Itching – Treatments and Drugs

The first rule of treatment for skin itching is to stop scratching since this may cause skin damage leading to secondary infections and other complications.

Washing your body can help relieve the itching in a safe way especially if you have been in contact with irritants, have folliculitis or perspire excessively.

After washing, try to stay cool to lessen the itching sensation in your skin. If your skin still feels itchy after you have bathed, you can apply camphor, eucalyptus, menthol, pramoxine or calamine lotion on the itchy area. You can also use cold compresses and apply it to your skin to numb the itchiness. This will help a lot especially if your itching comes from causes like:

  • Allergies
  • Insect bite
  • Contact dermatitis
  • Bacterial skin infection such as folliculitis

Moisturizers or Emollients

You can avail of these over-the-counter emollients/moisturizers easily and apply them on the affected skin areas after showering or bathing. These products should have no or at least minimal chemical additives in them as possible. You can also gently massage the itchy areas while you apply these products to minimize the itching.

Antipruritics

Antipruritics come in sprays or creams and can easily be purchased over-the-counter. Some of these drugs are prescription meds if they need to be taken orally.

Antihistamines

These are taken when the itching is caused by allergies. Diphenhydramine is the most widely known form of antihistamine. Antihistamines can make a person drowsy and so should not be taken if the person is driving or will drive. There are some antihistamines that do not cause drowsiness, fexofenadine and loratidin being two of these nonprescription drugs. Topical antihistamines strangely can cause side effects like allergic dermatitis to a person and should not be used when addressing itchy skin.

Corticosteroids

These often come in topical creams with 1% hydrocortisone concentration to address skin inflammation. Oral corticosteroids are given for systemic inflammatory problems like multiple sclerosis or extreme arthritis among others.

Local Anesthetics

These drugs can numb your skin to prevent you feeling any intense burning or itching sensation. Benzocaine topical cream is the most commonly used type of this drug.

Opioid-receptor Antagonists

These drugs are used to address severe pruritus caused by liver or kidney disease. Some opioid-receptor antagonists include naltrexone tablets, butorphanol intranasal spray and naloxone.

Tricyclic Antidepressants

For severe pruritus. These drugs include selective serotonin reuptake inhibitors (SSRIs) like fluoxetine or paroxetine, tetracyclic antidepressants like mirtazepine and amitriptyline and Doxepin

Astringents

Astringents constrict mucous membranes and skin vessels to lessen ithch and inflammation. Some examples of astringents include Burrow’s solution (with aluminum acetate). Astringents can also be applies as a cold compress to help lessen swollen and inflamed skin caused by cellulitis or hives (from poison ivy) or to relieve vaginal or vulvar itch

Topical Creams and Ointments

  • Capsaicin ointment – This medication can be effective in addressing localized tingling and back itch.
  • Tacrolimus ointment – For atopic dermatitis
  • Crotamiton/Eurax cream – For scabies

Exchange Resins

Drugs like cholestyramine helps relieve itch stemming from liver disease with cholestasis

Chelating Agents

These medications address itching caused by toxic metal contact.

Pramoxin

For rosacea

Low Protein Diet

This can be effective in relieving itchy skin due to chronic renal failure

Rifampin

Helps in itching relief due to bile flow obstruction

Aspirin

This can be effective when addressing itchy skin not caused by allergy. Aspiring should not be given to children with itch caused by viral infection since it can lead to Reye’s syndrome, which is a rare liver condition.

Antimicrobials

Bacterial, parasitic or fungal infections can be neutralized by oral or injectable antibiotics or by soaps or antimicrobial ointments. Viral infections like cytomegalovirus, herpes zoster or Epstein-Barr virus can be addressed by oral acyclovir or acyclovir ointment

Phototherapy

Phototherapy uses ultraviolet B rays to relieve skin itching caused by a number of conditions (aquagenic pruritus, AIDS, atopic dermatitis, prurigo nodularis and renal failure to mention some). PUVA or psoralen plus ultraviolet A phototherapy is used in treating in polycythemia

There are times when despite all forms of treatment have been used, the itch just would not go away. Waiting for the condition to heal by itself may be the only thing you can do. When time does heal the itch, the next step is to prevent the condition from repeating itself. This situation may apply for:

  • Ciguatera toxicity
  • Allergies
  • Contact dermatitis
  • Viral hepatitis
  • Pseudomonas or staphylococcal folliculitis
  • Almost all forms of viral skin infections

Acupuncture

According to the American Academy of Allergy, Asthma & Immunology, itching has four categories: psychogenic, neurogenic, neuropathic and pruriceptive. When body chemicals like norepinephrine and serotonin become imbalanced, the body experiences psychogenic itching that is usually treated with antipsychotic drugs or antidepressants. When the nervous system suffers from dysfunctions or damage, it can cause neuropathic itching.  Neurogenic itching, on the other hand, is caused by kidney or chronic liver disease. Pruriceptive itching comes from skin problems caused by skin inflammation, eczema, drug reactions and hives.

In treating itching acupuncturists carefully observe the symptoms of their patients to customize a treatment plan that specifically addresses their patient’s complaints. Even if patients report the same complaints they may be getting treatments different from each other. For itching symptoms like itch, red skin, acupuncture needles may be inserted along meridians of the Gall Bladder organ located on the thigh. For itching caused by eczema a Urinary Bladder meridian will be treated, usually located near the spine (at the back). For itching due to acne or hives another Urinary Bladder meridian will be treated by one or more acupuncture needles.

Dominic Sembello is a licensed and board certified acupuncturist and the clinical director of Health Source Acupuncture in Linwood, NJ.

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