Perimenopause itchy skin: why you're itching and what helps

It might be your arms, your back, your shins or your chest. There's often no rash to see, just an itch that won't leave you alone. It's usually worse in the evening, and worst of all when you're lying in bed trying to sleep.

Yes, perimenopause can cause itchy skin. The NHS lists "skin changes, including dry and itchy skin" among the symptoms of perimenopause and menopause. Its page on itchy skin says itching is common after menopause and usually gets better over time.

You're not imagining it. But itching has lots of other causes too, and a few of them need checking. So it's worth reading the box below first.

What does perimenopause itchy skin feel like?

It's different for everyone. You might notice:

• dry, tight skin that itches after a shower
• an itch with nothing to see on the skin
• itching that's much worse at night
• a crawling or tingling feeling, as if something is moving under your skin

That last one has a name: formication. A menopause toolkit published on the Women's Health Concern website lists it, along with "general skin itchiness", thinning skin and allergies such as dermatitis, as possible menopause symptoms.

Why does perimenopause make your skin itch?

The main reason seems to be dry skin. Oestrogen helps keep skin thick, springy and moist. A review of oestrogen and ageing skin explains that after menopause, skin gets thinner and drier, with less collagen (the protein that gives skin its strength).

Oestrogen also seems to affect how well your skin holds on to water. A 2022 review of menopause and skin problems found that itching is often seen in women after menopause, usually along with dry skin. It also mentions a large study in which eczema-type rashes were the skin problem women around menopause reported most often.

Age plays a part too. The British Association of Dermatologists says dry skin is the most common cause of itching without a rash, especially in older people. Menopause and age can add up.

Why is perimenopause itching worse at night?

If your itching seems to switch on at bedtime, there are real reasons for that. A 2016 review of night-time itching explains that:

• your skin warms up in the night as your body lets out heat, and warmer skin can itch more
• your skin loses more water overnight, so its protective barrier works less well
• your body's natural anti-inflammatory hormones are at their lowest in the evening and night
• there's nothing to distract you, so you notice the itch more

The same review found that itch happens most in the lighter stages of sleep. If night sweats are already waking you, a hot, damp bed won't help your skin either. Our article on night sweats has tips for keeping cool.

Perimenopause hives and allergies

Some women find they get hives (an itchy, raised rash), hay fever or skin allergies for the first time in their 40s and 50s. Others find old allergies get worse. The Women's Health Concern toolkit lists new or worse allergies as a possible menopause symptom.

Why this might happen isn't well understood. Mast cells are the cells that release histamine in an allergic reaction. A 2012 review explains that they carry receptors for female hormones, so hormone changes could affect them. But that's lab science. No one has shown that it explains new allergies in perimenopause.

What we do know is what sets hives off. The NHS lists triggers including heat, sweating, stress, certain foods, medicines, tight or itchy clothes, and contact with plants, animals, chemicals or latex. Hot flushes and sweating are common in perimenopause, so some of those triggers overlap.

Hives usually get better within a few days. See your GP or call 111 if they don't improve after 2 days, keep coming back, or come with swelling under the skin. If your lips, mouth, tongue or throat swell, or you struggle to breathe, call 999.

Other common causes of itchy skin

Before putting it down to menopause, it's worth ruling out the other usual causes. The NHS lists:

• skin reactions, such as allergies, hives and heat rash
• long-term skin conditions, such as eczema, psoriasis and dandruff
• fungal infections, such as thrush, ringworm and athlete's foot
• skin parasites, such as scabies and lice
• less often, other health problems, such as thyroid, liver or kidney problems

The NHS says not to try to diagnose yourself. If you're not sure, see your GP.

Some other things to think about:

• Low iron. The NHS lists itchy skin as a less common sign of iron deficiency anaemia. Heavy periods are a very common cause, and periods can get heavier in perimenopause.
• Medicines. The British Association of Dermatologists says some medicines can cause itching. HRT is one of them: both oestrogen and progestogen can cause a mild rash or itching. Never stop a medicine without talking to your GP or pharmacist first.
• Intimate itching. Itching around the vagina or vulva is common in menopause too, but it has its own causes and treatments, so mention it to your GP separately.

How to stop perimenopause itching: things to try tonight

These tips come from the NHS and the British Association of Dermatologists.

In the bath or shower

• Keep it short, lukewarm, and no more than once a day. Hot water strips the skin's natural oils.
• Swap soap and foaming shower gel for an unscented emollient (a plain moisturiser you can wash with).

Moisturising

• Use an unscented moisturiser or emollient several times a day. The drier your skin, the more often you need it.
• Keep a pot in the fridge. A cool emollient can feel very soothing on itchy skin.
• Choose one you like using.

At bedtime

• Keep your bedroom cool, and avoid heavy or heat-trapping bedding.
• If you feel hot and itchy, a fan can cool your skin down.
• Wear loose cotton or silk. Avoid wool and synthetic fabrics next to your skin.
• Lay a cool, damp flannel over an itchy patch.

When the itch strikes

• Pat or tap the skin instead of scratching.
• Keep your nails short and smooth.
• Notice when and where you scratch most. Knowing your pattern can help you break it.

Other changes

• Use a laundry detergent for sensitive skin.
• Avoid scented soaps, deodorants and moisturisers.

A safety note: emollients soak into clothes, bedding and dressings, and the fabric can then catch fire more easily. Keep away from naked flames and cigarettes, and wash your bedding and nightwear often.

What a pharmacist or GP can offer

A pharmacist can suggest things like antihistamines (for some types of itching) or cooling menthol creams. Tell them where the itch is and any other symptoms you have.

Your GP may:

• examine your skin and ask about your symptoms
• arrange a blood test to look for a cause
• prescribe a cream, ointment or tablets, such as a steroid cream or a non-drowsy antihistamine
• refer you to a skin specialist (dermatologist)

HRT is the main medical treatment for menopause symptoms. The NHS says oestrogen "can help manage your symptoms" (NHS menopause treatment). The 2022 skin review notes that oestrogen treatment has been shown to reduce water loss from the skin. But HRT can sometimes cause itching itself. It's one to talk through with your GP, especially if you have other menopause symptoms too.

When to see a GP about itchy skin

The NHS says to see a GP if your itching:

• is affecting your daily life
• doesn't get better with self-care, or keeps coming back
• comes with a new rash, lump or swelling that worries you
• covers your whole body
• is severe

And use the box at the top of this page for anything urgent. Our symptoms checklist lets you tick off everything you've noticed and print a list for your GP.

Where relaxation fits in

Night-time itching can leave you lying awake, scratching and getting crosser by the minute. If itching is keeping you awake at night, you might like something gentle to listen to once you've cooled your skin and settled down. Menopause sleep hypnosis is our bedtime recording, Deep Sleep Through the Change. It's designed to help you relax and drift off. It's a relaxation recording, not a treatment, and it doesn't replace advice from your GP.

Related

Itchy skin often comes with itchy ears, other skin changes in menopause and tingling or crawling skin, and you can see them all in our list of perimenopause symptoms.

This page is general information, not medical advice. If you're worried about any symptom, please talk to your GP or pharmacist.

See all perimenopause symptoms