DiabetesTeam members have described itching that keeps them up at night. “My feet are so itchy at night. Sometimes I want to scratch my skin off,” said one member. Another wrote, “I have an itchy scalp, ears, and neck during the night.”

Diabetes itself may lead to itchy skin. Other potential causes, unrelated to diabetes, include weather fluctuations, allergies, harsh soaps, hormonal changes, and overly frequent bathing. Itchiness may seem more noticeable at night when you have fewer distractions and want to relax.

Once you determine the underlying cause of troublesome itching, you can seek treatments for relief and get a better night’s sleep. Here are some possibilities to talk over with your doctor.

Diabetes-Related Causes of Itchy Skin

Between 30 percent and 70 percent of people with type 1 diabetes or type 2 diabetes experience some type of skin symptoms. In some cases, skin issues may even be the first sign of a problem with blood glucose (blood sugar). While not every skin condition related to diabetes causes itching, here are several that do.

Neuropathy

People with diabetes may develop diabetic neuropathy if high blood glucose levels damage their nerves over time. This nerve damage typically affects the legs, feet, and hands. Inflammation of the nerves and the release of signaling proteins called cytokines during the inflammation, contribute to neuropathy and itching in diabetes. Imbalance of the system that controls harmful oxidants in the body does, too.

Along with itching, diabetic neuropathy commonly causes sensations including burning, tingling, and numbness. Since diabetic neuropathy can lead to serious diabetes complications, keeping up with your health care appointments and following recommendations to care for your feet are critical.

Skin Infections

According to Skin Manifestations of Diabetes Mellitus, around 1 out of 5 people with diabetes develop skin infections — including fungal infections and yeast infections — which may be responsible for some of the itchiness. Impaired wound healing due to diabetic neuropathy and poor circulation from high glucose levels may raise your risk of infections. In addition, excessive scratching from other skin conditions can also lead to skin infections.

It’s important let your doctor know right away about any wounds with diabetes, especially those that aren’t healing well. You may need to take extra precautions to keep the area clean and clear of infections.

Dry Skin

People living with diabetes are more likely to develop dry skin compared to the general population. High blood sugar levels can contribute. This happens because, when you have too much sugar in your system, your body will draw fluid from your cells to produce enough urine to get rid of that extra sugar. Poor circulation can also contribute to dry skin.

Itchy Skin Conditions

People with diabetes are more likely to develop certain skin diseases that cause itching. Being aware of the risks can help you find the right diagnosis and treatment.

Eczema

Eczema is an inflammatory skin condition and one of the most common causes of itchy skin, affecting more than 31 million Americans. Atopic dermatitis is the most common type of eczema. People with eczema develop symptoms like itching, discoloration, rashes, and blisters in responses to allergens or irritants. People with food allergies or seasonal allergies are more prone to eczema, and genetic factors can also raise your risk.

Avoiding your triggers and maintaining a good skin care routine can help protect your skin barrier and manage the condition. Antihistamines and topical steroids can also help. For more severe flare-ups, other medications may be required.

Psoriasis

Psoriasis is an autoimmune disease of the skin that researchers have found to be associated with diabetes. In psoriasis, skin cells grow too fast and produce itchy, scaly patches.

There are different types of psoriasis and several treatment options, including topical ointments, light therapy, and medications. Many of the same lifestyle recommendations for diabetes can also help with psoriasis. A nutritious diet, regular exercise, and maintaining a healthy weight may improve your symptoms.

Hidradenitis Suppurativa

Hidradenitis suppurativa (HS) is a painful and sometimes disfiguring skin disease. Doctors aren’t exactly sure what causes HS, but people with this skin condition are three times more likely to have diabetes than the general population, according to Skin Manifestations of Diabetes Mellitus. Chronic inflammation in HS leads to skin lesions in the armpits and groin, among other places on the body.

Although itching isn’t a primary symptom of HS, affected areas can cause significant discomfort and may become infected, leading to itching and other symptoms that impair sleep quality.

Lichen Planus

Flat itchy bumps on the wrists, ankles, or near the mucous membranes may be caused by an inflammatory skin disorder called lichen planus. Around 25 percent of people with lichen planus also have diabetes, according to Skin Manifestations of Diabetes Mellitus, but researchers don’t fully understand the reason for this connection.

An experienced dermatologist can help identify if lichen planus is responsible for your itchy skin at night.

Prurigo Nodularis

If you get caught in the itch-scratch cycle, you may put yourself at risk for a condition called prurigo nodularis (PN). In PN, hard bumps or nodules develop on the skin, making the area intensely itchy. This, in turn, can affect your quality of life and disrupt your sleep.

PN often shows up after months of scratching from another skin condition, like atopic dermatitis or skin infections, or alongside a systemic inflammatory condition like diabetes. Scratching further raises inflammation and can worsen the problem and make it chronic (long-lasting).

Diagnosing and treating PN is difficult. People with the condition may feel ignored by health care professionals, who may not be familiar with it. Connecting with a social network such as MyPrurigoTeam can provide insight into the skin condition and vital support for those who feel isolated.

Tips To Soothe Itchy Skin at Night

For mild symptoms, simple changes like using lotion after your shower or wearing softer fabrics to bed can help. “I’ve found that Neutrogena makes a gel cream with hyaluronic acid that really soothes all my skin,” said a DiabetesTeam member. “I use it on all my eczema spots, so the itching no longer wakes me up at night.”

Drinking plenty of water to stay hydrated can also help ward off dry skin that’s itchy. “I was told that diabetes tends to become more active at night. My skin gets itchy, and it keeps me awake. But if I drink water, it tends to calm down the itch. It might also help with other issues, like burning feet or ‘the pricklies,’” shared another member.

However, if your itchy skin is getting worse or significantly interferes with your sleep, you may need to visit a dermatologist for evaluation of your skin problems. They may recommend blood tests or skin biopsies — removal of skin samples for study under a microscope — based on your symptoms and medical history. Some itchy skin conditions can be managed with topical creams and corticosteroids, while others may require phototherapy, antibiotics, or immunosuppressant drugs called biologics.

General tips to improve your sleep include keeping your bedroom temperature cool and cutting back on caffeine. You can also consider asking your doctor for a sleep study to see if anything else may be keeping you up.

There are various possible causes of itchy skin at night, and letting your symptoms go without further investigation may lead to needless suffering. Seek the medical attention you deserve so you can feel your best.

Talk With Others Who Understand

On DiabetesTeam — the online social network for people with diabetes and their loved ones — more than 132,000 members come together to ask questions, give advice, and share their stories with others who understand life with diabetes.

Have you had itchy skin and bumps with diabetes? Were you diagnosed with prurigo nodularis? Share your experience in the comments below, or connect with other people living with prurigo nodularis on MyPrurigoTeam.