Pruritus emollients

Pharmacologic Therapy Topical emollients have been used as treatment for pruritus in patients with dry skin, but are often not effective in relieving pruritus associated with CKD. Antihistamines, such as hydroxyzine 25 to 50 mg or diphenhydramine 25 to 50 mg orally or intravenously, are used as... 

Non-medicated moisturizers. Maintaining adequate skin moisture helps to control the scaling associated with psoriasis. Emollients restore skin pliability, reduce skin shedding, reduce pruritus, and help prevent painful cracking and bleeding.2 Non-medicated moisturizers may be liberally applied several times daily to help prevent skin dryness. Fragrance-free products should be selected when available. 

Okada, K. and Matsumoto, K. (2004). Effect of skin care with an emollient containing a high water content on mild uremic pruritus. Ther. Apher. Dial. 8, 419-422. 

Moisturizers and emollients have been used for years in patients with dry skin with some relief in pruritus. Moisturizers are one of the gold standards of treatment in atopic dermatitis, the hallmark... 

Pruritus ani is managed by attention to hygiene, emollients, e.g. washing with aqueous cream, and a weak corticosteroid with antiseptic/anticandida application used as briefly as practicable (some cases are a form of neurodermatitis). Secondary contact sensitivity, e.g. to local anaesthetics, is common. 

The most common short-term side effects of PUVA are pruritus and transient nausea. Up to 25% of patients experience pruritus, which is UV dose-related and is associated with dryness of the skin. Usually, the pruritus responds well to emollients and antihistamines. Transient nausea affects 12% of patients taking 8-MOP and can be minimized by taking the medication with food or using antiemetics. PUVA pain is a rare, intermittent, severe burning pain that occurs 4—8 weeks after the onset of PUVA therapy. Because the pain worsens with ongoing therapy, PUVA must be discontinued and the pain usually resolves spontaneously in a few weeks. Other reported adverse effects include erythema and burning, maculopapular rash, exacerbation of photodermatoses, increased incidence of herpes simplex, and hepatotoxicity. 

These are only indicated in cases of serious edema or pruritus during the first few days after an aggressive peel. It is always best to start with a short-acting corticosteroid (hydrocortisone or betamethasone). A cortisone-based cream can be used during the first few days after a peel to reduce excessive edema or pruritus. The deeper the peel, the greater is the need for emollients. Hydration after a peel is vital (except after a peel with Unna s paste) the hydrating cream should contain no alcohol or perfumes. 

Topical corticosteroids have been the standard approach for treating the inflammation and pruritus of AD. Typically used in shortterm reactive treatment of acute flare-ups, topical corticosteroids must be supplemented with emollients. Clinicians unfamiliar with topical corticosteroids find them a challenge to use, due to the numerous types, strengths, generic versus brand name formulations, and the wide variety of ways to use the products. The corticosteroids are ranked according to potency depending on vasoconstrictor assays (see Table 96-4 in Chap. 96, on psoriasis). Most commonly, the highest-... 

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