Novel Agents for Intractable Itch

C. B. Lynde; J. N. Kraft, MD; C. W. Lynde, MD, FRCPC

Disclosures

Skin Therapy Letter. 2008;13(1):6-9. 

In This Article

Traditional Topical Agents

Topical agents provide symptomatic relief. However, it must be stressed that successful management depends on establishing the underlying physiologic imbalance.

  • Menthol 1%, compounded in an aqueous cream or in a moisturizer base, sensitizes thermal receptors to cold and is considered a safe remedy that has been used for centuries.

  • Doxepin 5% cream is a topical tricyclic antidepressant that relieves pruritic symptoms associated with atopic dermatitis. Patients being treated with doxepin should be cautioned regarding adverse side-effects, such as systemic absorption and drowsiness.

  • Capsaicin 0.025%-0.3% cream is derived from chili peppers, and triggers the release of substance P from C nociceptors, which desensitizes nerve fibers. Local irritation can result.

  • Topical corticosteroids are only considered when there is a primary dermatosis, due to the potential for local side-effects (i.e., telangiectasia, atrophy, striae).

  • Topical anesthetics are seldom used as they are associated with an increased risk of allergic sensitization.

  • Other topical agents that may be of benefit include: moisturizers, oatmeal-based agents, calamine lotion, aloe and camphor.

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