Itchy skin? 17 reasons why your child is scratching

Here are the most common cause of itching in small children – and what you can do to help ease the itch

Itching all over | Itchy scalp or face | Itchy bottom | Itchy fingers, feet and toes | Itchy skin in a particular spot or area

Itching all over

1. Dry skin (xerosis or xeroderma)

What does it look like?

Patches of rough, flaky, scaly, sometimes sore skin. The skin can appear red on white skin, and whitish or greyish white on black or brown skin.

What causes the itching?

A toddler's skin is more susceptible to being dry than ours because it’s so delicate. Cold or dry weather, air conditioning and central heating, sun damage, harsh soaps, overbathing and swimming in chlorine can all cause dry skin. Xerosis isn’t infectious.

How to treat it?

• Avoid hot baths; use warm baths instead – and don't let your child soak for too long. Avoid soap and use emollient soap substitutes instead. These can make the bath slippery, so be sure to use a bathmat to prevent slipping. Straight after the bath, moisturise your child's skin with baby-friendly creams to help lock in the moisture.
• After swimming, make sure the chlorine doesn't dry on their skin; have a quick wash/shower and put on some moisturiser before you go home.
• Make sure to keep your child well hydrated.
• Dress your child in a skin-friendly way. In the wintertime, keep them bundled up from the cold with gloves and scarves; in the summertime, keep them dressed in cool, natural fabrics that will help wick away sweat and protect their skin from sun exposure. And use a sunscreen with a minimum of SPF 30 (the higher, the better).

2. Atopic dermatitis (atopic eczema)

What does it look like?

Patches of inflamed-looking, itchy, dry, cracked and sore skin that may be small or widespread. It can look red on white skin and dark brown, purple or grey on brown or black skin.¹

It can present on any area of the body but, in white children, it usually affects the skin creases – neck, back of knees, inside of elbows – while for children from Asian, African or Afro-Caribbean families, it tends to be around the front of the knees, the back of the elbows or as fine pimples over the chest and tummy.²

As with most forms of eczema, atopic dermatitis can be itchier at night time,³ partly because there are fewer distractions so children are more aware of the urge to scratch.

What causes the itching?

Atopic eczema is the most common type of eczema in children. It can be triggered or worsened by allergies (atopic means 'sensitive to allergens'), soaps and even stress. Eczema is not contagious.

How to treat it?

• Emollients (moisturising treatments), used multiple times daily.
• If appropriate, your doctor may recommend other treatments such as topical corticosteroids to reduce redness and itching.

3. Heat rash or prickly heat (milaria rubra)

What does it look like?

Tiny raised bumps, spots or blisters that sting or feel prickly. On black or brown skin, the blisters may appear grey or white; on white skin, the blisters often look red.

• See what heat rash looks like in our picture guide to children's spots and rashes

What causes the itching?

Prickly heat or heat rash can appear when your child gets hot and sweats more than usual. The sweat glands become blocked and form itchy bumps. Prickly heat is not contagious.

How to treat it?

• Remove clothing if your child is wrapped up; remove your child from a hot room or hot outdoor place
• Offer plenty of fluids
• Try a cool bath

4. Chickenpox

What does it look like?

An itchy, spotty rash that can appear anywhere on the body, including inside the mouth and around the genitals. Spots turn into fluid-filled blisters that crust over to form scabs, which eventually drop off. The spots may be red, pink, darker or the same colour as surrounding skin, depending on your skin tone. They will be harder to see on brown or black skin.

• See what chickenpox looks like in our picture guide to children's spots and rashes

What causes the itching?

Chickenpox is an infectious illness, most common in children under the age of 10, caused by the varicella-zoster virus. It's contagious and spreads very quickly from child to child.

How to treat it?

• Calamine lotion to soothe the itching
• Child-appropriate doses of ibuprofen or paracetamol if the itching is accompanied by fever
• Keep your child at home until all the spots crust over

Itchy scalp or face

5. Head lice/nits

What do they look like?

Head lice and nits are two different things: head lice are the insects that can live on the head and hair; nits are the eggs the head lice lay. Nits are brown or white, the size of a pinhead and tend to be attached to the hair. Head lice are dark brown, grey or black, the size of a sesame seed and live close to the scalp.

What causes the itching?

"The lice bite the skin of the scalp and the itching is the reaction of your child's skin to the saliva of the lice," says Dr Philippa. "It can take time for this reaction to develop, so your child can have had lice for a while before they start to itch." Head lice spread easily from child to child, if one child with head lice holds their head close to or touching another child's head.

• Do head lice jump? And other common questions about head lice and nits

How to treat them?

• Get a headlice treatment from the chemist. The itch will only go when they’re gone! Most treatments require a second application 7 days after the first.
• Comb your child's head with a nit comb regularly for at least a week after the 2nd treatment to check for and remove remaining lice and new nits. "Head lice can be very good at evading the comb," says Christine Brown, head lice specialist and former nurse consultant. "They’ve got six legs and move through hair like gibbons through a forest."

6. Dandruff

What does it look like?

Flaky, white or yellow skin gathering in the parting of the hair or falling off the hair onto the shoulders. It tends to be more noticeable in darker hair.

What causes the itching?

There are quite a few possible causes of dandruff, including an overproduction of secretions from the sebaceous glands on the scalp to fungal colonisation or the presence of a yeast called malassezia. All of them cause irritated, flaky skin, which can be very itchy. Dandruff is not contagious.

How to treat it?

• You can try an over-the-counter medicated shampoos that's suitable for children.
• You could also try coconut oil: rub 3tsps into the scalp, leave for 1 hour, then shampoo out and rinse.
• Brush hair regularly but don't over brush.

Itchy bottom

7. Threadworms or pinworms

What does it look like?

Threadworms are white and look like a tiny pieces of thread. You're likely to spot your child scratching her bottom – especially at night time – before you see the worms, though they can often be seen in your child's poo.

What causes the itching?

Threadworms are small parasites. If your child is infected with them, they will lodge in your child's intestines and lay eggs around your child's anus, usually at night. When the worms lay their eggs, they also secrete a mucus which causes intense itching.

Threadworms can pass easily from person to person through skin contact: the eggs can stick to fingers – and then clothes, toys, bedding – when an infected person scratches, and if someone else touches those surfaces, then touches their mouth, they can swallow the eggs.

How to treat them?

• Get a threadworm treatment over the counter at the chest. "It is important to treat the whole household, not solely the child affected, threadworms are so infectious," says Dr Philippa
• Cut your child's fingernails and make sure they wash their hands frequently
• Wash sheets and towels on a hot wash every day for several days after the treatment
• Make sure everyone in your house wears underwear at night for several days after the treatment and changes it in the morning

Read more about threadworms, how to get rid of them and how to stop them coming back

8. Nappy rash (irritant dermatitis)

What does it look like?

Sore, angry patches or spots that may look shiny and glazed on your child's bottom or nappy area. Spots can appear red or brown but may be less noticeable on brown and black skin⁵. The skin can also appear cracked or blistered.

• See what nappy rash looks like in our picture guide to children's spots and rashes

What causes the itching?

Your child's skin has become irritated – most commonly by being in contact for too long with wee or poo in their nappy or by the nappy rubbing against your child's skin. Nappy rash can also be caused by thrush or irritation from fragranced baby wipes. It is not contagious.

How to treat it?

• Use lots of nappy cream or barrier ointment in the first instance
• Keep the skin clean and dry by changing wet or dirty nappies as soon as possible, using water, not wipes, and then patting dry
• Leave nappies off during the day whenever possible

Itchy fingers, feet and toes

9. Pompholyx (dyshidrotic eczema)

What does it look like?

Watery blisters on the hands or feet that come and go, and are intensely itchy; symptoms usually last 2 to 3 weeks at a time⁶. There is often subsequent peeling as the skin dries out, according to the National Eczema Society, and people of any skin colour can experience skin that is red or darker than the surrounding skin, as well as dry, with painful cracks.

What causes the itching?

The exact causes of pompholyx eczema are not known but it's thought that contact with strong chemicals like soaps, cleansers and detergents, heat and sweat, stress or an allergy or sensitivity to certain metals can trigger symptoms. Pompholyx is not contagious.

How to treat it?

• "Avoid using soaps and perfumed products," says Dr Philippa. "Instead, use simple emollient products and apply multiple times a day.
• See your GP if things don't improve, as they may think it appropriate to treat it with a topical steroid cream or ointment.

10. Scabies

What does it look like?

"Scabies can be quite difficult to see at first," says Dr Philippa. "You may be able to see little silvery lines with a darker dot at the end – the burrows of the mites that are causing it. Then there may be a more widespread rash of small bumps, spots, blisters and scabs."

On white skin, the rash can look red or brown; on brown or black skin, it can look darker than your usual skin colour and is often harder to spot – although you'll be able to feel the raised bumps on the skin.

• See what scabies looks like in our picture guide to children's spots and rashes

What causes the itching?

Scabies is a skin infestation caused by sarcoptes scabies mite. When the mites borrow into the skin, they cause inflammation that is intensely itchy. "The itching is often worse when your child is hot – so, after a bath, for example, or at night," says Dr Philippa. Scabies is highly contagious and is spread though skin contact.

How to treat it?

• See your GP if your child is under 2 year old.
• For children over 2, you'll need to get an over-the-counter scabies treatment from the chemist. You'll need to do 2 treatments, a week apart.
• Your child should stay off nursery or school until 24 hours after the first application of treatment.
• You'll need to disinfect clothes, bedding and towels to kill the mites.
• Read more about spotting and treating scabies in children

11. Warts and verrucas

What does they look like?

Warts are small, raised, rough lumps that can appear on palms, knuckles, knees and fingers. They are usually skin coloured but may appear darker on black or brown skin.

A verruca is a flat patch of hard skin with a tiny black dot in the centre that can grow on the sole of the foot.

What causes the itching?

They are caused by the human papilloma virus (HPV) and cause your child's body to create an excess of keratin, a hard protein, which is what makes the texture of warts and verrucas rough. Not all warts itch but, if they do, it'll be because the skin in the area has become irritated; verrucas are more likely to be painful, rather than itchy.

Verrucas spread quickly in swimming baths, as the virus survives in the humid environment, and children are often barefoot. Warts are very contagious and spread through close skin-to-skin contact with an infected person.

How to treat them?

• They often go away without treatment, although it can take months or years for them to fade.
• Ask your pharmacist about the best treatment. They should be able to recommend the best course of action, depending on the location and extent of the affected area⁷.

Itchy skin in a particular spot or area

12. Insect bites

What do they look like?

A small, swollen lump on the skin that may look red, often with a central point. It may be more difficult to see on black or brown skin, but you should be able to feel it. There may be many bites grouped together.

What causes the itching?

More than the bite itself, the saliva of the insect can lead to a reaction in the skin causing inflammation and itching. Insect bites are not contagious.

How to treat them?

• Remove any visible stings or ticks.
• Wash the area with soap and water to lower the chance of infection.
• Apply an ice pack to reduce swelling.
• Consider an over-the-counter, child-safe antihistamine cream to relieve the itching.

13. Contact dermatitis

What does it look like?

Blistered, dry and cracked skin, most commonly on the hands and face, that usually occurs within a few hours or days of exposure to an irritant or allergen. White skin can become red and brown or black skin can become dark brown, purple or grey.

What causes the itching?

Irritation caused by contact with an allergen or a particular substance, such as a soap, bubble bath or detergent. It is not contagious.

How to treat it?

• Try to identify and avoid the irritant or allergen that triggered the symptoms.
• Use moisturisers to stop the affected skin becoming dry.
• If things don't improve, see your GP, who may want to prescribe steroid ointments or creams.

14. Hives or urticaria

What does it look like?

Slightly raised marks or 'weals' of different shapes and size that can look pink or red on white skin; the colour may be harder to see on brown and black skin. The rash appears suddenly on one particular part of the body, and the weals can fade or change shape or be replaced by others.

• See what hives looks like in our picture guide to children's spots and rashes

What causes the itching?

High levels of histamine and other chemicals that are released in the skin – often triggered by an allergen, such as shellfish, peanuts, eggs, contact with nettles or other plants or a wasp or bee sting, or by a reaction to medication. Hives are not contagious.

How to treat it?

• A child-appropriate antihistamine medication should help (speak to your pharmacist for advice on what is suitable for toddlers), although the weals often fade of their own accord after a few days.
• If the rash is accompanied by facial swelling, puffy eyes or difficulty breathing, seek urgent medical help.

15. Ringworm

What does it look like?

An inflamed, scaly circle of skin that may look red or darker than the surrounding skin and spreads outwards, leaving paler skin in the centre. It can appear on any part of the body, including the scalp.

• See what ringworm looks like in our picture guide to children's spots and rashes

What causes the itching?

Ringworm is a fungal infection – and has nothing to do with worms. The infection causes a rash which triggers the itching. It is contagious and spread by skin to skin contact.

How to treat it?

• Get an antifungal treatment from your chemist: they should be able to recommend the most appropriate treatment, depending on the age of your child and the location of the rash. They will also tell you if should take your child to a GP.
• Your child can go to nursery or school once treatment has started

16. Impetigo

What does it look like?

There are 2 types of impetigo: bullous impetigo and non-bullous impetigo. Bullous impetigo causes large, painless, fluid-filled blisters; non-bullous impetigo causes sores that rupture quickly and leave a yellowy brown crust. The blisters and sores are often initially clustered around the nose and mouth, though they can appear anywhere on the body.

• See what impetigo looks like in our picture guide to children's spots and rashes

What causes the itching?

Impetigo is a skin infection, usually caused either by staphylococcus aureus bacteria or the bacteria known as Group A Strep. The inflammation caused by the bacteria is what can make the skin itchy or painful. Impetigo is very contagious.

How to treat it?

• You'll need to see your GP or a pharmacist to get the appropriate treatment – usually an antibiotic cream.
• You'll also need to extra hygiene measures to prevent the infection spreading to others.
• Read more about what to do if your child has impetigo

17. Molluscum contagiosum

What does it look like?

Small, pearly, raised, dome-shaped lesions which often have a central dimple in them. Molluscum tends to come in patches of 20 or so and can appear anywhere on the body but children are most likely to have it on their arms, face, neck, chest, bottom and stomach.

• See what molluscum looks like in our picture guide to children's spots and rashes

What causes the itching?

Molluscum is a skin infection caused by virus, and the skin around the bumps can sometimes become rough and feel itchy, especially if your child scratches them. It is mildly contagious, and spread by touching clothes or sharing towels and bedding – but you don't need to keep your child off school or nursery.

How to treat it?

• There's no treatment: left alone, the spots will disappear and heal without scarring. They can take a long time to disappear, though: generally 18 months or longer.

Additional research by Gabrielle Nathan. Pic: Getty Images

References used to compile and research this article:

^{Atopic eczema. (NHS online); The National Eczema Society; Nocturnal Pruritus: The Battle for a Peaceful Night’s Sleep (Lavery et . Int. J. Mol. Sci. 2016, 17, 425); Chickenpox (NHS online); Dandruff (NHS online); Nappy rash (NHS online); Pompholyx/dyshidrotic eczema (NHS online); Warts and verrucas (NHS online); Hives (NHS online); Ringworm (NHS online); Impetigo.(NHS online)}

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