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What Causes a Back Itch & How to Find Relief

A person with a brush scratching her back.
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Reasons for why your back is so itchy can include an allergic reaction from certain hygienic products, chemicals, or plants. Another itchy back cause is shingles, also known as herpes zoster. Read below for more information on causes and how to relieve your back itch.body

6 most common cause(s)

Back itch symptoms

A back itch can be a bothersome symptom, especially since it can be in hard to reach area. There are several potential causes for a back itch, that may or may not involve a rash. Although scratching may provide relief, the underlying cause should be identified to prevent any skin damage.

Common characteristics of back itch

Scratching associated with a back itch can cause breaks in the skin that can lead to bleeding or infection, often further exacerbating the issue. You should try to avoid the urge to scratch.

Common accompanying symptoms

In addition to itchiness, you may also experience the following symptoms.

  • Pain or tenderness
  • Numbness or tingling
  • Rash
  • Redness
  • Warmth
  • Blisters or bumps
  • Dryness
  • Changes in skin texture: Skin becomes scaly, leathery, or papery

These symptoms may be localized to one area on the back or spread throughout the back. However, it may be difficult to see any skin changes without a second pair of eyes. On the other hand, a back itch may not be associated with visible symptoms at all. Therefore, following up with your physician for proper treatment is important.

Back itch causes

An itch, also known as pruritus, occurs due to irritation or stimulation of cells and receptors on the skin, mostly related to nerves. Multiple conditions can stimulate these nerve cells and cause itching. The following details may help you better understand your symptoms; however, you should see your physician for a proper diagnosis.

Localized causes with rash

Skin conditions that involve a rash may include the following.

  • Dermatologic: Many skin conditions such as eczema, hives, psoriasis, and a variety of other illnesses that specifically affect the skin can result in localized itchiness on the back. 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.
  • Allergens: The skin works primarily as a protective barrier and is very sensitive to environmental factors. Allergens can include drugs, topical treatments such as soaps or lotions, certain fabrics or metals, plants, foods, and a variety of other substances. Itchiness serves as a warning from using these irritants.
  • Infectious: Multiple infectious pathogens, including bacteria, viruses, and fungi can cause itchy, localized infections of the back. For example, varicella zoster is a virus that causes shingles, a very painful and itchy rash that often affects the back.

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Localized causes without rash

Localized causes of a back itch that are not associated with rash or skin changes are rare and usually related to psychogenic (a psychological origin or cause rather than a physical one) causes.

Shingles (herpes zoster)

Shingles (herpes zoster) is a disease caused by the varicella-zoster virus - the same virus that causes chickenpox. Early signs of shingles include burning or shooting pain and tingling or itching, usually on one side of the body or face. Rashes or blisters appear anywhere from one to 14 days later. If shingles appears on the face, it may affect vision or hearing.

You should go to a retail clinic or your primary care physician to be treated for shingles. Most common treatments involve pain killers and prescription antiviral medicines.

Generalized itch

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.

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.

Chronic kidney disease

Chronic kidney disease is a general term for kidney damage caused over time by other illnesses, especially high blood pressure and diabetes. Eventually kidney function becomes impaired and wastes are no longer properly filtered from the blood, leading to serious illness.

Most susceptible are those over age 50 with high blood pressure, diabetes, obesity, and/or a family history of kidney disease.

Symptoms include fatigue; difficulty concentrating; poor appetite; muscle cramps at night; dry, itchy skin; swollen eyes, feet, and ankles; and increased urination.

Left untreated, chronic kidney disease results in serious illness, kidney failure, and death. It is important to see a medical provider as soon as symptoms begin.

Diagnosis is made through physical examination; a blood test called Glomerular Filtration Rate (GFR;) ultrasound or CT scan of the kidneys; and sometimes a kidney biopsy.

Treatment includes medications for high blood pressure, high cholesterol, and fluid retention, and a low-protein diet to reduce the work the kidneys must do. Dialysis and kidney transplant are only done if there is kidney failure.

Allergic contact dermatitis of the back

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: back redness, back itch, scabbed area of the back

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

Urgency: Self-treatment

Back itch treatments and relief

At-home treatments

You can stop or prevent many causes of back itch with simple lifestyle changes.

  • Keep the skin adequately moisturized: We often overlook the back in skin moisturizing regimens, predisposing it to dryness. Using unscented, dermatologically tested lotions and moisturizing creams on the back can prevent dryness.
  • Avoid allergens: Take note of symptoms that occur after being around 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 triggers.

When to see a doctor

If your back itch persists despite the home remedies above, make an appointment with your doctor. If by an underlying metabolic, hematologic, or neurologic condition is causing your itch, your doctor 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 since they are both anti-inflammatory and immunosuppressive.
  • Antihistamines: If your itching is due to an allergic reaction, your doctor 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.

When it is an emergency

You should seek immediate medical attention for a back itch associated with abscesses that grow in size or become severely painful, as well as if you have a high fever, nausea, or vomiting.

Back itch treatment quiz

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FAQs about back itch

What is postherpetic neuralgia?

Postherpetic neuralgia is a complication of shingles — a painful, itchy and blistering rash caused by the virus varicella zoster. Varicella zoster is a type of virus that can persist in the body and lie dormant in the peripheral nerves for years [3]. When it reactivates, shingles results. Even after the resolution of the initial rash, some individuals may continue to experience severe pain known as postherpetic neuralgia in the area. Often, shingles and postherpetic neuralgia occurs on the lower or upper back.

What is Pityriasis rosea?

Pityriasis rosea is an acute skin rash characterized by red, oval, and scaly lesions that often appear on the back [4]. See an image of pityriasis rosea here. Often, the rash is described as having a “Christmas tree” distribution on the back and can be extremely itchy. Fortunately, this rash is self-limited and often resolves on its own with minimal treatment.

Is a rash always associated with a back itch?

No. Rash is often associated with a back 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.

What are the complications of back itch?

Complications of back 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.

Are my symptoms of back itch temporary or chronic?

Your back itch can be either temporary or chronic depending on the underlying cause. Usually, once the allergen is eliminated or avoided, the back itch resolves. However, back itch associated with chronic conditions such as diabetes or liver disease can persist, especially without adequate treatment.

Questions your doctor may ask about back itch

  • Do you have a rash?
  • Is the red area flaky and rough to the touch?
  • Did your symptoms start after you were exposed to glues, fragrances, preservatives, hair dyes, soaps, detergents, or other common household chemicals?
  • Did your symptoms start after you were exposed to nickel (commonly found in jean snaps, metal pens, paper clips, cigarettes, etc.)?

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

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
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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References

  1. Pruritus. U.S. National Library of Medicine: MedlinePlus. Updated June 6, 2018. MedlinePlus Link
  2. Informed Health Online [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Eczema: Light therapy and oral medications. 2017 Feb 23. NCBI Link
  3. Shingles: Hope through research. National Institute of Neurological Disorders and Stroke. Published March 2015. NINDS Link
  4. Pityriasis rosea. American Academy of Dermatology. AAD Link