What is the role of topical therapy for renal pruritus?

Updated: Mar 03, 2020
  • Author: David F Butler, MD; Chief Editor: William D James, MD  more...
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Answer

Topical therapy is especially helpful in cases of localized pruritus.

Capsaicin 0.025% cream is effective for localized pruritus due to chronic renal failure, as has been shown in double-blinded, placebo-controlled studies.

Topical application of a eutectic mixture of local anesthetics (eg, EMLA cream) before capsaicin treatment may reduce the burning sensation associated with capsaicin. [25]

Tacrolimus 0.03% ointment has shown promising results for localized renal pruritus in a prospective study, but randomized placebo-controlled studies are needed. Tacrolimus is a calcineurin inhibitor, it decreases the differentiation of type 1 helper T lymphocytes, and it reduces the production of interleukin 2. [26]

Topical gamma linolenic acid appears promising. [27] Topical gabapentin cream (3-6%) has been reported to help vulvodynia and could potentially be used to treat localized areas of neurogenic pruritus such as pruritus vulvae, pruritus scroti, and notalgia paresthetica. [28]


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