia).

Thyroid disorders (both hypo- and hyperthyroidism).

Iron deficiency / anemia.

Polycythemia vera (itching after warm bath/shower).

Diabetes.

Recommended Tests

Liver function test (LFT) – to rule out cholestasis.

Renal function test (RFT / Creatinine, BUN) – kidney health.

Thyroid profile (TSH, T3, T4).

CBC with iron studies – anemia or polycythemia.

Fasting glucose / HbA1c – diabetes check.

Viral markers (HIV, Hepatitis B, C) if risk factors. Advise Use mild soap-free cleanser and thick moisturizer (like Cetaphil, Aquasoft, Aveeno) after bath and before bed.

Avoid hot showers (they worsen itching).

Wear loose cotton clothes at night.

Antihistamine at night (Cetirizine, Levocetirizine, Hydroxyzine) – helps with sleep + itching .

Keep bedroom cool, avoid excess sweating.

Nighttime pruritus, particularly focused on the lower extremities, can be a challenging symptom to manage. It’s important first to consider underlying conditions that might contribute to this. Common causes can include xerosis (dry skin), eczema, or even more systemic conditions like iron deficiency anemia, liver or kidney issues, or thyroid dysfunction. Given your long-term symptoms, it might be prudent to have a medical evaluation to rule out these potential causes through a blood test or focused physical examination. Meanwhile, there are some practical steps you can take to potentially reduce the itching. Ensure that your skin is well-hydrated by applying a heavy-duty moisturizer, preferably containing ceramides or dimethicone, right after bathing and before bed. Opt for lukewarm baths rather than hot ones to avoid drying out your skin further. Consider using gentle, fragrance-free soaps and detergents, as scented products can sometimes be irritants. During the night, keeping your bedroom cool can help reduce itching, as heat can exacerbate the sensation. If your environment is dry, especially during winter months, using a humidifier might also be beneficial. Wearing loose, breathable cotton pajamas can reduce skin irritation caused by tight or synthetic materials. Antihistamines, available over-the-counter, can sometimes help to alleviate itching, particularly if it has an allergic component, but it’s wise to discuss this with a healthcare provider to ensure it’s suitable for your situation. Monitoring your symptoms to see if they align with any particular food intake or activities during the day can provide insights. If your symptoms persist, worsen, or you notice additional symptoms like weight loss, fatigue, or changes in your urine or stool, seeking further evaluation from a dermatologist or your primary care physician would be crucial.