Anxiety and itching may seem like unrelated issues, but they are actually more connected than you might think. Itching is one of the lesser-known physical symptoms of anxiety, and many people experience this sensation during periods of high stress.
You might have noticed a tingling or crawling feeling on your skin, an uncontrollable urge to scratch, or a subtle irritation that seems to pop up out of nowhere—especially in situations where you’re feeling anxious, overwhelmed, or nervous.
When you experience an itch during a stressful moment, it can draw your attention to the sensation, making it feel more intense. The more you focus on the itch, the more anxious you might become. This can lead to a vicious cycle—the anxiety makes the itching worse, and the itching, in turn, makes you more anxious.
On the other hand, if you find that feeling itchy becomes something to obsess over and control, this could be a sign of obsessive-compulsive disorder (OCD). Somatic OCD, a subtype of OCD, can cause you to fixate on physical sensations, like itching, or feel an overwhelming need to perform rituals to relieve these sensations.
In this article, we’ll explore how anxiety can impact how your skin feels and what you can do if you are experiencing anxiety-related dermatological concerns.
How anxiety causes itchy skin
Anxiety is a complex reaction to worrying about future events. It involves both mental and physical responses as the body prepares for what it thinks is a threat—even if that threat may not be real.
Anxiety can serve as a natural motivator, keeping us alert and prepared for potential challenges. In small amounts, anxiety can help us focus, meet deadlines, or avoid mistakes. However, when anxiety becomes chronic or excessive, it can become counterproductive, leading to stress, fatigue, and even physical health problems. For example, the constant worry and tension that come with anxiety can make it difficult to concentrate, disrupt sleep patterns, and lower our ability to make decisions. This kind of ongoing stress not only affects mental health but can also take a toll on the body
“Chemical processes, when it comes to anxiety, involve several neurotransmitters and hormones, including norepinephrine, serotonin, dopamine and gamma-aminobutyric acid (GABA),” explains NOCD therapist Tracie Zinman-Ibrahim, LMFT, CST. “As a result, people can get itches, hives, heart racing, sweating, feeling hot, shaking, tight chest, shallow breathing, and a whole lot more somatic symptoms as well.”
The amygdala is a key brain region involved in generating fear responses and anxiety. These same areas are frequently activated during experiences of itch and scratching. When we experience stress, the release of stress hormones like cortisol can trigger sensory symptoms such as itching or a burning sensation. Additionally, raised levels of cortisol have been shown to increase skin inflammation, impair skin barrier function and wound healing, and suppress immunity.
It’s important to remember that the physical symptoms of anxiety can differ from one person to another. Some people may scratch, rub their skin, or engage in sensory stimulation, to self-soothe and relieve anxiety. These behaviors, often referred to as “self-soothing” techniques, can help provide a temporary sense of comfort or distraction in moments of heightened stress. By focusing on the physical sensation, people may shift their attention away from anxious thoughts and redirect their energy into a repetitive, calming activity.
Anxiety and skin conditions
A 2016 study found that several skin conditions, including itching, are common in people experiencing stress, have psychological conditions such as anxiety, or going through a major life event.
Other skin conditions that may be impacted by anxiety include:
- Psoriasis: The autoimmune skin condition is characterized by the rapid growth of skin cells. Stress and anxiety are common triggers for psoriasis flare-ups and can also intensify itching caused by the condition.
- Acne: The common skin condition is marked by an overgrowth of bacteria, increased sebum production, and inflammation. However, some studies found that increased acne severity is significantly associated with stress levels.
- Eczema: In people with eczema, stress contributes to immune and inflammatory dysfunction and leads to increased sensitivity to allergens. Additionally, the discomfort and visible symptoms of eczema can itself be a source of anxiety, creating a cycle where stress worsens eczema, and eczema exacerbates stress.
- Rosacea: Stress and anxiety can increase inflammation, which can contribute to rosacea flare-ups. Anxiety can directly impact the blood vessels in the face and worsen the redness and flushing commonly associated with rosacea.
When itching may be a sign of something else
Certain mental health disorders can also further exacerbate physical symptoms. Obsessive-compulsive disorder (OCD) is a chronic mental health condition characterized by a cycle of obsessions and compulsions.
Obsessions are recurrent intrusive thoughts, images, feelings, sensations, or urges that cause distress or anxiety. In somatic OCD specifically, obsessions center on physical sensations that you can’t control. You may focus on the feeling of breathing, blinking, swallowing, or the sensation of movement in your muscles. These sensations may be completely normal, but you may become hyper-aware of them, and the anxiety surrounding the lack of control over these functions intensifies.
Some somatic OCD obsessions can look like:
- “I can’t stop itching my arms. What if I’m doing more damage by scratching?”
- “What if this itch means something is seriously wrong with my skin?”
- “What if I’m allergic to something, but I don’t know what it is?”
- “I have a bump on my skin. What if it’s a skin cancer I didn’t notice before?”
- “Why do my hands feel numb? What if it’s a neurological disorder?”
Obsessions can range from a variety of bodily experiences, such as feeling an itch, discomfort, or even sensations that aren’t necessarily there. A person with somatic OCD may fixate on these sensations and feel compelled to perform certain actions, known as compulsions, in an attempt to alleviate their anxiety.
Somatic OCD compulsions can look like:
- “I have to touch or scratch my skin repeatedly until the sensation feels ‘just right’ or goes away.”
- “I keep googling my symptoms to make sure I’m not missing anything serious.”
- “I keep checking my skin to make sure there’s nothing wrong, but I can’t stop thinking there might be something I missed.”
- “Is it normal to have these physical sensations or is there something wrong with me?”
- “I don’t want to wear certain clothing because it might cause my skin to itch.”
Although these compulsions may provide temporary relief or distraction from the anxiety, they ultimately reinforce the OCD cycle. The more you check, scratch, or seek reassurance, the more your brain interprets the sensation as something dangerous or abnormal, making the obsessions worse over time.
The best treatment option for somatic OCD
Like all types of OCD, exposure and response-prevention (ERP) therapy is the best course of treatment for somatic OCD. Working with a specialized therapist, you’ll confront your intrusive thoughts and triggers, and instead of responding with compulsions, you’ll learn to sit with the discomfort that these thoughts cause.
In ERP, you’ll start with less distressing situations or triggers related to your somatic OCD and gradually work your way up to more difficult ones. For example, if you have an intrusive thought about itching or a specific bodily sensation, you might begin by exposing yourself to the sensation in a controlled way without engaging in the compulsion of checking or itching. You may also work to stop seeking reassurance from friends, family, or even medical professionals, as this can reinforce the cycle of anxiety and checking. Instead, you’ll focus on accepting uncertainty and building trust in your body’s ability to manage discomfort without constant validation.
How to treat anxiety itching
Generally, if anxiety itching is persistent, severe, or impacting your daily life, it’s important to see a healthcare provider, advises Ibrahim. Treatment for itching can vary widely depending on the underlying cause, so it’s important to first identify the root of the issue. If you think your itching is a result of a skin condition, it’s a good idea to consult with a dermatologist to receive a formal diagnosis and treatment plan.
If anxiety is an underlying issue, you should reach out to a therapist who can help you manage your symptoms. However, if you think you’re experiencing OCD in connection to itching or bodily sensations, it’s best to work with a therapist who specializes in ERP.
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All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Key Takeaways
- Itching and anxiety can be interconnected. For example, the anxiety you feel can lead to a heightened awareness of sensations on your skin, causing you to focus on the itch and make it feel more intense.
- Somatic OCD can cause intrusive thoughts and compulsive behaviors related to physical sensations, like itching. The constant focus on the sensation can make it worse, creating a cycle of anxiety and scratching.
- Finding the root cause of itching is important to determine what treatment option is best for you. If itching is caused by skin conditions, reaching out to a dermatologist may be helpful. On the other hand, if itching is caused by anxiety or conditions like somatic OCD, addressing the underlying psychological cause is key.