An itchy rash can have many causes, and some look alike. Where the rash is, when it itches and who else has it are the best clues. Use this guide to narrow it down, then see a doctor if you’re unsure, especially if more than one person at home is itching.
Scabies
- Itch: intense, worst at night.
- Where: between the fingers, wrists, elbows, armpits, waist, buttocks and genitals.
- Look: small red bumps and thin, wavy burrow lines.
- Clue: family members or partners itch too.
- Needs prescription treatment for everyone in close contact. See scabies symptoms and treatment.
Bed bug bites
- Itch: noticed in the morning after sleeping.
- Where: skin exposed in bed, such as arms, shoulders, neck and face.
- Look: red, itchy bites, often in a line or cluster of three or more.
- Clue: tiny blood spots or dark specks on sheets and mattress seams, especially after travel.
- The bites heal by themselves. The real treatment is getting rid of the bugs, usually with professional pest control.
Eczema
- Itch: comes and goes in flares, often worse with dry skin, heat or stress.
- Where: elbow creases, behind the knees, hands, neck and face.
- Look: dry, rough, scaly patches; can crack or weep.
- Clue: long-term or recurring, often with allergies or asthma in the family. It isn’t contagious.
- Thick fragrance-free moisturisers every day are the foundation of treatment.
Hives
- Itch: sudden.
- Where: anywhere, and they move around.
- Look: raised pale or red welts that fade within 24 hours, while new ones appear elsewhere.
- Often helped by a non-drowsy antihistamine such as cetirizine. See hives: causes and relief.
Flea and chigger bites
- Fleas: small itchy bites mainly on ankles and lower legs, often with pets in the home.
- Chiggers: very itchy bites around the sock line, waistband or skin folds after time in grass or woods.
Quick comparison
- Worse at night + between fingers + others itch → think scabies.
- New bites each morning in lines → think bed bugs.
- Dry patches in skin creases that come and go → think eczema.
- Welts that move and fade within a day → think hives.
See a doctor if
The itch keeps you awake, others at home are itching, the rash is spreading or looks infected (pus, crusts, fever), or it hasn’t improved after 2 weeks. Get emergency help if hives come with swelling of the lips, tongue or throat, or difficulty breathing.
More in our Lice and Parasites guide: all our articles on this topic in one place.
This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.
