Can menopause cause itchy skin? Causes, crawling skin and relief
Yes, menopause can cause itchy skin, mainly because falling estrogen makes skin drier and weakens its protective barrier. Gentle skin care and regular moisturizer help most people, but itching that lasts or comes with other symptoms should be checked for other causes.
See a doctor if itching lasts more than a few weeks despite moisturizing, or keeps you awake. Go sooner if it comes with weight loss, fever, drenching sweats, yellow skin or eyes, or itch with no visible rash. Also see a doctor for itching around the vulva, broken or infected skin, or a crawling feeling with confusion.
Why menopause can make skin itch
Estrogen helps skin hold water and keeps its outer barrier working.1 When estrogen falls, skin loses more water and becomes dry. Dry skin (xerosis) is the most common cause of itch in this age group.1
Lower estrogen also means less collagen, so skin gets thinner and more fragile.1,4 Itch becomes one of the main skin complaints in older women.1
Menopause can also bring eczema back after many years, or trigger it for the first time.4 Scratching then damages the skin further, which leads to more itching.4
Dry, itchy skin at night
Many women find itching worse at night. Warm bedding and night sweats can play a part, because sweat irritates dry or eczema-prone skin.4 Itch from some health conditions, such as kidney disease, can also be worse at night.2
Things that may help at night:4
- Keep the bedroom cool and use lighter bedding.
- Take short, lukewarm showers rather than hot baths.
- Moisturize straight after washing, then again before bed.
- Try keeping moisturizer in the fridge for a cooling effect during hot flashes (hot flushes in the UK).
- Use a humidifier if the air is dry.
Formication: when skin feels like it is crawling
Formication is a feeling of insects crawling on or under the skin when nothing is there. It has been linked to the hormone changes of perimenopause and menopause, possibly through effects on nerve sensitivity.3 Research on this link is limited.
Formication has many other causes. These include some medicines, alcohol withdrawal, low vitamin B12, and some nerve and mental health conditions.3 Mention it to a doctor if it keeps coming back, disturbs your sleep, or leads to sores from scratching.3
Other causes to rule out
Itching is not always caused by menopause. A doctor may check for:2
- an underactive or overactive thyroid
- iron deficiency, which is more common if you have had heavy periods
- liver disease, where itch often starts on the palms
- kidney disease, often with itch that is worse at night
- diabetes, which can damage nerves in the feet and legs
- reactions to medicines
- rarely, blood cancers such as lymphoma, often with itch all over but normal-looking skin
Itch that lasts six weeks or more counts as chronic and is worth checking.2 Itching around the vulva has its own causes; see vaginal dryness.
Skin care that helps
Dermatologists suggest these steps, which also help dry skin:1,2,4
- Moisturize often. Use a fragrance-free product, ideally with ceramides, and a thicker cream if skin is very dry.
- Avoid soap and bubble bath. Use a mild cleanser and pat skin dry.
- Choose gentle laundry products without perfume.
- Keep nails short to limit damage from scratching.
- Wear loose, light clothing and keep rooms at a comfortable temperature.
If you have eczema, a doctor may prescribe a steroid cream for flares.4 Very dry skin may need a prescription cream.2
Hormone therapy and itch. In studies, HRT makes skin thicker and helps it hold water.1 Eczema UK says it often eases dry, itchy skin.4 However, it has not been tested as a treatment for itch, and experts do not recommend it for skin problems alone.1 It is not suitable for everyone, for example women at high risk of breast cancer or blood clots, so a doctor needs to weigh the risks and benefits.4 See hormone therapy.
What helps: options rated
| Option | Evidence | What the research shows |
|---|---|---|
| Steroid creams for eczema flares | First-line prescribed treatment for eczema flares, which can return around menopause.4 Not for itch from other causes without advice. | |
| Regular fragrance-free moisturizer | Standard dermatology advice that targets dryness, the main driver of itch; few menopause-specific trials.1,2 | |
| Mild cleanser, lukewarm water, short showers | Recommended by dermatologists and eczema charities to protect the skin barrier; based on expert advice.2,4 | |
| Cool bedroom and light bedding | Advised to reduce night-time itch and sweat irritation; supported by expert guidance rather than trials.4 | |
| Hormone therapy (HRT) | HRT improves skin hydration and thickness in studies, and eczema charities report it often eases itch.1,4 It has not been tested for itch itself and is not prescribed for skin alone.1 |
Ratings explained: how we rate. Always talk to a doctor or pharmacist before starting a medicine or supplement.