Itchy Skin and Alzheimer’s Disease

WebMD Medical Reference in Collaboration with the Cecil G. Sheps Center at the University of North Carolina at Chapel Hill Logo for UNC Chapel Hill, Cecil G. Sheps Center

People with Alzheimer’s disease might itch and scratch or pick at their skin for many reasons. It may be hard for your loved one to let you know what the problem is, so you’ll need to pay close attention and see if you can figure it out.

Dry skin is one of the most common causes of scratching and picking. It’s common in older adults because as we age our skin gets thinner and doesn’t hold as much moisture. This often makes the skin irritated and itchy. It can also result from using harsh cleansers or soaps, bathing too often, or bathing in hard water or well water. And it’s common in areas where the climate is hot or cold and the air is dry.

Itchy skin with red bumps may result from bug bites:

Bed bugs. These small oval insects feed on blood. They live on furniture, on beds, and in carpets. They’re mostly active at night. Their bites don’t hurt, but they leave small, flat or raised bumps often in a row on the skin. The bites are commonly found on the face, neck, hands, and arms. They cause redness, swelling, and intense itching. Steroid creams or oral antihistamines, like Benadryl, can help relieve the itch. Pest-control experts can get rid of bed bugs in the home.

Fleas . They commonly infest pets and areas such as pet bedding and carpet. Their bites cause itchy red bumps that may swell. The inflamed area often turns white when pressed. Fleas usually bite the ankles, waist, armpits, and in the bends of knees and elbows. Clean any bites with soap and water, then pat dry. To relieve the itch, use hydrocortisone cream or calamine lotion. Cold compresses may also help if the bites are swollen or inflamed. To get rid of fleas, bathe pets with flea shampoos or use flea treatments. Clean all carpeting and pet bedding with insecticide powders, foggers, or sprays. Follow the directions. Some products have toxic fumes and you can’t go back into the house for a couple of hours after you use them.

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Scabies. These tiny parasites, also known as itch mites, burrow under the skin to live and lay eggs. They can show up anywhere on the body but prefer the wrist, underarm, elbow, waistline, buttocks, groin, and between the fingers. The bites cause intense itching, especially at night, and a pimple-like rash at the infested area. You might also see red, raised burrows or tracks on the skin. Scabies are contagious and easily spread by prolonged skin-to-skin contact. You need a prescription for treatment, so call your doctor if you think scabies are why your loved one is scratching and picking. To ease the itch, put cool, wet washcloths on the area. You can also use calamine lotion. Wash all clothing, bedding, and towels in hot soapy water and machine dry on high heat.

Lice. Lice are flat-bodied parasites, about the size of a sesame seed, and tan to whitish-grey in color. They can be found on the scalp, pubic area, and other parts of the body. They lay yellow to white eggs that are often found attached to body hair. The bites cause intense itching and leave little pink-red bumps on the skin. To get rid of head and pubic lice, you can shave the affected area or use over-the-counter shampoos or lotions for lice. To help get rid of body lice, use good hygiene habits and change clothes regularly. Lice can also live on clothes, towels, and bedding, so wash these in hot water and machine dry on the hot cycle. Individuals who’ve come in contact with people who have lice should be checked for lice as well.

Ants and mosquitoes. If your loved one has been outside, they might have ant or mosquito bites. Clean the area with soap and water, then pat dry. Use hydrocortisone cream or calamine lotion to calm the itch. Cold compresses may also ease the swelling and inflammation.

​Infections by some types of fungus are another common cause of itching and scratching. Common ones include:

Athlete's foot (tinea pedis). This itchy, red, scaly rash usually grows between the toes. It can also spread to the top, sides, and sole of the foot. It’s common in people with sweaty feet who wear tight-fitting shoes. You can spread it if you share shoes, clothes, or towels, or walk barefoot on contaminated carpets or floors. To treat it, use over-the-counter antifungal creams, powders, or sprays. Keep skin on the feet dry, especially between the toes.

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Ringworm (tinea corporis). This starts as an itchy, red, scaly patch on the skin. The borders then rise and grow slightly to form a ring shape. The area inside the ring may be clear, scaly, or have scattered red bumps. There could be more than one ring, and they might overlap. This infection spreads by direct skin-to-skin contact with an infected person or animal. To get rid of it, use an over-the-counter antifungal lotion or cream on the infected area.

Candidiasis. This itchy, bright red rash is often especially red on the edges. It's typically found in moist areas, such as the armpits, under the breasts, abdominal folds, inner thighs, buttocks, and groin. It’s caused by a yeast-like fungus. It can get worse if your loved one sweats a lot or doesn’t bathe or change clothes often. Antibiotics or steroids like prednisone can also cause the fungus to grow. To ease the rash, keep the skin clean and dry, let the area have contact with the air, and use an anti-yeast cream.

Allergies are another common cause of itching and scratching. Allergies to medicines or foods can make someone itch and scratch all over. Allergies that result from contact with an irritant will result in a rash at the point of contact.

If you can’t figure out why your loved one scratches or picks at their skin all the time, it could be a behavior linked to the condition. It may be a way for them to comfort or distract themselves. People who do this aren’t usually upset, but they can hurt themselves. Also, because of changes in their thought process as part of Alzheimer’s disease, your loved one may not have good personal hygiene. That may lead to itchy skin and scratching.

Home Care for Scratching and Picking

Keep skin moisturized to prevent dryness and skin tearing. Use unscented lotions or those designed for sensitive skin.

If your loved one’s scratching or picking is related to Alzheimer’s disease, it may help to give them something to do with their hands. Give them a safe object, like a washcloth, busy blanket, or a small soft squeeze ball. You can also give them something they’ve used as part of their job or a favorite hobby. It may help to trim nails short, cover the area with a gauze bandage, or have them wear long-sleeved shirts that are difficult to roll up or unbutton. They may need to wear gloves, especially at night.

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Complications

Infection is the main complication to watch for from scratching and picking. Signs of skin infection include swelling, pain, red streaks, and fever. The skin may feel hot, and it may leak fluids or pus. If you think your loved one has an infection, call or see the doctor within 24 hours.

How to Help Prevent Itching and Scratching

Help your loved one with hygiene. They should bathe every other day with unscented, gentle soaps. Use lotion after a bath or shower and as needed to keep skin hydrated. Keep them away from things they’re allergic to.

If they scratch and pick repeatedly, prescription medications may help. Talk with their doctor for advice.

Protect Yourself

If your loved one has a wound from scratching or picking, wear disposable gloves when you clean or dress it. Wash your hands before and after. If they have scabies or a fungal infection, wear disposable gloves and don’t touch the area with your bare skin.

WebMD Medical Reference in Collaboration with the Cecil G. Sheps Center at the University of North Carolina at Chapel Hill Reviewed by Stephanie S. Gardner, MD on July 26, 2018

Sources

SOURCES:

Clinical Dermatology: “Dry Skin in the Elderly: Complexities of a Common Problem.”

International Journal of Dermatology: “Geriatric Dermatoses: A Clinical Review of Skin Diseases in an Aging Population.”

Geriatric Nursing: “Family Members’ and Care Providers’ Interpretations of Picking Behavior.”

Lipton, A.M. & Marshall, C.D. Common Sense Guide to Dementia For Clinicians and Caregivers, Springer, 2012

Aging Well: “Ambiguous Itching.”

Mayo Clinic: “Itchy skin (pruritus).”

Today’s Geriatric Medicine: “Careful Attention to Aging Skin.”

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