Pruritus Itch Treatments

As already described, pruritus is an obvious sensory feature of many different external and internal sources. The motor response that the sensation of itching evokes (i.e., scratching with the nails of the hands or feet), if not controlled, often perpetuates and intensifies the symptom and may lead to serious skin damage (e.g., abrasion, laceration, lichenification [skin thickening]), thereby reducing the ability of the skin to fimction as 

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Pruritus of the elderly is another common dermatosis associated with itch.5 One study has shown that elderly patients with generalized pruritus had a higher degree of skin dryness than in age matched control subjects.6 This study also demonstrated that skin surface conductance, a marker of stratum corneum water content, was decreased in elderly patients with generalized pruritus. The study was also successful in demonstrating an acquired abnormality in keratinization in these patients. This abnormality manifested with increased intracorneal cohesion compared with the controls. Another study showed an increase in histamine release and hypersensitivity in patients with senile pruritus.7 Paradoxically, oral anti-histamines are not very efficacious in the treatment of senile pruritus. 

The role of opioid antagonists in the treatment of pruritus in cholestatic liver disease has been reviewed (5). Their use is based on the theory that implicates opioid neurotransmission as the cause of itching in this condition, and it has been observed that opioid antagonists, while providing relief from itching in patients with cholestasis, also cause symptoms similar to those seen in the opioid withdrawal syndrome. It has therefore been suggested that... 

Nerve blocks can be given in cases of very painful outbreaks. A mixture of lidocaine with adrenaline (epinephrine) and ropivacaine or bupivacaine" can be used. In some cases, the doctor will have to prescribe opioids to relieve severe pain. However, treatment with opioids might well get rid of the pain but will not affect the itching. It could even aggravate the pruritus. The itching sometimes resists hydroxyzine and diphenhydramine. Asken reported that he once had to inject propanolol intravenously to relieve unbearable pruritus. 

Despite advances in dialysis treatment, prurims (itching) remains a problem for 60% to 90% of ESKD patients. The pathogenesis of uremic pruritus is poorly understood, but has been attributed to multiple factors such as inadequate dialysis, skin dryness, secondary... 

Tinea cruris is an infection of the proximal thighs and buttocks." It is referred to as jock itch and is more common in males. The scrotum and penis often are spared from infection. Treatment with topical therapy is recommended and shonld continne for 1 to 2 weeks after symptom resolntion. Severe infections may reqnire oral therapy (see Table 118-8). Relief of pruritus and burning may be facilitated by the use of short-term (2 to 3 days) topical steroids (2.5% hydrocortisone)." ... 

Azelastine is an ophthalmic antihistaminic preparation. It is indicated in the treatment of symptoms of seasonal allergic rhinitis, such as rhinorrhea, sneezing, and nasal pruritus treatment of symptoms of vasomotor rhinitis, such as rhin-orrhea, nasal congestion, and postnasal drip (nasal inhalation) treatment of itching of eye associated with allergic conjunctivitis (ophthalmic). 

Uses Antihistamine drug for relief of symptoms of head colds, common flu, sinus congestion, hay fever to elevate blood pressure treatment of allergic reactions of skin and mucous membranes, e.g., acute urticaria, atopic dermatitis, allergic rhinitis for temporary relief of itching skin, e.g., atopic dermatitis, contact dermatitis, pruritus, and insect bites jaundice Manuf./Distrib. ICN Biomed. Research Prods. http //www.icnbiomed.com Ruger http //www.rugerchemical.com Spectrum Quality Prods. 

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