Treatment of itching skin (pruritus)

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 13.6 Pruritis

Doxepin cream

  • Apply three or four times a day
  • Use for localised areas of itch (e.g. pruritus ani) rather than generalised itching.
  • See 13.6 Pruritis

Oral treatments

Chlorphenamine

Hydroxyzine

Amitriptyline

 

Home > Formulary > Chapters > 13. Skin > Treatment of itching skin (pruritus)

 

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