Formulary

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Chapter 13: Skin Toggle Pages
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Treatment of itching skin (pruritus)

First Line
Second Line
Specialist
Hospital Only

Whilst skin conditions such as eczema, dry skin and scabies are the commonest causes of generalised itch, it is important to conduct a thorough general examination to exclude systemic causes. If the cause of the itch is not readily diagnosable on appearance or by skin biopsy, consider causes such as:

  • Anaemia (FBC and ferritin)
  • Uraemia (check U&Es)
  • Obstructive jaundice (check LFTs)
  • Thyroid disease (check TFTs)
  • Lymphoma (especially in young adults)
  • Carcinoma (colonic Ca)
  • Diabetes (HbA1c)
  • Other tests should be guided by history and examination findings (for example chest radiography, urinalysis, faecal occult bloods).

Topical treatments

Crotamiton

  • Apply two or three times a day
  • Exclude scabies before use as crotamiton masks this and it is not fully effective as an acaricide.
  • See 13.3 Antipruritics

Doxepin cream

  • Apply three or four times a day
  • Use for localised areas of itch (e.g. pruritus ani) rather than generalised itching.
  • See 13.3 Antipruritics

Oral treatments

Chlorphenamine

Hydroxyzine

Amitriptyline

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