Why do heroin users often itch and scratch themselves? Learn why itchiness often accompanies opioid use and how to manage it.

Wondering why heroin makes you itch? Itching is a frequently observed behavior in people struggling with heroin addiction. What’s interesting is that it’s not just heroin that makes people itch — all opioids can make people feel itchy. Why is that?

Article at a Glance:

  • 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

The Causes of Heroin Itching

Heroin causes many unpleasant side effects, one of which is itching. Here are a few different ways that heroin use may cause itching:

  1. Immune System: Normally, the immune system induces 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.
  2. Nerves: 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.
  3. Injuries to the Skin: Heroin itchiness can also result from more visible sources. Small injection injuries can also itch. When you inject heroin, the process can lead to injuries, abscesses and skin infections at the injection site. These will likely itch as they heal.

How to Treat Heroin Itching

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.

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

Heroin Skin Picking

Skin picking is a common behavior among heroin users. Picking is often due to the intense itching that comes from drug use. Skin picking may occur when using heroin and also during withdrawal. The anxiety and restlessness of heroin withdrawal can lead users 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.

You Might Be Interested In: Heroin Withdrawal Timeline & Withdrawal Medications

Sometimes, skin picking is due to a mental disorder (Dermatillomania) 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.


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 & Heal Wounds

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.

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 skincare 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
a man with a beard wearing glasses and a hoodie.
Editor – Thomas Christiansen
With over a decade of content experience, Tom produces and edits research articles, news and blog posts produced for Advanced Recovery Systems. Read more
a man with a beard wearing a suit and tie.
Medically Reviewed By – Benjamin Caleb Williams, RN
Benjamin Caleb Williams is a board-certified Emergency Nurse with several years of clinical experience, including supervisory roles within the ICU and ER settings. Read more
Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with 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 providers.