Q It's fine during the day but severely itchy only at night. Why does it get worse at night?
A Worsening of itching at night is a classic symptom of the Blood-Deficiency Wind-Dryness (hyeolheo-pungjo) pattern; as skin moisture decreases and the parasympathetic nervous system becomes active, the itch sensation is amplified. It is especially common in age-related dry skin.
Detailed Answer
There are two reasons itching worsens at night. First, the skin temperature rises and moisture evaporates compared to daytime, weakening the skin barrier. Second, as the parasympathetic nervous system becomes dominant, the threshold for processing itch signals lowers. This pattern is pronounced in patients with age-related dry skin, atopic dermatitis, psoriasis, and liver disease.
Korean Medicine Clinic Perspective
In Korean medicine, this is viewed as Blood-Deficiency Wind-Dryness (hyeolheo-pungjo) - a state in which the blood is insufficient, so the skin is not nourished and becomes dry. A characteristic feature is that symptoms worsen in the evening and at night, when yin declines. Replenishing blood and moistening dryness (bonhyeol-yunjo) with formulas in the Danggwi-eumja (Angelica Decoction) family relieves nighttime itching.
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