Itching can occur anywhere on the body. Some patients suffer from itchy ankles, which is often the result of an underlying skin condition. However, itchy ankles may also indicate other, more serious causes. The itching causes many patients to scratch their ankle(s), causing injuries or a rash, but it is also possible that a rash may first appear, causing patients to itch. Essential itching (not associated with rash or lesions) often starts quickly and affects the patient’s daily life. The doctor then identifies the underlying problem that reduces the itching. Finally, a visit to the doctor is indicated when the itching lasts longer than a few days, when the itching worsens or when other symptoms are associated with the itching of the ankle(s).

• Skin conditions and itching of the ankle or ankles

• Dry skin
• Eczema
• Hives
• Psoriasis
• Heat rash
• Sunburn

• Immune system problems and ankle area that itches

• Allergies
• Autoimmune diseases
• Contact dermatitis

• Infections and ankle itching

• Cellulite
• Parasitic infections
• Fungal infections

• Other causes of ankles that itch

• Diabetes mellitus (diabetes)
• Insect bites
• Cancer
• Damage
• Liver problems
• Poor blood circulation

• Alarm signals and itchy ankles
• Diagnosis and examinations
• Prevention of itchy ankles

Skin conditions and itching of the ankle or ankles

Long-term exposure to the sun causes dry skin, which sometimes leads to ankle itching / Source: Blueeve, Pixabay

Dry skin

Certain products or climatic conditions lead to dehydrated skin around the ankles. This increases the risk of cracked skin, which also makes the patient itch more quickly. Dry skin sometimes also indicates an underlying condition, such as eczema or psoriasis. When the dryness is due to an environmental factor, such as prolonged exposure to the harmful UV rays of sunlight or very dry air, moisturizers help relieve the itching.

Eczema

Eczema is a group of conditions that cause red, inflamed skin. This skin disease often starts in childhood. This causes a bumpy or scaly rash on the backs of the knees, ankles, hands, wrists and/or feet. In some cases, the skin only feels dry in the affected skin areas. Over-the-counter and prescription medications are available.

Hives

Hives (urticaria) is a common rash characterized by raised and swollen bumps, commonly known as hives. They are often the result of contact with irritants, medications and foods. Hives are often caused by an allergic reaction. Medical attention is needed because the reaction sometimes leads to other problems. The patient avoids the substances that cause hives. Furthermore, prescription creams are available to relieve pain and itching.

Psoriasis

Psoriasis is a common skin condition that causes a rash. The rash occasionally appears on the ankles, making them itchy. Psoriasis may cause red spots around the joints, sometimes with scaly and white areas. The symptoms of the chronic condition disappear and then sometimes flare up again. Lifestyle changes and prescribed medications are possible with the skin disease.

Heat rash

Heat or physical exertion cause sweat in the socks. Socks that are too tight or shoes that are not sufficiently ventilated are more likely to cause clogged sweat glands. This causes skin irritation and a rash. Heat rash may cause ankle itching.Sun protection is necessary / Source: Dimitrisvetsikas1969, Pixabay

Sunburn

Excessive sun exposure may result in painful and itchy skin. First, a skin rash starts that causes itching. The skin then starts to flake, which initiates the healing process of sunburn (red, painful skin due to sun exposure). The itching therefore disappears when the skin has healed. Aloe Vera creams speed up the healing process. The patient must protect himself from the sun by wearing sun protective clothing or using sunscreen so that sunburn does not occur. This also reduces the risk of skin cancer.

Immune system problems and ankle area that itches

Allergies

Allergies are a response of the immune system to contact with a foreign element. The symptoms may be local and only affect the ankles (or another part of the body). The treatment for an allergic reaction usually consists of topical (applied to the skin) creams containing an antihistamine (drug used to treat an allergy). If necessary, the doctor may prescribe corticosteroids. Furthermore, patients limit contact with the allergen (triggering substance) that leads to the allergic reaction.

Autoimmune diseases

An autoimmune condition may affect the skin cells, causing itching. Ankle itching may be the result of systemic lupus erythematosus and rheumatoid arthritis (inflammation of joints and organs).

Contact dermatitis

Contact dermatitis (skin rash with redness and itching) is an exaggerated reaction of the immune system, caused by contact with a foreign substance such as animals (e.g. a dog allergy), hand or body soaps, jewelry, perfume, poison ivy (poison ivy: North American climbing plant of the Cashew family that secretes an irritating oil from its leaves, which causes inflammation of the skin in a number of patients), socks or other clothing. The most common symptom of contact dermatitis is an itchy red rash. Sometimes the patient also presents with blisters, hives, swelling and/or ulcers. The treatment of contact dermatitis consists of identifying the underlying cause and avoiding future contact. Over-the-counter creams provide relief from itching.

Infections and ankle itching

Cellulite

In cellulite, the skin is inflamed as well as the adjacent soft tissue layer. This is the result of bacterial infections caused by staphylococcal or streptococcal bacteria. The skin infection is characterized by ulcers, tenderness, redness, swelling and possibly itching when this occurs in the ankle area. Cellulitis requires professional medical treatment because left untreated or poorly treated, the condition leads to abscesses, bone infections and gangrene (tissue death with changes to the skin). Antibiotics can be used to treat cellulite.

Parasitic infections

Parasites such as lice and fleas reach the foot area more quickly because the feet often touch the ground. They cause local irritation in the ankles, resulting in itching, redness, inflammation, a rash and blistering. The often severe itching causes patients to scratch the skin.

Fungal infections

Athlete’s foot and groin fungus are common fungal infections that cause itching of the ankles. The fungi like warm and moist environments. Wearing closed shoes for a long time therefore increases the risk of a fungal infection. In addition to the ankle itch, redness, itching, flaking, a burning sensation, blisters and painful feet (foot pain) occur. The doctor prescribes antimycotics (antifungals) to treat these fungal infections.

Other causes of ankles that itch

Diabetes mellitus (diabetes)

Diabetes mellitus causes elevated blood sugar levels (hyperglycemia). Poorly controlled diabetes mellitus can lead to many short- and long-term health problems. Diabetic neuropathy, skin infections, dry skin and poor blood circulation are some complications of this disease. Itchy ankles in diabetics often indicate insufficient blood flow to the feet. Treatment consists of taking insulin, dietary changes and exercise. By adopting a healthy lifestyle it is possible to slow down the progression of the condition.

Insect bites

A common cause of an itchy ankle is an insect bite or insect sting. Bed bugs, mites and mosquitoes are often the culprits. Walking and exposing the ankles in places where insects are most likely to live increases the risk of a bite or sting.

Cancer

Occasionally, certain cancers cause generalized itching and itchy ankles. This mainly happens with blood cancer, skin cancer, cancer of the lymphatic system, liver cancer or kidney cancer. Some cancer treatments, such as chemotherapy, lead to ankle itching.

Damage

If the patient has a sprain or wound on the ankle, this may cause itching during the healing process. This mainly happens when the patient wears a plaster or a wound, pressure or plaster bandage. An itchy ankle also appears by stretching the skin when the area is swollen. The painkillers that the patient takes for an injury sometimes also cause itching as a side effect.A fluid buildup in the abdomen is often a sign of liver damage / Source: James Heilman, MD, Wikimedia Commons (CC BY-SA-3.0)

Liver problems

Liver problems may lead to ankle itching. Damage to the substance results in the release of bilirubin into the blood. Increased bilirubin levels in the blood (hyperbilirubinemia) causes itchy ankles. The exact cause of this is not known as of October 2020.Other symptoms of liver damage are:

• stomach ache
• chronic fatigue
• dark urine
• a pale stool
• an increased risk of bruising
• a loss of appetite
• a fluid accumulation in the abdomen (ascites)
• jaundice
• nausea and vomiting

If there are signs of liver problems, medical attention is needed as soon as possible.

Poor blood circulation

Due to poor blood circulation to the feet, itching occurs more quickly. A pooling of the blood in the lower extremities leads to damage to the veins. This causes the skin to start swelling, resulting in itching. The feet and ankles are also prone to ulceration that may become infected, causing itching. Some tips improve blood circulation.

Alarm signals and itchy ankles

Patients with diabetes mellitus, liver problems and other conditions that often lead to a rash or itching should consult a doctor about itchy ankles. Unexplained itchy ankles also require medical attention. The doctor should also identify the underlying problem when the itching is accompanied by other signs (such as fever), when the itching worsens, or when the ankles are still itchy after several days.

Diagnosis and examinations

The doctor asks the patient about the start of the itching, as well as whether it is permanent or appears occasionally. He also wants to know whether certain things improve or worsen the ankle itch. The patient also reports whether other parts of the body are affected by itching. During the physical examination, the doctor examines the itchy ankle area. Based on any other symptoms present, the doctor will determine whether further tests are necessary, such as a blood test, a biopsy (removal of a tissue sample and examination under a microscope) or imaging tests.Eating a balanced, healthy diet is necessary to reduce the risk of ankle itching / Source: Jill111, Pixabay

Prevention of itchy ankles

Some tips reduce the risk of ankle itching:

• Avoid contact with known allergens or irritants
• regulate diabetes mellitus
• eat a balanced, healthy diet
• Avoid prolonged, unprotected sun exposure
• treat underlying conditions
• exercise regularly
• drink enough fluids