Why Your Lower Legs Might Feel Itchy and How to Stop It

Itchy lower legs can be a real nuisance, often caused by dry skin, allergies, or insect bites. Thankfully, simple remedies like moisturizing regularly or using hydrocortisone creams can provide relief.

Dry Skin

Dry skin commonly causes itchy legs. If your leg skin feels rough and looks flaky, cracked, or scaly, dry skin might be the issue. It’s more prevalent in winter due to cold weather and low humidity. Frequent showering, bathing, and swimming can also dry out your skin. 

Older adults are more prone to dry skin, especially on elbows, lower legs, and arms. As we age, skin loses fat and thins, increasing dryness risk.

How to Relieve Itchiness

Dry skin can often be relieved by applying lotion once or twice a day to the affected areas. Drinking plenty of water throughout the day can also help keep your skin hydrated. 

Insect Bites

Insect bites from mosquitoes, chiggers, fleas, and bed bugs can cause intense itching. Spending a lot of time outdoors or having household pets may make you more susceptible to getting a bug bite.

Insect bites can trigger an inflammatory response in the body, causing the location of the bite to itch. The itchiness may be accompanied by raised red bumps, small hives, or rash on your skin when insect bites are to blame. 

How to Relieve Itchiness

Scratching insect bites can increase itchiness, so it’s best to avoid it. Most bites stop itching after a few days. Apply a cold compress or over-the-counter hydrocortisone cream for temporary relief.

Allergic Reactions

Contact dermatitis occurs when something irritates your skin or triggers an allergic reaction. You might develop itchy skin and a rash or blisters hours or days after contact with allergens.

More than 15,000 different substances can cause an allergic reaction on the skin. Personal care products like cosmetics, lotion, perfume/colognes, and certain soaps often contain ingredients that can lead to contact dermatitis. Contact with certain metals (e.g., nickel) may also cause irritation and itchy legs. 

How to Relieve Itchiness

Identify the cause of your allergic reaction. Track products and substances that contact your skin to help determine triggers.

Skin Conditions

Atopic dermatitis (eczema) is a common cause of itchy skin. On the lower leg, dermatitis may appear as red and swollen plaques/patches of skin. In milder cases of dermatitis, the irritated patches may appear dry and scaly. Blisters may be a part of the rash in more severe cases of dermatitis. 

Other skin conditions that can cause itchy lower legs include:

How to Relieve Itchiness

Skin conditions are managed differently depending on the type. Your healthcare provider or dermatologist (medical skin doctor) can provide an accurate diagnosis and remedies to provide relief.  

Medication

Some medications can trigger intensely itchy skin. Known as drug-induced pruritis, symptoms may appear within hours or weeks after you start taking the medication. In most cases, there is no rash with the itchiness, just scratch marks. 

The most common medications that cause itchy skin include opioids, chemotherapy medications, psychotropics, and chloroquine. Certain antibiotics, cardiovascular medications, and antiseizure medications (ASMs) may also cause this reaction.

How to Relieve Itchiness

Talk to your healthcare provider about your symptoms. They may advise you to stop taking the medication and replace it with an alternative. Your skin may continue to be itchy for days or weeks after you stop taking the medication, but it will eventually subside.

Diabetes

Diabetes affects more than just your blood sugar (glucose) levels—it can affect many major organs, including your skin. For some people, itchy skin may be the first sign they have diabetes.

People with diabetes are more at risk of developing skin rashes, skin infections, and dry skin. Chronically high blood sugar levels may lead to poor circulation, causing itchy skin, especially on the lower legs. 

How to Relieve Itchiness

Carefully managing your diabetes can help protect your skin and prevent itchiness and infections. To reduce itchiness and prevent infections, use mild soap with moisturizer when you bathe, avoid very hot baths/showers, and apply moisturizer to your skin after bathing. 

Vein Disease

Poor circulation can lead to skin changes, including dry, itchy skin in the legs and other parts of the body. Some of the vein diseases that can cause itching include:

How to Relieve Itchiness

If a problem with the veins in your leg is causing itchiness, it’s important to avoid scratching. This can make the itching worse and cause damage to the skin that could potentially lead to an infection.

You may be able to relieve the itching with a fragrance-free moisturizing cream applied at least twice a day. Topical hydrocortisone and/or anti-itch creams may also help.

Nerve Damage

Sometimes nerve damage can cause itchy skin. This is known as a neuropathic or neurological itch. Injury or damage to neurons in the central nervous system (brain and spinal cord) or peripheral nervous system (nerves that branch out into organs, limbs, and skin) can result in chronic itching. Scratching does not tend to relieve a neuropathic itch, and can sometimes make it worse. 

Neuropathic itching is sometimes accompanied by painful sensations, such as burning, coldness, electric-like shocks, or prickling. There are several potential causes of neuropathic itching, including autoimmune conditions, infections, injury, multiple sclerosis, nerve damage, or stroke.

How to Relieve Itchiness

Ask your healthcare provider about how to manage neuropathic itching. Some healthcare providers recommend pain-relieving medications or antidepressants for this type of itch.

Antihistamines don’t usually improve symptoms, but a sedating antihistamine like Benadryl (diphenhydramine) may help you sleep. Topical anesthetics can provide short-term relief, and topical steroid creams can help reduce inflammation. You can also try wrapping the itchy skin with a bandage.

Some healthcare providers recommend talking to a therapist. Therapy may help you learn to cope with itching and resist the desire to scratch.

Other Health Conditions

Other health conditions that may cause itchy legs include:

How to Relieve Itchiness

These remedies can help certain types of itch, including those from the conditions listed above:

• Cold compress: Apply an ice pack or a wet (cold) cloth to the itchy areas
• Oatmeal bath: Adding colloidal oatmeal powder to a warm (not hot) bath can help clean and moisturize the skin. Thanks to its anti-inflammatory properties, colloidal oatmeal soothes and protects irritated skin.
• Moisturize daily: Applying a fragrance-free lotion to your skin one to two times a day can help reduce itchiness and hydrate dry skin. 
• Drink plenty of water: Drink at least eight 8-ounce glasses of water each day to keep your skin properly hydrated. 
• Wear comfortable clothing: Avoid materials that may irritate your skin (e.g., wool), and aim to wear comfortable, loose clothing made of a material softer on the skin, such as cotton. 
• Use over-the-counter products: Antihistamines, topical steroid creams, pramoxine cream, and menthol-containing topicals may provide much-needed itch relief for certain skin conditions (e.g., eczema, contact dermatitis, bug bites).

When to See a Healthcare Provider

While there are many home and over-the-counter remedies for itching, they may not help your condition. See your healthcare provider if you have the following issues:

• The itchiness persists for longer than two weeks. 
• It distracts you from your daily routine and/or prevents you from getting quality sleep (nocturnal pruritus).
• Itchiness seems to be spreading to other areas of your body.
• You have other symptoms, such as fever, sweating, and unexplained weight loss.
• You have a rash that has blisters, pus, or bleeding.