Itchy Feet at Night

Did You Know?
Itchy feet may indicate that you have developed an allergy to some specific foods. So, undergoing food allergy test and then modifying the diet may help to resolve the issue.

One can somehow tolerate itchy feet and hands during the day but when it occurs at night, it is unbearable and disturbs a good night's sleep. When we say that a person has an itchy skin, we assume that the person is suffering from a skin rash or other skin disorders like dermatitis.

However, in some cases, there is intense itching on feet, but surprisingly many times the skin shows the absence of blisters. The skin only become red after scratching but there are no blisters formed on it. Now, annoying itching feeling in feet at night with no skin rash, How does one explain it?

Cholestatis
When itchy feet that worsens at night and occurs everyday, it cannot be neglected. Believe it or not, burning itchy feet at nighttime is something related to cholestasis. This is a condition that interferes with the normal flow of bile from the liver. The bile is a digestive juice that promotes breakdown of fats, to ensure proper digestion.

The liver is actually responsible for producing the bile. Once the bile is produced, the liver sends it to another organ (gallbladder) below it. The gallbladder passes the bile to the intestine to digest the ingested food.

All these organs are connected through tubes (bile ducts) that allow the bile to flow from the liver to the intestine. Now, the liver's inability to transfer the bile to the intestines may be due to a wide number of reasons such as formation of tumors in the bile duct, liver problems like pancreatitis or narrowing of the bile duct.

Cholestatis sufferers show a steep rise in bile levels in the blood. This is because the blocked ducts stimulate the liver to send the bile directly into the bloodstream. Cholestatis not only causes itching in feet at night but also brings a nauseatic feeling and is accompanied by dark urine and clay colored bowel movement.

In some cases, people with cholestatis suffer from jaundice, a condition that turns the skin yellow.

Scabies is a parasitic skin infection that occurs when the mite Sarcoptes scabiei burrows the topmost layer of the skin. These nasty mites after burrowing prefer to stay beneath the skin. Once under the skin, they lay their eggs, which eventually leads to their proliferation.

The urge to scratch frequently is a common complaint among people affected with scabies. Scabies makes the skin terribly itchy and is often marked by formation of burrow tracks. A rash may also develop along the burrowing track. The reddish itchy skin rash on the feet can make it quite difficult to sleep at bedtime.

Hands, elbows and soles of the feet are the common sites of scabies infection. Although the itchy sensation associated with scabies occurs throughout the day, it is far more severe at night. Prolonged physical contact with people affected with scabies is the most common way by which the infection spreads.

Itchy feet at night has also been linked to blood circulation problem. When the blood flow to the extremities such as the hands and the feet, is inadequate during nighttime, it can also cause intense itching. Bad blood circulation is often found to be the culprit behind itchy legs.

Feet itching during nighttime has also been reported in patients suffering from diabetes. Skin complications are common in diabetes. Studies indicate that diabetic patients are prone to skin problems.

They have higher risk of developing fungal or bacterial infections of the skin than those with healthy blood sugar levels. Itchiness in diabetes without any rash is confined to lower legs and is often related to disturbances in blood circulation.

It is observed that pregnant women often complain about itchy feet that worsens at night. Itchiness is at its worst during late pregnancy. Generally, after 36 weeks pregnancy, women are seen scratching their feet and hands frequently. Sometimes the itching is so intense that it keeps them wide awake the whole night.

This is an indication of cholestasis and when it occurs during pregnancy, it is referred to as intrahepatic (obstetric) cholestatis. Cholestasis during pregnancy also changes the normal color of urine. Dark yellow colored urine accompanied by excretion of light-colored feces, indicate the presence of cholestasis.

As we all know, hormonal imbalance is common during pregnancy. This alteration in normal hormone levels is the primary reason behind occurrence of cholestasis, which brings foot itch at night. High level of pregnancy hormones such as progesterone and estrogen can influence the normal working of the gallbladder.

The gallbladder may not be able to empty itself properly. As a result, some amount of bile cholesterol always remains in the gallbladder, eventually leading to formation of gallstones (hardened cholesterol deposits). Over time, these gallstones move out of the gallbladder and get stuck up in the tube that connect it to the liver.

This obstructs the flow of bile from the liver to the gallbladder. In such cases, the liver may pass the bile directly to the blood for circulation. This condition is referred as cholestasis of pregnancy. Obstetric cholestatis, regarded as a complication in pregnancy increases the bile levels in the blood.

• In order to get relief from this terrible sensation in feet at night, the doctor may prescribe anti-itch cream. A calamine lotion or moisturizers containing tea tree oil or aloe vera gel are useful to soften the skin and relieve the itchiness.
• To reduce allergy related itching, use of antihistamine medications like Benadryl are recommended.

The patient will be asked to undergo a liver function test as well, to confirm the presence of cholestasis. The test determines whether the liver is functioning properly.

A serum bile acid test will also be done to assess the bile levels in the blood. To improve flow of bile, the doctor may prescribe oral medications like ursodeoxycholic acid (actigall). Vitamin K supplements may also be prescribed to resolve digestive problems.