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Rheumatoid Arthritis and Itching Attacks

Updated on October 24, 2022
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Laurie Berger

If you experience persistent and painful itching with rheumatoid arthritis (RA), you’re not alone. Although itching is not a “classic” symptom of RA, myRAteam members are frequently affected by prickly skin patches, rashes, and hives.

“I’ll scratch and scratch. It makes me crazy!” reported one member. “It feels like something is crawling on me,” said another. “I’m literally digging myself raw,” added one member.

What Causes Itching With RA?

Itchy skin in people with RA may be caused by some RA medications, result from other health conditions, or may be associated with RA itself.

RA Medication

The reason for itching that myRAteam members report most frequently is adverse reactions to RA medications. These reactions include general itching or hives — itchy, raised bumps that may indicate an allergic reaction. Disease-modifying antirheumatic drugs (DMARDs) like methotrexate may cause itching. Biologics might also cause itching because of their impact on the immune system.

Hives can cause persistent, painful itching in some people with rheumatoid arthritis. The raised welts may be pink, red, brown, or black, depending on the skin’s natural color. (CC BY-NC-ND 3.0 NZ/DermNet)

“Since my first Rituxan (rituximab) infusion, I’ve been itching,” one member wrote. “It’s an unbearable itch; the worst areas are on my hands and feet.”

Members have reported that some pain medications prescribed for RA joint pain trigger “unbearable” itching. “Does Tramadol make anyone else itch like crazy!?” asked one member. “It has been a lifesaver, but I can only take it at night because I also need Benadryl to prevent scratching.”

Another member agreed: “I had crazy itching and a pimply rash between my fingers from Tramadol. It’s now on my allergy list.”

If you experience itchy skin and/or hives from taking an RA medication, contact your doctor immediately. They will help you determine if you’re allergic to the medication, whether you should stop taking it, and can suggest an alternative, if necessary.

RA Inflammation

Some members of myRAteam complain of itching from inflammation caused by RA. “I get itchiness around the joints when swelling is occurring,” explained one member.

Research studies have found that RA and other inflammatory autoimmune conditions are associated with chronic hives. Medically known as urticaria, hives are typically very itchy and can be acute (lasting less than six weeks) or chronic (lasting longer than six weeks). Although hives may be a sign of an allergic reaction to a product or medication, it’s less clear what might cause chronic hives in people with RA.

Other Conditions

Other health conditions, whether or not they’re related to RA can trigger itching.

A small percentage of people with severe, long-term RA may be at risk of rheumatoid vasculitis, a related condition involving inflammation of blood vessels that causes itchy skin and eyes. “My rheumatologist is looking at vasculitis as another add-on to my diagnosis,” shared one member.

Rheumatoid vasculitis involves inflammation of blood vessels, manifesting as an itchy rash in a small percentage of people with severe, long-term rheumatoid arthritis. (CC BY-NC-ND 3.0 NZ/DermNet)

Another member shared, “Many of us also have fibromyalgia, which can feel like ants are crawling all over your body, especially during the night.”

Other health conditions that cause itching include allergies, psoriasis, eczema, liver or thyroid disease, certain types of cancer, multiple sclerosis, diabetes, and shingles. It’s possible to have RA and one or more of these conditions.

The raised, scaly plaques (patches) of psoriasis can cause itchy skin in people with rheumatoid arthritis. (CC BY-NC-ND 3.0 NZ/DermNet)

“I have skin issues that I thought were eczema,” said one myRAteam member. “After getting a diagnosis, it’s definitely psoriasis.”

Scratching Itchy Skin

Uncontrolled scratching of itchy skin from any cause can create more inflammation, which can result in more itching. This process is known as the itch-scratch cycle.

Persistent scratching can also lead to skin disfigurement and deformities. “Whenever I scratch around a knuckle, a more pronounced bump appears a day or two later,” one myRAteam member said. “The joints in some of my fingers and toes are starting to show damage [from itching],” shared another.

Itching With RA: Members’ Remedies

Doctors typically recommend topical corticosteroids, oral antihistamines, and over-the-counter medications like Benadryl to reduce itching from various causes. Members of myRAteam often pair those medications with their own home remedies. Talk to your doctor if you have itchy skin. They can help you determine whether this itching is related to your RA or a different condition and how to best treat it.

Hot or Cold Compresses

“I find immediate relief from applying a wet washcloth to my feet. It can be cold, warm, or hot, whatever you want at the time. Many nights, I fall asleep with these wet cloths on the itchy area. No more itching! Just sleep,” said one member.

Ice or Cooling Products

“An ice pack will take the itching away,” said another. “It’s my sister’s favorite thing. If I tell her this or that itches, she says, ‘Put ice on it.’ Since she’s older and bossy, I do what she says!”

One member described using a cooling gel to help with their itchy skin: “I use either [lidocaine cream] or a roll-on cooling gel.”

Coconut Oil

“For dry, itchy skin, coconut oil works wonders. I slather myself up some nights — coconut oil in my hair and on my face. By morning, everything feels moisturized. And coconut oil doesn’t leave oily marks on my pillow like some other oils do,” wrote a member of myRAteam.

Cannabidiol (Where Legal)

“I’ve been using a couple of drops of CBD (cannabidiol) oil on the palms of my hands, and it has really helped the itchiness,” shared one member.

Oatmeal Baths

Another myRAteam member recommended the following strategy: “Grind up oatmeal and use it to make a soak for your legs — or make a paste out of it and apply to itchy spots.”

Make sure to consult with your rheumatology care provider or dermatologist before starting a new remedy for itching. Any over-the-counter or new product brings the risk of an allergic reaction or side effects, or it could interact with one of your current medications. To avoid making your itching worse, discuss at-home remedies with your doctor or a dermatologist.

Talk To Others Who Understand

On myRAteam, the online social network and support group for those living with RA, members talk about a range of personal experiences including itching. More than 197,000 members come together to share their stories, ask and respond to questions, and offer support.

Have you experienced itching and RA? How do you manage your symptoms? Go to myRAteam today and start — or join — a conversation. You’ll be surprised how many others share similar stories.

Updated on October 24, 2022
All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Laurie Berger has been a health care writer, reporter, and editor for the past 14 years. Learn more about her here.

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