Wondering why heroin makes you itch is a common question that you may have. Because itching is a frequently observed behavior in people struggling with heroin addiction, many people are curious about what causes the unusual itchiness. What’s interesting is that it’s not just heroin that makes people itch — all opioids can make people feel itchy. So what is it specifically about heroin that causes itching?

Why Does Heroin Cause Itches?

Heroin is an opioid like oxycodone and fentanyl. It is illegally manufactured from morphine. When a person takes heroin, the chemical binds to opioid receptors in their nervous system. This process causes a rush of euphoria, the high that people take it for. It also causes many unpleasant side effects, one of which is itching.

There are a few different ways that heroin use causes itching.

Immune System

The first way heroin causes itchiness is due to the immune system. Normally, the immune system causes itchiness to get rid of harmful substances in the skin, like infectious microbes or allergens. When your body detects a foreign invader in your skin, nose, or eyes, it activates an immune response which includes producing histamines. Histamines cause inflammation as well as itching. The body can mistake heroin chemicals as allergens or other invaders. When heroin circulates throughout the body, it triggers that same immune reaction and feeling itchy is the result.


A second reason heroin causes itching has to do with how nerves work. Feelings of itchiness are transmitted from your skin to your brain through your nerves. Some of the neurons in your skin contain specific receptors that heroin can bind to. When heroin interacts with these receptors, it activates them and causes them to send itch signals to your brain.

Heroin itchiness can also result from more visible sources. Small injection injuries can also itch. When people inject heroin, the process can lead to injuries, abscesses and skin infections at the injection site. These will likely itch as they heal.

Skin Picking and Heroin

Skin picking is a common behavior among people who use heroin. Picking is often due to the intense itching that comes from drug use. Sometimes, skin picking is due to a mental disorder where people can’t keep themselves from scratching or picking at their skin. Skin picking doesn’t usually cause major health effects, but it can make inflammation worse and leave unsightly marks on the skin. The act of picking itself can lead to stress and other mental health issues.

Skin picking may occur when someone is on heroin and also when they’re in withdrawal. The anxiety and restlessness of heroin withdrawal can lead people to want to self-mutilate. One symptom of withdrawal is the sensation often described as bugs crawling out of their skin, which can trigger skin picking.


Dermatillomania also called “excoriation disorder” or “skin picking disorder” is a type of obsessive-compulsive spectrum disorder where a person has a repeated urge or compulsion to pick at their skin. Dermatillomania often occurs with other psychiatric disorders such as anxiety and depression as well as substance abuse. People who use heroin and other opiates sometimes end up developing this disorder.

How to Stop Skin Picking

If skin picking is severe enough to cause discomfort and distress in your life, you should seek medical care. However, there are a few methods and ideas you can try at home to help keep from picking:

  • Keep your hands busy. Try a fidget cube, a simple craft or even a stress ball.
  • Wear gloves
  • Identify picking triggers
  • Try to resist the urge for longer and longer periods
  • Perform skin care when you feel the urge to pick. Try putting on moisturizer instead.
  • Keep your skin clean
  • Keep your nails trimmed short
  • Ask other people to alert you when they see you picking
  • Don’t keep things like tweezers or pins in easily-accessible places

Treatment for Skin Picking

Skin picking was just recently recognized as a mental disorder. Because of this recent recognition, no standard treatment has been established yet. However, a combination of medications and counseling can be successful. Medications can help with anxiety and physical causes of itching, while counseling can teach a patient how to stop skin picking through different techniques. Often, cognitive behavioral therapy helps patients learn skills to control their impulses and develop positive behavior.

How to Treat Heroin Itching

The best way to overcome the itching associated with heroin use is to stop using heroin. Recovery from heroin use can be a long process and requires professional care and guidance for the safest and most-effective treatment.

While you are in treatment, there are some things you can do to relieve the itch. Anti-itch medications like antihistamines or topical steroids can help with physical symptoms. Anti-anxiety medications can also help with stress and mental compulsions. Seeking help from a trained therapist is also a good idea.

Key Points: Heroin Itching

Heroin users frequently feel itchy. They may scratch their arms where they inject heroin, or where they feel bugs crawling during a hallucination. The following key points cover the general concepts of heroin itching:

  • Itching is a common side effect of heroin use
  • Causes of heroin itching can be both physical and psychological
  • Injecting heroin can cause physical injuries that itch as they heal
  • Medications can help relieve anxiety and physical causes of itching
  • Counseling and cognitive behavioral therapy can help you control skin picking impulses
  • Heroin addiction treatment is the best long-term solution for heroin itch

If you or a loved one use heroin, contact The Recovery Village to speak with a representative about how treatment can work for you. Individualized treatment plans offer patients the care and support needed to address their addiction and any co-occurring mental health disorders. You deserve a healthier future, call today.


Washington University School of Medicine. “Researchers block morphine’s itchy side effect.” October 13, 2011. Accessed April 27, 2019.

National Health Service. “Skin picking disorder.” January 18, 2018. Accessed April 27, 2019.

American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders.” May 2013. Accessed April 20, 2019.

Gallinat C, Moessner M, Haenssle HA, Winkler JK, Backenstrass M, Bauer S. “SaveMySkin: An Internet-based self-help intervention for skin picking. Study protocol for a randomized pilot study.” Contemporary Clinical Trials Communications, March 2019. Accessed April 27, 2019.

Lochner C, Roos A, Stein DJ. “Excoriation (skin-picking) disorder: a systematic review of treatment options.” Dove Press, July 14, 2017. Accessed April 27, 2019. 

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.