Why does eczema become itchy at night?
Updated: 5 days ago
If you have eczema, you may notice that the itching becomes more noticeable or intense at night, just when you are trying to relax and sleep.
Why does this happen?
Nighttime itching can be influenced by several factors, including the body's circadian rhythm, changes in skin barrier function, temperature and humidity, the sleeping environment, and the itch-scratch cycle.
In this article, I look at some of the reasons eczema may feel itchier at night and share some simple ways you can make your nighttime routine more comfortable.
Eczema, also known as atopic dermatitis, is a chronic skin condition characterised by red, inflamed, and itchy patches of skin.
Many individuals complain about nighttime itching, which disrupts their sleep, leading to fatigue, lack of focus at work or school, and mood swings.
It's common for individuals with eczema to experience increased itching at night. Several factors contribute to this nighttime exacerbation:
#1 - Circadian Rhythms
Body Temperature and Hormones
Our body and skin follow natural circadian rhythms, and several changes that occur in the evening and during sleep may contribute to increased itching at night.
For example, body temperature and skin temperature change throughout the day. In the evening, changes in blood flow and heat dissipation can increase skin temperature, and increased skin temperature has been associated with more intense nighttime itching. Changes in skin barrier function and the natural rhythm of hormones such as cortisol may also contribute.
Changes in the autonomic nervous system may also be involved. During sleep, sympathetic activity decreases and parasympathetic activity becomes relatively more prominent. Some literature has associated increased parasympathetic activity with nighttime itching, although the relationship between the autonomic nervous system, body temperature and itch is complex and is not yet fully understood.
This combination of circadian changes may be one reason why eczema can feel particularly itchy at night.
#2 - Environmental Factors
Temperature and Humidity
Bedrooms might become warmer or drier at night, especially if heating systems are used, which can dry out the skin and worsen eczema symptoms.
Bedtime Routines
Irritants like certain fabrics, detergents, or allergens (e.g., dust mites) in bedding can trigger or intensify eczema flare-ups.
#3 - Distraction and Perception
Reduced Distractions
During the day, activities and external stimuli can divert attention away from itching. At night, in a quieter and less stimulating environment, individuals may become more aware of their itching sensations.
#4 - Behavioral Factors
Scratching During Sleep
Unconscious scratching during sleep can exacerbate eczema, leading to more intense itching or skin irritation upon waking.
#5 - Immune System Activity
Inflammatory Responses
Immune and inflammatory processes also follow daily rhythms, which may contribute to changes in eczema symptoms and itching at night.
Managing Nighttime Itching in Eczema
If nighttime itching is disrupting sleep or worsening eczema symptoms, consider the following strategies:
Moisturize Regularly
Apply emollients or moisturizers before bedtime to keep the skin hydrated.
Use Mild Detergents
Wash bedding and clothing with hypoallergenic, fragrance-free detergents to reduce potential irritants.
Maintain a Comfortable Environment
Keep the bedroom cool and use a humidifier if the air is dry.
Wear Soft Fabrics
Opt for breathable, soft fabrics like cotton for sleepwear and bedding to minimize skin irritation.
Establish a Bedtime Routine
Incorporate calming activities and ensure a consistent sleep schedule to promote better sleep quality.
Conclusion
Nighttime itching is common with eczema and can have a significant impact on sleep and everyday wellbeing.
Understanding the factors that may contribute to nighttime itching can help you identify what might be affecting your skin and make your bedtime routine more comfortable.
If the itching continues to disturb your sleep or your symptoms keep recurring, you may wish to explore your individual symptoms in more detail.
If you would like to explore the homeopathic perspective on skin conditions in more detail, you may also find my article on Homeopathy for Eczema helpful.
If nighttime itching continues to disturb your sleep or your symptoms keep recurring despite looking at these everyday factors, you may wish to explore your individual symptoms in more detail.
In homeopathy, a consultation looks at the individual pattern of your symptoms and your overall experience, rather than focusing only on one symptom such as itching.
If you would like to learn more about how I work with clients experiencing skin concerns, you can find more information about my consultations below.
Love and gratitude
Hiroko
References;
Cameron, S., et al. (2024) ‘Mind and skin: Exploring the links between inflammation, sleep disturbance and neurocognitive function in patients with atopic dermatitis’, Allergy, 79(1), pp. 26–36. doi: 10.1111/all.15818.
Patel, T. and Yosipovitch, G. (2016) ‘Nocturnal pruritus: The battle for a peaceful night’s sleep’, International Journal of Molecular Sciences, 17(3), p. 425. doi: 10.3390/ijms17030425.
Podder, I., Mondal, H. and Kroumpouzos, G. (2021) ‘Nocturnal pruritus and sleep disturbance associated with dermatologic disorders in adult patients’, International Journal of Women’s Dermatology, 7(4), pp. 403–410. doi: 10.1016/j.ijwd.2021.02.010.
Tivoli, Y.A. and Rubenstein, R.M. (2009) ‘Pruritus: an updated look at an old problem’, Journal of Clinical and Aesthetic Dermatology, 2(7), pp. 30–36.
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