Itches all over but no rash? That can be the reason

Behind itching all over the body, which is accompanied by a rash, there are often internal diseases – such as the liver. What causes are possible.

Itching does not always only affect a specific area of ​​skin: it can also be felt all over the body. In some cases it is associated with a rash, in others the skin looks unchanged – apart from possible scratch marks.

If itching occurs more or less everywhere and no rash is visible, the cause is often diseases that affect the whole organism (systemic diseases). Sometimes some areas of the body itch more than others.

Possible causes of itching all over your body without a rash include:

• Diseases of the gallbladder and liver
• diseases of the kidneys
• dry skin, especially in old age
• reactions to medications
• diseases of the blood
• malignant tumors
• Hormonal and metabolic diseases
• Contact with irritating substances
• mental illness
• malnutrition
• Infections, such as HIV infection
• pregnancy

Itching without a rash can occur as part of a blockage of bile (cholestasis). The liver continuously produces bile. This is either temporarily stored in the gallbladder or gets into the small intestine via the bile ducts. In the case of cholestasis, however, the bile cannot flow into the small intestine, or not enough, so that it builds up. Certain areas of the skin may itch more than others.

Itching is often the first symptom that indicates liver or gallbladder disease. Possible causes are for example:

• primary biliary cholangitis and primary sclerosing cholangitis, two rare diseases associated with bile duct inflammation
• inflammation of the liver (hepatitis)
• Liver damage from drugs
• Narrowing of the bile ducts outside the liver, such as a gallstone

In addition to itching all over the body, bile stasis can cause other symptoms. This includes in particular yellowing of the skin and eyes.

Chronic kidney disease can also cause dry skin and itching all over the body, especially in advanced kidney failure. If the kidneys can no longer clean the blood sufficiently, various metabolites accumulate in the body (uraemia), which presumably triggers the itching. Exactly how, however, is unclear. It is often a persistent itching with no visible rash.

If the skin is too dry, itching all over the body can be the result. This is typically not accompanied by a rash.

This occurs particularly frequently in people of old age (pruritus senilis). This can be explained, among other things, by the fact that the production of sweat and sebaceous glands decreases with age. However, itching in old age can have many other causes and should therefore always be clarified by a doctor.

Certain active ingredients and groups of active ingredients trigger itching all over the body in some people. These include, for example:

• ACE inhibitors, such as those used to treat high blood pressure
• Bleomycin for the treatment of cancer
• certain antibiotics
• Painkillers from the group of non-steroidal anti-inflammatory drugs (NSAIDs)
• Quinidine used to treat cardiac arrhythmias
• Opioids such as morphine used to treat pain
• Chloroquine for the treatment of malaria

Sometimes a rash can also be seen. The itching usually goes away once the medication is stopped.

Itching can also be felt all over the body with certain blood disorders – with or without a rash. Possible causes are, for example:

• Polycythemia vera, a rare disease of the blood-forming cells in the bone marrow
• leukemia
• Cancers of the lymphatic system (malignant lymphomas)
• multiple myeloma, a malignant disease of the bone marrow

Itching with dry skin can also occur in the context of iron deficiency anemia, while a rash is absent.

Various hormonal or metabolic diseases can cause itching all over the body, for example with

• Diabetes mellitus,
• an overactive thyroid,
• Hemochromatosis, a condition in which iron builds up in the body, or
• increased uric acid levels (hyperuricaemia).

Many women suffer from itching during pregnancy. In most cases, it is due to dry skin or the increasing distention of the abdomen. It is then typical that the itching occurs without a rash. The high concentration of pregnancy hormones is probably also responsible for the tendency to itch.

There are many other possible causes of itching all over the body without a rash. For example, metal dust, glass wool, or dust can trigger the symptom. Various infectious diseases can also be accompanied by itching, such as HIV disease. In addition, neurological diseases such as polyneuropathy can cause itching and tingling.

Last but not least, itching all over the body can be psychologically caused, for example by fear or stress.

A special case is the so-called dermatozoa delusion: those affected are convinced that their body is infested with parasites and perceive tingling and itching. Delusional dermatozoa can, for example, be the result of a mental disorder or an organic brain disorder, but it can also be caused by drugs.

If the itching lasts longer than two weeks and/or other symptoms appear, those affected should have this clarified by a doctor. An earlier visit to the doctor is necessary if there are severe symptoms such as yellowing of the skin. It is also advisable to arrange a doctor’s appointment as soon as possible in the event of weight loss, fatigue or night sweats.