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Itchy Neck: Symptoms, Causes, and Treatment – Verywell Health

Shamard Charles, MD, is a physician-journalist and public health doctor who advances health policy through health communication and health promotion.
Katlein Franca, MD, is a board-certified dermatologist and clinical professor at the University of Miami Miller School of Medicine.
You may not want to ignore that annoying neck itch (pruritus). Most of the time, the cause of your itch is not serious. But sometimes, it can be a sign of an underlying health condition, so you don't want to dismiss this subtle sign entirely.
If your itch lasts for two or more weeks or goes from a local neck itch to affecting multiple parts of your body, the likelihood of an underlying condition being the cause becomes more likely. You'll probably want to know what's causing it so you can take care of it. 
You treat your itch by applying an anti-itch lotion and avoiding scratching it. While this may work most of the time, it sometimes isn't enough. Chronic pruritus can be frustrating to live with, but, fortunately, there are many ways to improve your symptoms.
This article will discuss the symptoms associated with an itchy neck, its causes, potential complications, and ways to treat it. 
AndreyPopov / Getty Images
An itchy neck may not be your only symptom, especially if it is caused by a systemic condition (one that affects your entire body) like diabetes or shingles. The following symptoms may accompany your pruritus:
A myriad of conditions can cause your neck to itch. Most of these are benign and either resolve on their own or improve greatly with the use of dermatologist-approved lotions. The following conditions may cause you to have an itchy neck:
Poor hygiene is a common cause of an itchy neck, as is dry skin. Using lotion after you shower can help prevent dry or cracked skin. Therefore it is important to moisturize, especially during the winter when the air is colder and less humid.
In children, parasitic infections with scabies or head lice are a common cause of itchy neck. A prescription cream is needed to treat scabies. Head lice can be treated with over-the-counter (OTC) products like Rid (pyrethrins plus piperonyl butoxide) and Nix (permethrin lotion 1%).
If your itch is due to food or substance-related allergies, prevention (avoiding certain foods, soaps, detergents, or substances that trigger your itch) may be the best “treatment.”
An itchy neck may also be a sign of an underlying medical condition. If that’s the case, treating your underlying condition is the best way to get rid of your itch. For example, managing your diabetes with medication, a diabetes-friendly diet, and exercise can lessen your itching and any associated symptoms.
In chronic or severe cases of an itch, an antidepressant, immunosuppressant, or corticosteroids may be necessary, although these treatments are often considered after more conventional treatment options have failed.
No matter the cause, wearing loose, light clothing around your neck and using a cool compress, an anti-itch lotion, or hydrocortisone cream can relieve the itch. 
Chronic itching can cause the skin to break, increasing your risk of scarring and infection. Other scratch-induced complications include lichen simplex chronicus (a thickening of the skin) and impetigo (a bacterial infection of the skin that may appear as small vesicles or blisters that ooze or bleed). 
Of note, acanthosis nigricans (AN) is discoloration and change in the skin’s texture due to chronically high blood glucose levels. Diabetes-related changes in the body can make it harder to stay hydrated, further drying out the skin and causing it to itch and crack.
Moisturizing your neck with a dermatologist-approved moisturizer may help. Ultimately,  lowering your blood sugar and maintaining it at a healthy level is the best way to relieve your itch long term.
Some allergies carry the risk of developing a severe allergic reaction (anaphylaxis) that is a medical emergency. Your healthcare provider may prescribe an EpiPen (epinephrine auto-injector pen) to use at the first signs of anaphylaxis. These include:
The most common conditions that cause an itchy neck, like dry skin or eczema, typically do not require testing for a formal diagnosis. A healthcare provider will use your report of symptoms, medical history, and physical examination to make a diagnosis.
If your itch lasts for two or more weeks, affects different parts of your body, impacts your quality of life, or does not improve with standard anti-itch treatment, your healthcare provider may do further tests to determine the cause. 
If diabetes is suspected, you may be asked to take a blood glucose test or a hemoglobin A1C test (a snapshot of your blood glucose levels over the past three months). An A1C level above 6.5% is diagnostic of diabetes. 
If food allergies or contact dermatitis is suspected, you may be referred to an allergist for a full allergy evaluation. One allergy test, a skin prick test, is a quick and easy way to check for immediate allergic reactions to as many as 50 different substances at the same time.

People with eczema or psoriasis usually develop symptoms early on in life and receive a formal diagnosis from a dermatologist in their youth, but this isn’t always the case. Skin conditions can arise at any time. 
Eczema is a clinical diagnosis based on your symptoms, medical history, and a detailed physical examination. Eczema typically presents as a red, itchy rash. Over time, dry, scaly patches and leathery patches may develop. Common triggers include stress, cold weather, food allergies, fragrances, and dry skin.
Most of the time, your healthcare provider can determine whether you have psoriasis after performing a thorough clinical evaluation. But if there are any questions about the nature of your lesions, a skin biopsy may be performed. The cause of psoriasis is unknown, but it is thought to be an autoimmune condition that commonly presents with itchy, thick, scaly patches called plaques.

In children, an itchy neck may be a sign of head lice. A careful examination of the scalp, using a microscope and a fine-toothed comb, by a healthcare provider such as a pediatrician or school nurse may detect the presence of live nymph or adult louse on your scalp or hair.

Scabies may also cause an itchy neck. It is usually diagnosed after witnessing one of the unique characteristics, such as the presence of burrows, a distinctive-looking rash, and the scabies parasite itself. A microscopic evaluation may detect the presence of mites or eggs.
If your itchy neck lingers for two or more weeks or is associated with pain, inflammation, or a rash, you may want to check with a healthcare provider. While an itchy neck is rarely a sign of a medical emergency, it may be a subtle sign of an underlying medical condition that needs to be addressed urgently.
If you rapidly develop itchy hives on your neck and other symptoms of a severe allergic reaction, such as wheezing, difficulty breathing, and swelling, seek emergency medical attention.
An itchy neck may indicate dry skin, an allergy, an infection, a skin condition such as eczema or psoriasis, or an underlying medical condition. The diagnosis can often be made based on symptoms, medical history, and clinical examination.
Generalized symptoms may point to a broader medical problem that must be resolved to relieve your symptoms. Treatment will be based on the cause of the itchy skin.
Although an itchy neck can be a subtle symptom of a systemic condition like allergies or kidney disease, most of the time, it is due to benign conditions, and cases are mild, resolving on their own or with OTC treatment.
Knowing when to get your symptoms checked is important to get a quick diagnosis and proper treatment. If your itchy neck does not go away in a few days with lifestyle modifications and topical treatment, contact your healthcare provider.
American Academy of Dermatology. Acanthosis nigricans: Signs and symptoms.
Centers for Disease Control and Prevention. Scabies medications.
Centers for Disease Control and Prevention. Head lice treatments.
American Academy of Dermatology. Acanthosis nigricans: diagnosis and treatment.
American Academy of Allergy, Asthma & Immunology. Anaphylaxis
American Diabetes Association Professional Practice Committee. 2. Classification and diagnosis of diabetes: Standards of medical care in diabetes—2022Diabetes Care. 2022;45(Supplement_1):S17-S38. doi:10.2337/dc22-S002
Kapur S, Watson W, Carr S. Atopic dermatitisAllergy Asthma Clin Immunol. 2018;14(Suppl 2):52. doi:10.1186/s13223-018-0281-6
NYU Langone Health. Diagnosing psoriasis.
Centers for Disease Control and Prevention. Head lice diagnosis.
By Shamard Charles, MD, MPH
Shamard Charles, MD, MPH is a public health physician and journalist. He has held positions with major news networks like NBC reporting on health policy, public health initiatives, diversity in medicine, and new developments in health care research and medical treatments.

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