Is Itchy Skin a Symptom of Rheumatoid Arthritis? Here’s What to Know
August 30, 2024
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Yes, itchy skin can occur with rheumatoid arthritis (RA). It may be due to inflammation from RA itself or possibly from medication side effects, hives, or other related conditions.
RA is an autoimmune disease that primarily affects the small joints of the hands, wrists, feet, ankles, and neck.
RA is also a systemic condition, meaning it affects your whole body — not just your joints. It can affect your skin, including making it itchy or causing what some people refer to as “itching attacks.”
“My whole body itches, but not always at the same time or in the same place.”
– Julie, RA patient
“Sometimes I scratch without realizing it. Sometimes I can’t even find the itch.”
– Kaycee, RA patient
5 potential causes of itchy skin with RA
Different skin conditions are associated with RA, including rheumatoid nodules and rheumatoid vasculitis.
Changes to your skin can also occur from medication use, including injection site reactions or sun sensitivity.
Having itchy skin is also sometimes reported by patients, though we don’t know just how often it occurs and it’s not currently featured in research so far.
There are several reasons why itchy skin with RA could occur:
1. Overactive immune system and chronic inflammation
RA is an autoimmune condition. This means your immune system is overactive and mistakenly attacks your healthy body cells. This can result in inflammation, including inflammation of your skin, which can present as dry, irritated, or itchy skin.
Inflammation of your joints, including associated symptoms like swelling, can also mean your skin might be stretched, leading to itchy skin.
2. Medication side effects
Itchy skin is a rare side effect of some RA medications.
Hydroxychloroquine can cause skin changes, which could result in itchy skin. This can be mild or more serious. Other medications can contribute to dehydration, which can lead to dry and itchy skin, too.
If you notice skin itching as a new symptom, you should call your rheumatologist right away.
Usually, treatments for this reaction include symptom management, including emollients and corticosteroids to soothe itchy skin. But ultimately, the medication may need to be stopped and an alternative found.
“Hydroxychloroquine ramped up my itching after starting on this. I use lotions with tea tree oil, menthol, cortisone creams, and lidocaine rollers (like Salonpas) to help manage my symptoms.”
– Jourdan, diagnosed with RA in 2019
“I recently started Olumiant and I noticed this made my dry skin much worse. I avoid hot showers and use Vaseline after to moisturize my skin. I also take an antihistamine when I need it.”
– Retha, diagnosed with RA in 2023
3. Hives
Hives, or urticaria, are raised bumps that may appear red, pink, or flesh-colored on light skin and flesh-colored on brown or black skin. Hives can be itchy.
They’re usually caused by an allergic reaction, but they can also occur without any identifiable cause — and this could be related to your immune function.
There’s a type of chronic hives that’s more common in people living with autoimmune diseases, like RA.
If your hives are a new symptom and are associated with dizziness, shortness of breath, tongue and throat swelling, or chest tightness, these are more serious signs of an allergic reaction. You should call 911 or go to the nearest emergency room.
This could be an allergic reaction to your RA medication, or an allergic reaction to something else completely unrelated.
“I have hives and itching on my arms, shoulders, neck, back, and face. The itching is so bad sometimes that it burns. A course of steroids didn’t even get rid of them.”
– Kim, RA patient
4. Eczema
Eczema, or atopic dermatitis, is dry and itchy skin that varies in severity from a small area to a large area of open, blistered skin that oozes clear fluids.
It may appear red or pink on light-colored skin tones and darker than the surrounding area, or have a gray, purple, pink, or red hue on dark skin tones.
People living with eczema have a higher likelihood of developing RA. However, people living with RA don’t appear to have a higher risk of developing eczema.
5. Other autoimmune and inflammatory conditions associated with RA
There’s a link between RA and other inflammatory conditions that can affect the skin.
Sweet syndrome is an inflammatory skin condition that can present as tender or painful bumps or lesions on the skin, among other symptoms. It could be a potential cause of itchy skin.
The causes of this skin condition are not fully understood, but one possibility is the presence of an existing inflammatory condition, such as RA. It’s a very rare skin condition, though.
Sjogren’s syndrome is an autoimmune condition that affects moisture-producing glands. It can cause dry eyes, dry mouth, and dry skin that cracks and itches. It frequently occurs with another autoimmune condition, and research suggests about 20% of reported Sjogren’s cases occur with RA.
How can you determine the cause of your itchy skin?
The cause of your itchiness can be difficult to determine, and sometimes skin conditions can cause similar symptoms.
If your itchy skin occurs during a flare or is located near a swollen or painful joint, it could be related to inflammation from RA.
If itchy skin is a sudden new symptom and lines up with taking a new medication, it could be a side effect and you should let your rheumatologist know.
You might be able to identify hives by their raised bumps. These could be directly related to your RA. But if they’re accompanied by other symptoms, such as shortness of breath, they could be a sign of an allergic reaction and you should get medical care immediately.
To determine whether your itchy skin is a symptom of another condition, such as eczema or Sjogren’s syndrome, a doctor can help diagnose with an assessment, blood test, and possibly a skin biopsy.
“I’ve always had RA and I’ve always had dry skin. I’m honestly not sure if they’re connected. Moisturizing 1 to 2 times a day helps, and avoiding chlorine in pools helps, too.”
– Meg, diagnosed with RA in 2016
7 treatments and remedies for itchy skin
The best way to prevent RA-associated itching is to first manage your RA as best as possible.
Take your medications as prescribed, stay active, eat a nutritious and well-balanced diet, prioritize sleep, and practice other self-care habits that optimize your overall health.
Whether your itchy skin is known to be associated with your RA or not, you should always make sure to discuss any new symptoms with a doctor to update your treatment plan accordingly.
Of course, even with the best treatment plan and intentions, symptoms and side effects can still occur.
Soothing itchy skin can be testing, but here are some tips that should help:
1. Try not to itch
Although this can be challenging, try to avoid scratching your skin when possible.
Healthy bacteria live on your skin, and when you scratch too much and too often, you can disturb these bacteria and break the skin’s protective barrier.
Pro tip
If you itch a lot in your sleep, wear long sleeves, pants, gloves, or socks.
2. Moisturize
Use a high quality moisturizer. This is particularly effective if your skin is dry as well.
Usually, thicker products offer more moisture. Avoid products with dyes and perfumes, as these can sometimes irritate skin and make any current concerns worse.
The best time to apply moisturizer is right after a shower or bath when your skin is still slightly damp and your pores are open. If your dry and itchy skin seems worse at night, moisturize before bed.
You can help seal in the moisture by wearing clothing, gloves, or socks on top of the moisturizing product.
Opt for moisturizing body soaps in the shower to avoid stripping your skin of moisture.
“I have struggled with extreme dry skin ever since my RA diagnosis. I apply mineral oil (baby oil) immediately out of the shower.”
– Stephanie, diagnosed with RA and Hashimotos thyroiditis in 2019
3. Cooler showers
Turning down the temperature of your water while showering may help, too.
Taking very hot showers or baths can dry out the skin, making any concerns worse.
When you dry off, gently blot your skin with a towel. Wiping roughly can also strip moisture from your skin, making dry, itchy skin worse.
4. Humidify
Central heating and central air conditioning can contribute to dry skin.
If needed, you can use humidifiers in your home and workspace to add moisture to the air.
“When I travel on an airplane, I always put vaseline in my nose, on my lips, and on my feet under my socks to avoid the extreme dryness I always experience after a plane ride.”
– Stephanie, diagnosed with RA and Hashimotos thyroiditis in 2019
5. Diamine oxidase (DAO)
Although more research is needed, diamine oxidase (DAO) is an over-the-counter enzyme that may help break down excess histamine in the body, which could help manage itchy skin. DAO can sometimes be used to manage chronic and spontaneous hives with no known cause.
Always check with a doctor before starting any new medications.
“After starting DAO supplementation, I noticed a marked difference with my incessantly itchy skin.”
– Jourdan, diagnosed with RA in 2019
6. Wear sunscreen
Sun exposure and sunburns dry out the skin, which can make itchy skin worse. Using high quality sunscreen and reapplying it when you’re outside or in water for more than 90 minutes can help your skin retain moisture by avoiding burning.
“When I work outside all day, I use a timer on my phone to remind me to reapply my sunscreen every 90 minutes. At the end of the day, after I’m inside and cooled off, I apply lotion to avoid getting too dried out.”
– Mary, RA patient
7. Stay hydrated
Drinking enough water throughout the day can help prevent dry and itchy skin. Aim for 11 to 15 cups per day, unless you’ve been very active or are in the heat, then you likely need more.
“The weather changes can make my dry, itchy skin worse. Using a moisturizer and staying hydrated help me control my dry skin. Managing my stress helps too.”
– Jen, diagnosed with RA in 2012
The takeaway
RA not only affects your joints, but it can also affect your skin.
Chronic inflammation from your RA could cause itchy skin. Other causes may include medication side effects, hives, or other autoimmune conditions such as Sjogren’s syndrome.
It can be hard to determine the exact cause, but sticking to your RA treatment plan and keeping up with skin health practices — such as wearing SPF, hydrating, and moisturizing — can help prevent skin irritations.
Medically reviewed on August 30, 2024
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