What causes itching worse at night?

Eczema, including atopic dermatitis, can cause an itchy, dry, inflamed skin barrier that disrupts sleep. Scabies often produces intense night-time itching and may affect close contacts; it commonly involves areas such as the finger webs, wrists, waist, or genitals. Head lice can cause scalp itch and visible nits or crawling insects. Dry air, hot bedding, sweat, wool, fragranced products, or a new medicine can also aggravate itching without one obvious rash.

The timing alone does not identify the cause. The distribution, rash, household symptoms, recent exposures, and medicines provide more useful clues.

Keep the bedroom comfortably cool, use breathable bedding, and apply a plain moisturiser to dry skin after bathing. Keep nails short and try tapping or using a cool compress instead of scratching. Avoid new fragranced products until the trigger is clearer. If scabies or head lice is suspected, avoid sharing bedding, towels, brushes, or clothing and arrange an assessment; treatment may need to include close contacts.

Arrange a medical review when itching repeatedly interrupts sleep, spreads, develops a new rash, or affects other people in the household. Seek urgent help for itching with facial swelling, breathing difficulty, faintness, or widespread blistering. Scratched skin that becomes increasingly painful, warm, swollen, or oozy also needs prompt assessment.

Tell your doctor when the itch began, where it starts, whether anyone close to you is itchy, and which products or medicines changed recently. Ask whether the pattern fits eczema, scabies, lice, or another cause, and whether scabies treatment is appropriate.