Itchy skin in menopause: dryness, crawling sensations, and how to get relief

It starts on your shins, or your back, or somewhere you can't quite reach. Lotion helps for an hour. Some nights it feels like ants are walking across your arms. If you're in perimenopause or past menopause, you're not imagining it, and you're definitely not the only one scratching.

Is itchy skin really a menopause symptom?

Yes. The NHS lists skin changes, including dry and itchy skin, among menopause symptoms. A 2022 dermatology review in Clinical and Experimental Dermatology notes that itching is frequently seen in postmenopausal women, usually together with dry skin (doctors call it xerosis).

Why menopause makes skin dry and itchy

Estrogen helps keep skin thick, plump and well sealed. When it drops, a few things happen:

• Collagen falls fast. The same review reports that skin loses nearly a third of its collagen in the first five years after menopause, then about 2.1% a year over the following 15 years.
• The barrier weakens. More water escapes through the skin, which leaves it dry and more reactive.
• Skin gets touchier. Drier skin can be more sensitive to irritants like harsh soaps and detergents.

MedlinePlus advises avoiding prolonged heat and humidity when your skin is itchy, which is one more way hot flashes and night sweats can pile on.

What about crawling skin (formication)?

Formication is the feeling of insects crawling on or under your skin when nothing is there. It's a type of paresthesia, meaning an abnormal skin sensation like tingling or prickling. It's reported during menopause but considered uncommon, and good research on it is thin. We couldn't find solid data on how often it happens or exactly why.

What we can say: crawling, tingling or numb sensations have many possible causes besides menopause, including diabetes, an underactive thyroid, low B vitamins and some medicines, according to MedlinePlus. So if this is new for you, it's worth getting checked rather than assuming it's hormones.

What helps: dermatologist-approved basics

The American Academy of Dermatology's dry skin advice is simple, cheap and works for a lot of us.

MedlinePlus adds a few more: keep nails short, try not to scratch, use cool compresses, and consider an oatmeal bath. The 2022 dermatology review also mentions low-pH emollients at least once a day, humidifiers, shorter baths and avoiding soap for postmenopausal itch. The AAD suggests checking with a dermatologist before using anti-itch creams.

Can hormone therapy help skin?

Some evidence says yes. The dermatology review reports that estrogen therapy can raise skin collagen back toward premenopausal levels, with changes seen as early as three months, and that transdermal estrogen can improve barrier function. It concludes hormone therapy can reduce or reverse some menopausal skin changes. That said, skin isn't usually the main reason to start hormones, and no one should start them for itch alone without a full conversation about benefits and risks. If you're weighing it for other symptoms too, start with what changed with HRT labels.

Itching down there

Vulvar and vaginal itching after menopause is often part of genitourinary syndrome of menopause, which responds well to treatment. See vaginal dryness in menopause. But one condition deserves a mention: lichen sclerosus causes itchy white patches, usually around the vulva and anus, and is much more common in women over 50. It needs a prescription treatment and regular checks, so see a clinician if you notice an itchy white patch.

When itching is not menopause

Itching can be a sign of something else, so don't let anyone (including you) wave it off as "just hormones." Mayo Clinic and MedlinePlus list causes such as:

• Skin conditions like eczema, psoriasis, hives or scabies
• Liver disease or kidney disease
• Iron deficiency anemia
• Thyroid problems and diabetes
• Certain cancers
• Nerve problems such as shingles
• Medicines, including opioid pain relievers and some antibiotics

When to call your clinician

• Itching that lasts more than two weeks and doesn't improve with self-care.
• Itching all over your body, or that came on suddenly without an obvious reason.
• Itching with weight loss, fever or night sweats.
• Yellowing skin or eyes, or itching with other unexplained symptoms.
• Itch so severe it disrupts your day or your sleep.
• An itchy white patch on the genitals, or a lump, thickened skin or sore that won't heal there.
• Call 911 if tingling or numbness comes with sudden weakness, trouble speaking, vision changes or confusion.

Questions to ask your clinician

1. Could this be menopause-related dry skin, or should we check for other causes?
2. Do you recommend blood tests, such as thyroid, iron, liver, kidney or blood sugar?
3. Could any of my medicines be causing this?
4. Is this crawling or tingling feeling worth a nerve evaluation?
5. Would hormone therapy make sense for my overall symptoms, and might it help my skin?
6. Should I see a dermatologist?

Itch is easy to dismiss in a 15-minute visit. Write down when it started, where it is and what you've tried. Our doctor visit playbook helps you make sure it gets taken seriously. And if it's part of a bigger cluster of changes, our full symptom list may connect some dots.

Questions

Can menopause cause itchy skin?

Yes. The NHS lists dry, itchy skin among menopause symptoms. Lower estrogen reduces collagen and weakens the skin barrier, so skin loses water and gets irritated more easily.

What is formication in menopause?

Formication is the sensation of insects crawling on or under the skin. It's a type of paresthesia that's reported during menopause but considered uncommon. Because diabetes, thyroid problems, low B vitamins and medicines can cause similar sensations, it's worth getting checked.

Does HRT help with itchy skin?

A 2022 dermatology review reports that estrogen therapy can increase skin collagen and improve barrier function, and can reduce some menopausal skin changes. It's not usually a reason to start hormones on its own, so discuss your full picture with your clinician.

When is itchy skin a sign of something serious?

See a clinician if itching lasts more than two weeks despite self-care, affects your whole body, or comes with weight loss, fever or night sweats. Liver, kidney, thyroid and blood conditions, and some cancers, can cause itching.

Keep reading

• Night sweats in perimenopause: why they happen, how to get relief, and when it's not menopause
• Early signs of perimenopause: can it really start in your 30s?
• How long does perimenopause last, and how long do the symptoms stick around?
• Perimenopause blood test: can FSH or any lab really tell you where you are?
• Menopause and your bones: osteoporosis risk, bone density scans and what protects you
• Do menopause supplements work? An honest look at black cohosh, soy and the rest

Education and personal experience, not medical advice. Talk with your own clinician before making health decisions.