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Pruritus (PDQ®)

Treatment of Pruritus

Treatment of pruritus in cancer patients involves learning what the triggers are and taking steps to avoid them.

It is important for you and for caregivers to know what triggers itching, such as dry skin or hot baths, so you can take steps to prevent it. You may need more than one type of treatment to relieve or prevent pruritus, protect your skin, and keep you comfortable.

Self-care, drugs, and comfort measures may all be used to treat pruritus.

Self-care

Self-care includes avoiding pruritus triggers and taking good care of your skin:

  • Keep your home cool and humid. Warm, dry air can cause skin to become dry and itchy. Cool, humid air may prevent itching.
  • Eat a healthy diet and drink plenty of fluids. This helps your skin stay moist and healthy.
  • Avoid detergent residue on clothing and bed sheets. Traces of laundry detergent and fabric softener may be left behind on fabrics and can make pruritus worse. The residue can be reduced by adding vinegar (one teaspoon per quart of water) to the laundry rinse cycle or by using a mild laundry soap that is used for washing baby clothes.
  • Wear cotton clothing and use cotton bed sheets. Body heat, wool, and some man-made fabrics can trigger itching. Wear loose-fitting, lightweight cotton clothing and use cotton bed sheets.
  • Control stress. Stress and anxiety can make it harder for you to cope with pruritus. Ways to control stress include relaxation therapy, positive imagery, music therapy, and distracting yourself with activities. Talk with your doctor if stress is a problem for you.
  • Use moisturizing creams and lotions. A skin moisturizer prevents dryness, which can cause itching. A moisturizer contains water and forms a film over the skin's surface to keep it moist. Choose a moisturizer that meets your own needs. Some ingredients, such as petrolatum, lanolin, mineral oil, alcohol, and menthol, cause allergic reactions in some people. Topical steroid creams can reduce itching but may cause skin to become thin and easily injured.
  • Avoid hot baths. Hot baths can trigger itching. Baths that are just warm and last no longer than one half hour every day or every two days can help relieve itching. Bathing more often can make dry skin worse.
  • Use mild soaps. Mild bath soaps contain less soap or detergent that can irritate skin. Oil can be added to the water at the end of a bath or applied to the skin before drying.
  • Avoid powders, bubble baths, cornstarch, deodorants, and antiperspirants. These products should be used with care because they can irritate the skin and cause itching.
    • Cornstarch can help prevent itching of dry skin caused by radiation therapy but should not be used where skin is moist. When cornstarch becomes moist, fungus may grow. Avoid using it on areas close to mucous membranes, such as the vagina or rectum, in skin folds, and on areas that have hair or sweat glands.
    • Some powders and antiperspirants, such as those that contain talc and aluminum, cause skin irritation during radiation therapy and should be avoided when you're receiving radiation treatment.

Drugs

Your doctor may prescribe an antibiotic if your pruritus is caused by an infection. You may also be given an oral antihistamine to relieve itching, with a larger dose at bedtime to help you sleep. For pruritus that is not related to radiation, you may use a mild corticosteroid on your skin, to relieve itching. Corticosteroids should not be used if the cause of pruritus is unknown.

Other drugs that may be used if other treatments do not work to control pruritus include sedatives and antidepressants. Antidepressants can have strong antihistamine and antipruritic effects.

Talk with your doctor about medicines you take that may be causing pruritus, such as opioids, morphine, or antibiotics. Changing to a different drug may stop the itching.

Comfort measures and acupuncture

The following may help relieve itching:

  • A cool washcloth or ice held over the itchy area.
  • Firm pressure on the itchy area or on the same area on the opposite side of the body.
  • Acupressure or acupuncture.
  • Rubbing or vibration on the itchy area.
  • Updated: February 5, 2014