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Lower Leg Itch: Symptoms & Treatments

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Itchy lower legs can be a nuisance and have related symptoms of redness, bumps on the lower legs, dryness, and pain. The many causes of a lower leg itch include skin conditions like eczema and dermatitis, damage to the nerves that may be caused by diabetes, or an allergic reaction from plants, foods, or insects. Read below for more information on causes and treatment options for itchy lower legs.

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Common symptoms of itchy lower legs

An itch is an uncomfortable sensation on the skin that causes the urge to scratch. Although it is likely due to some sort of minor irritant or dryness, this sensation in the lower leg can be associated with various conditions. There are several main symptoms including:

Scratching

Scratching is also an important symptom of lower leg itch. Even though scratching can be helpful in relieving an itchy sensation, it only offers temporary relief. Scratching can also result in breaks in the skin that can lead to bleeding or infection, further exacerbating the issue.

Other characteristics to consider

Sometimes a lower leg itch may not be associated with any visible skin changes. In this case, it is important to take note of other symptoms associated with your lower leg itch such as:

  • Timing: Does the itch happen during a specific time in the day? After certain activities?
  • Laterality: Does the itchy sensation occur in one leg (unilateral) or both (bilateral)?
  • Acuity: Is this the first time the sensation has occurred? Or have you experienced lower leg itch before?

Although conditions associated with lower leg itch are not usually serious or life-threatening, it is important to make an appointment with your physician in order to get appropriate, long-lasting care and prevent complications.

Why do my lower legs itch?

An itch, also known as pruritus, occurs as a result of irritation or stimulation of cells and receptors on the skin particularly those related to nerves. Stimulation of these nerve cells and the itching that results can be caused by multiple conditions that can be grouped in the following categories:

Dermatologic

Many skin conditions such as eczema, hives, psoriasis and a variety of other illnesses that specifically affect the skin and its layers can result in itchiness of the lower extremities. Often, such conditions are also associated with symptoms such as redness, blisters or flaking. On the other hand, skin that is simply dry due to old age or temperature changes can also result in itchy skin.

Systemic

Itching in the lower legs may be a sign of an underlying, systemic condition. There are many illnesses that can also cause itching and they can be grouped into the following categories:

  • Metabolic: Conditions such as diabetes, renal disease and thyroid disease that affect the metabolic homeostasis of the body can result in itching of the lower leg as well as other parts of the body.
  • Hematologic: Blood conditions such as anemia and leukemia can cause itching in addition to symptoms such as fatigue and weight loss.
  • Neurologic: Conditions that affect the nervous system such as shingles, diabetes, and multiple sclerosis can also result in itching of the lower extremities and other parts of the body.

Environmental

Certain environmental causes can lead to an itch, including:

  • Allergens: The skin works primarily as a protective barrier and is very sensitive to environmental factors that cause irritation or allergic reactions. Allergens can include drugs, topical treatments such as soaps or lotions, certain fabrics or metals, plants, foods and a variety of other substances. Itching that results is a form of warning or deterrent from using these irritants.
  • Insect bites: A bite from any insect mosquito, spider, flea, etc. can easily stimulate the nerve cells on the skin that results in itchiness.
  • Stress: Some people scratch when they are stressed, or scratch their skin as a habit in certain conditions.

This list does not constitute medical advice and may not accurately represent what you have.

Insect bite from a chigger

Chiggers are mites that feed on humans and animals only while they are larvae, or their infant form. People can contract chiggers when they contact infected grass. Chiggers feed for three to four days on a piece of skin, and secrete a fluid that causes intense itching.

Rarity: Rare

Top Symptoms: lower leg itch, lower leg redness, knee itch, ankle itch, ankle redness

Urgency: Phone call or in-person visit

Mosquito bite

Mosquito bites are bites from flying insects that feed on the blood of animals, including humans. Mosquito bites are more common during the summer or in warmer climates, at dawn or dusk, and near bodies of water.

In most cases, mosquito bites will cause a local skin reaction that gets better on ..

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Restless legs syndrome (RLS)

Restless Legs Syndrome, also called RLS or Willis-Ekbom Disease, is a neurologic and sensory disorder. It causes uncomfortable sensations in the legs that are only relieved by walking or by moving the legs.

The cause is not in the legs but in the brain. One theory is low levels of iron in the brain.

RLS may be hereditary. It is more common in women than in men, especially in middle age. It may get more severe as the person gets older.

Symptoms may happen only a few times a week and are usually worse at night.

There will be an irresistible urge to move the legs in order to relieve the uncomfortable sensations; difficulty sleeping, with daytime exhaustion and inability to concentrate; and sometimes depression and anxiety due to the effect on quality of life.

Diagnosis is made through patient history and physical examination. Blood tests and sleep studies may be done.

Treatment involves first addressing any underlying medical condition, such as iron deficiency. In some cases, anti-seizure medications can be helpful.

Normal episode of itchy skin

Itchy skin is also called pruritis. There are a number of "normal" causes for itching, meaning the cause is not disease-related and does not result in seriously damaged skin.

The most common causes are:

  • Dry skin, due to bathing in soap or bubble bath that may be too harsh and is stripping the natural oils from the skin.
  • Mild allergies, which may be caused by dust; certain plants and flowers; nickel-containing jewelry; and any sort of soap, detergent, lotion, or perfume.
  • Pregnancy, due to stretching of skin or to a condition called prurigo. Prurigo causes small, itchy bumps which may be due to an autoimmune system dysfunction during pregnancy.
  • Menopause, due to hormonal changes that may leave the skin overly dry.

Diagnosis is made through physical examination and sometimes allergy tests.

Treatment involves bathing only with mild, hypoallergenic soap; regular moisturizing with unscented lotion; wearing soft, loose, non-synthetic clothing; avoiding any substances that seem to provoke the itching; and sometimes prescription medicated creams.

Rarity: Common

Top Symptoms: feeling itchy or tingling all over

Symptoms that always occur with normal episode of itchy skin: feeling itchy or tingling all over

Urgency: Self-treatment

Non-specific insect bite

Insect bites are very common. They often cause itchiness, redness, and some swelling. Most insect bites can be treated at home.

Rarity: Common

Top Symptoms:

Urgency: Self-treatment

Eczema (atopic dermatitis)

Atopic dermatitis, also called eczema, dermatitis, atopic eczema, or AD, is a chronic skin condition with an itchy rash.

AD is not contagious. It is caused by a genetic condition that affects the skin's ability to protect itself from bacteria and allergens.

AD is most often seen in infants and young children. Most susceptible are those with a family history of AD, asthma, or hay fever.

Infants will have a dry, scaly, itchy rash on the scalp, forehead, and cheeks. Older children will have the rash in the creases of elbows, knees, and buttocks.

Without treatment, a child may have trouble sleeping due to the intense itching. Constant scratching may cause skin infections and the skin may turn thickened and leathery.

Diagnosis is made through physical examination, patient history, and allergen skin tests.

AD cannot be cured, but can be controlled through prescribed medications, skin care, stress management, and treatment of food allergies. Those with AD often have allergies to milk, nuts, and shellfish. Keeping the skin clean and moisturized helps prevent flareups.

Dermatofibroma

A dermatofibroma is a fairly common skin growth that usually appears on the lower legs, but may appear anywhere on the body. These mole-like growths are benign (noncancerous.)

The cause is not known, though a dermatofibroma may appear after a minor injury. The growths are not contagious.

Dermatofibromas are most common in adults and are rarely found in children.

Symptoms include a hard, raised growth that is red, pink, or brown and less than half an inch across. They are usually painless but may be tender or itchy, and may appear alone or in groups.

Any new growth on the skin should be seen by a medical provider, especially if the growth is very dark in color or changes its shape or appearance quickly.

Diagnosis is made through physical examination and sometimes biopsy.

A dermatofibroma does not require treatment unless it is interfering with clothing or is unsightly. They can be surgically removed, though this will leave a scar and the growth may eventually return.

Allergic contact dermatitis of the lower leg

Allergic contact dermatitis means the skin has touched something that provoked an allergic reaction, causing inflammation and irritation.

"Contact" means the allergic reaction came from touching something, not from consuming something. The first exposure to the substance sensitizes the immune system, and then the second exposure actually causes the symptoms.

The most common causes of allergic contact dermatitis are:

  • Nickel, a metal often used in belt buckles, the buttons on pants, and jewelry, including piercing jewelry.
  • Poison ivy.
  • Various types of perfumes, including those founds in soaps, fabric softeners, and detergents.
  • Of course, there are many more.

Symptoms include red, itching, scaling, flaking skin that may be painful due to the irritation and inflammation.

Diagnosis is made through first avoiding contact with any suspected substance, to see if the dermatitis clears. Patch testing can be done if the results are not certain.

Treatment involves fully avoiding the allergy-provoking substance and using topical steroid cream as prescribed. Cool compresses and calamine lotion can help to ease the discomfort.

Rarity: Common

Top Symptoms: lower leg redness, lower leg itch, scabbed area of the lower leg

Symptoms that always occur with allergic contact dermatitis of the lower leg: lower leg redness

Urgency: Self-treatment

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How to relieve itchy ankles, calves, etc.

Treatments include at-home remedies and lifestyle changes and further medical options you can receive from your physician.

At-home treatments

Many causes of lower leg itch can be stopped or prevented with simple lifestyle changes that can be done at home:

  • Keep the skin adequately moisturized: Using unscented, dermatologically tested lotions and moisturizing cream on the lower leg can prevent skin dryness that can cause itchiness [4].
  • Avoid allergens: Take note of symptoms that occur after using or ingesting certain substances and try to avoid them. It may be helpful to get formal allergy testing in order to be prepared and knowledgeable about your allergic triggers.
  • Reduce stress: Stress can exacerbate itching and scratching. Try stress-relieving strategies such as meditation, yoga or behavioral modification therapy.

Medical treatments

If your lower leg itch persists despite the home remedies above, make an appointment with your physician. If your itching is caused by an underlying metabolic, hematologic or neurologic condition, your physician will focus on treating that condition first. If your symptoms are due to another cause, he or she may suggest the following treatments that may help relieve your itchy skin:

  • Corticosteroid creams: If your itching is due to a rash or skin disorder such as eczema or dermatitis, corticosteroids are helpful given their anti-inflammatory effect in addition to their immunosuppressive role.
  • Antihistamines: If your itching is due to an allergic reaction, your physician may prescribe medications that fight the immunologic response causing your inflammation and itching.
  • Light therapy (phototherapy): This treatment involves exposing the skin to specific wavelengths of ultraviolet light in order to help get the itching sensation under control.

FAQs about lower leg itch

Why is the itching only in my lower legs?

The lower extremities are particularly sensitive to changes in temperature and become easily dry and itchy, especially in low humidity conditions. The skin overlying the shin is the thinnest and often the first to be affected in many dermatologic conditions, especially skin dryness.

Will the itching spread from the lower leg to the rest of my body?

Depending on the specific cause of your lower leg itch, there is a possibility that the itching can spread from the lower leg to the rest of the body. For example, in many systemic diseases, itching may result in multiple extremities while in the case of an insect bite, the itching likely will not spread.

Is a rash always associated with a lower leg itch?

No. Rash is often associated with lower leg itch in conditions that cause irritation or specifically affect the skin layers. However, in systemic conditions or conditions related to stress or certain allergens, there is often no rash present [5].

What are the complications of lower leg itch?

Complications of lower leg itch are usually the result of persistent scratching. Scratching can cause breaks in the skin that lead to infection or another skin injury. Furthermore, scratching can lead to scarring and thickening of the skin.

Is lower leg itch a temporary or chronic condition?

Lower leg itch can be either temporary or chronic depending on the underlying cause. Usually, lower leg itch associated with allergens resolves once the offending agent is discontinued. However, lower leg itch associated with chronic conditions such as diabetes or liver disease can persist especially if adequate treatment is not obtained [3].

Questions your doctor may ask about lower leg itch

  • Do you have trouble sleeping?
  • Are your symptoms worse during the late afternoon or night?
  • Do your symptoms get worse at rest?
  • Are you sleepy during the day?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

Hear what 1 other is saying
Very itchy lower legsPosted April 27, 2021 by J.
Every morning my lower legs are extremely itchy. I have been tested for diabetes, which came back as clear, but I suffer from blisters on the legs, which can range from small blisters to big ones. The bigger ones cause pain. The smaller ones don't cause pain but make my skin very thin and, if scratched, removes my skin, which becomes very scabby. I've seen doctors and I just keep getting told not to scratch the itch. I've also been tested for a lot of things like soap powder or washing soaps and I've tested and been cleared from diabetes. But I just don't get the answers I need, like how do I stop the itch. This is now getting very frustrating. I am 56 years old and I've had this trouble with my legs now for the last 7 years that seems to get worse. I am a night worker and always on the move. I would like help to stop the itch. I suffer from Klinefelter syndrome and have since I was a child. For the last 5 years, I have been getting injections of testosterone. Can this have anything to do with the itch??
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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