Itchy hands can be caused by a number of different conditions, but most commonly it is associated with a nutritional deficiency. Some of the main deficiencies that can lead to itchy hands include iron deficiency, vitamin B12 deficiency, and zinc deficiency. Understanding the causes and getting proper treatment is important, as persistent itchiness can negatively impact daily life.
Iron Deficiency
One of the most common nutritional deficiencies, iron deficiency is a frequent cause of itchy hands. Iron helps produce hemoglobin, a protein found in red blood cells that carries oxygen. When iron levels are low, the body cannot produce enough hemoglobin, leading to anemia. This causes less oxygen to reach tissues throughout the body, including the hands, resulting in itchiness.
Some statistics on iron deficiency include:
- Worldwide, iron deficiency is the most common nutrient deficiency, affecting over 2 billion people
- Women and young children are most at risk since they lose blood regularly through menstruation and growth spurts
- Up to 20% of women, 50% of pregnant women, and 3% of men in developed countries have iron deficiency
- In developing countries, the rates of iron deficiency are even higher, affecting up to 80% of pregnant women and preschool children
The main symptoms of iron deficiency include:
- Fatigue and weakness
- Pale skin
- Shortness of breath
- Dizziness or headaches
- Strange cravings to eat non-food items like dirt or ice (known as pica)
- Difficulty concentrating
- Itchy skin
Itchy hands can develop as iron builds up in tissues due to improper transport and utilization in the body. Iron deficiency can also lead to inadequate oxygen supply to skin cells, resulting in itchiness.
Iron deficiency is diagnosed through blood tests measuring ferritin levels. Ferritin is a protein that stores iron in the body. Low ferritin corresponds to diminished iron reserves.
Treatment involves iron supplementation, either through diet changes or direct oral iron tablets. Foods rich in iron include red meat, seafood, nuts, beans, and spinach. Iron tablets are also readily available but can cause digestive side effects like nausea, constipation, or diarrhea. Vitamin C aids iron absorption while calcium, tea, and coffee can inhibit it if taken at the same time as iron.
Vitamin B12 Deficiency
A lack of vitamin B12 is another key nutritional deficiency leading to itchy hands. Vitamin B12 plays a vital role in many body processes including red blood cell formation, neurological function, and DNA production.
When levels of vitamin B12 are inadequate, it negatively impacts cell growth and health. This can affect skin cells and nerves, resulting in possible itching, tingling, or numbness in the hands that may come and go.
Statistics on Vitamin B12 Deficiency
- It’s estimated that vitamin B12 deficiency affects around 6% of people under 60 years old, and 20% of those over 60 years old.
- People over 50 are at a higher risk of B12 deficiency because as we age, we produce less stomach acid which is needed to separate B12 from foods.
- Vegans and vegetarians have a higher chance of deficiency since B12 is naturally found in animal products.
- Certain medical conditions like celiac disease, Crohn’s disease, and atrophic gastritis affect the absorption of B12 and can predispose people to deficiency.
- Long term use of acid-reducing medications like omeprazole and metformin for diabetes can also decrease B12 absorption from food.
In addition to itchy hands, some other symptoms of vitamin B12 deficiency include:
- Fatigue and weakness
- Pale skin
- Numbness and tingling in extremities
- Difficulty thinking and confusion
- Depression
- Vision changes
Vitamin B12 levels can be checked through a simple blood test. Deficiency is defined as a blood level less than 200 pg/mL.
Treatment is vitamin B12 supplementation, either through pills, sublingual tablets, nasal spray, or monthly injections. High dose oral supplementation of 1000-2000 mcg per day may be required, especially for those with absorption issues. Food sources of B12 like meat, eggs and dairy can also help restore adequate levels.
Zinc Deficiency
Zinc is an essential mineral that is involved in many enzymatic processes in the body. It plays a key role in immune function, protein synthesis, DNA metabolism, and cell division.
Low levels of zinc can result in improper keratinization and epithelial tissue function. This can manifest as skin rashes, dermatitis, and dry itchy skin like on the hands and feet.
Key Zinc Deficiency Statistics
- It’s estimated about 17% of the global population has inadequate zinc intake or absorption.
- Deficiency is highest in developing countries, affecting an estimated 31% of people in South Asia and Sub-Saharan Africa.
- Vegetarians and older adults are at a higher risk of deficiency.
- Alcoholism, digestive diseases, diabetes, and sickle cell disease can increase chances of zinc deficiency.
Along with itchy hands, other zinc deficiency symptoms can include:
- Rashes and dry flaky skin
- Hair loss
- Frequent infections
- Diarrhea
- Loss of appetite
- Impaired wound healing
- Depression
Testing for zinc deficiency involves a simple zinc blood test. Normal ranges are 60-130 mcg/dL.
Zinc deficiency can be treated through oral zinc supplementation, with dosage based on the severity of deficiency. Zinc gluconate, acetate or citrate are commonly used forms. Foods high in zinc like oysters, beef, nuts and legumes can also help restore levels.
Other Nutritional Deficiencies Related to Itchy Hands
While not as common as the major deficiencies described, a few other nutritional shortcomings may potentially contribute to itchy hands:
Vitamin A Deficiency
Vitamin A supports skin health by promoting cell growth and turnover. Inadequate vitamin A can lead to keratinization defects, causing dry, scaly, itchy skin.
Essential Fatty Acids
Essential fatty acid deficiency impairs skin barrier function. This can cause increased moisture loss and dryness leading to eczema, itching and dermatitis.
Vitamin D Deficiency
Vitamin D modulates immune responses in the skin. Deficiency may increase susceptibility to skin inflammation and itching.
Vitamin E Deficiency
Vitamin E is an antioxidant that protects cell membranes against damage. Low levels are linked to skin irritation and contact dermatitis.
Biotin Deficiency
Biotin aids in keratin production which forms the skin barrier. Inadequate intake can result in seborrheic dermatitis and itchy rashes.
Testing levels of these nutrients may be warranted if diet history suggests potential insufficiency or skin symptoms are unresponsive to treatment of major deficiencies like iron, B12 and zinc. However, they are less likely overall causes of isolated itchy hands.
Medical Causes of Itchy Hands
While nutritional deficiencies are a prime culprit, itchy hands can stem from certain medical conditions including:
- Kidney disease – Buildup of waste products causes uremic pruritus and itchy skin.
- Liver disease – Itching occurs as bilirubin accumulates in tissues.
- Diabetes – High blood glucose levels can damage nerves causing itching.
- Thyroid disorders – Both low and high thyroid hormone can alter skin function.
- Cirrhosis – Scarring of liver tissue leads to accumulation of bile acids.
- Lymphoma – Cancerous lymphocytes infiltrate the skin.
- STDs – Sexually transmitted diseases like herpes and HPV cause itching.
Diagnostic testing like liver enzymes, kidney function tests, glucose level and thyroid hormone levels can help uncover any underlying medical issues. Skin biopsies may also be done. Treatment of the primary disorder along with topical creams, antihistamines and baths can provide relief from itching.
Other Factors That Can Cause Itchy Hands
In addition to internal medical issues, external and environmental factors that commonly provoke hand itching include:
- Dry skin – Cold dry weather, low humidity, harsh soaps and frequent hand washing rob moisture from skin.
- Contact dermatitis – Allergic reaction to poison ivy, metals, creams, soap or other irritants.
- Insect bites – Bites from mosquitoes, bees, spiders or bed bugs cause itchy bumps.
- Psoriasis – Common chronic skin condition that causes red, scaly plaques.
- Eczema – Immune reaction and inflammation induces dry, itchy rashes.
- Fungal infections – Ringworm, athlete’s foot and Candida yeast can infect hands.
- Sunburn – UV radiation damages the skin causing pain and itching.
Avoiding triggers like irritants, proper care of insect bites, and using moisturizers can alleviate external itching causes. Medicated ointments, anti-itch creams, phototherapy and oral medications help manage chronic skin conditions.
When to See a Doctor
Occasional mild itching may be bothersome but not an outright medical concern. However, you should consult a doctor or dermatologist if you experience:
- Constant itching that severely impacts sleep and activities
- Itching not relieved by over-the-counter topical steroids and antihistamines after 1 week trial
- Significant skin damage like bleeding, oozing or scabbing from repeated scratching
- Itching accompanied by worrisome symptoms like weight loss, fatigue and fever
- Failure of itching to improve after correction of nutritional deficiencies
- Itching that begins suddenly and spreads quickly
Evaluation by a medical professional can help determine if there is an underlying condition behind severe, persistent itching that requires specific treatment beyond general symptomatic relief.
Diagnostic Tests
To get to the root cause of itchy hands, doctors may first perform a physical exam, ask about your medical history, and order certain diagnostic tests including:
- Blood tests – Complete blood count, liver enzymes, bilirubin, glucose, kidney function, zinc, iron, B12 and other vitamin levels
- Skin biopsy – Removal of a small skin sample to check for fungal infection, eczema, psoriasis, and other skin disorders
- Allergy testing – Patch testing to identify potential environmental and contact allergies
- Thyroid tests – Levels of thyroid hormones T3 and T4, thyroid stimulating hormone (TSH)
Based on initial results, more targeted testing may be ordered such as hepatitis panel, ANA (autoantibodies), SPEP (abnormal blood proteins), and serum protein electrophoresis if results suggest an underlying systemic illness.
Treatment Options
Treating the root cause, if identified, is key to resolving chronic itchy hands. Possible treatment approaches include:
- Correcting nutritional deficiencies with diet changes and supplements
- Phototherapy or systemic medications for dermatological diseases
- Steroids or immunosuppressants for autoimmune and inflammatory conditions
- Antiviral medications for infectious causes
- Thyroid hormone therapy for hypothyroidism
- Medications and dialysis for kidney failure
Symptomatic relief can be provided with:
- Corticosteroid creams and ointments
- Oral antihistamines like diphenhydramine, hydroxyzine, or cetirizine
- Topical anesthetics and anti-itch agents containing pramoxine or menthol
- Wet wrap therapy – wet gauze overlaid with a dry bandage to soothe eczema
- Phototherapy with UV light applied to hands
Lifestyle and home remedies that can further reduce itching include:
- Using gentle, fragrance-free moisturizing lotions and thick creams after bathing
- Avoiding harsh soaps, detergents and cleaning products
- Humidifying the air to prevent dry skin
- Taking lukewarm baths with colloidal oatmeal, Epsom salts or baking soda
- Wearing gloves for wet work and cold weather
- Stopping smoking, which dries skin and reduces circulation
- Applying cool compresses to itchy areas
Anti-itch gels containing menthol or camphor can provide cooling relief when applied topically. Light massage with sesame, coconut or olive oil can also calm itchiness. Keeping nails trimmed short lessens damage from scratching.
Prevention
You can take certain steps to help prevent the onset of itchy hands:
- Eat a balanced diet with adequate intake of iron, B vitamins, zinc and other nutrients
- Stay hydrated – drink plenty of water
- Moisturize hands frequently with thick, fragrance-free lotion or cream
- Avoid excessive hand washing and use gentle cleansers
- Wear gloves for wet work and when using harsh chemicals/cleaners
- Treat any skin conditions like eczema early to prevent flares
- Use insect repellant and promptly treat bites to prevent itching
- Identify and avoid contact allergens
Routine bloodwork with your doctor can help detect any nutritional deficiencies before they progress. Be sure to report any symptoms of itching or skin changes early as well. Staying vigilant and minimizing skin irritation and damage will help keep annoying hand itching at bay.
Conclusion
Itchy hands are primarily caused by nutritional deficiencies in iron, vitamin B12 and zinc which are vital to skin health and nerve function. Medical conditions like kidney disease, liver disease and diabetes can also provoke itching. External factors including dry skin, rashes, insect bites and contact allergens frequently aggravate itchiness.
Mild itching can be managed with moisturizers, anti-itch creams and avoiding irritants. However, severe persistent itching or itching with other concerning symptoms warrants medical evaluation. Doctors can diagnose any underlying disorder through physical exam, blood tests and skin biopsy.
Treating the root cause, whether nutritional deficiency, medical illness or skin condition, is key to resolving chronic itchy hands. Lifestyle measures like proper skin care, moisturizing, humidifying air and wearing gloves can aid comfort. Be sure to eat a balanced diet with essential vitamins and minerals to prevent deficiencies that commonly provoke itchy hands.