Pruritus is a common symptom that occurs in a wide variety of clinical settings, such as dermatologic disorders, neuropathic disorders, and systemic or psychiatric disease. In addition to physical effects (eg, skin injury, secondary infections, scarring, and loss of sleep), pruritus can contribute to emotional disturbances such as agitation and depression . In severe cases, pruritus can be incapacitating.
The inciting factor for pruritus and the extent and severity of symptoms influence the approach to treatment. While in some patients amelioration of pruritus is easily attained, treatment is extremely challenging in other individuals.
A wide variety of therapies have been used for pruritus; however, data are limited on the efficacy of many treatment options (table 1A-B). The therapies used for pruritus and the approach to the management of pruritus will be discussed here. Inciting factors for pruritus and the evaluation of patients with pruritus are reviewed separately. (See "Pruritus: Etiology and patient evaluation".)
Both nonpharmacologic and pharmacologic therapies may be beneficial in the treatment of pruritus. Topical therapies are commonly used for localized forms of pruritus; systemic agents are typically needed for patients with generalized symptoms. (See 'Local pharmacologic therapies' below and 'Systemic therapies' below.)
Nonpharmacologic interventions — The elimination of aggravating factors for pruritus is an important component of symptom management. Interventions that may be beneficial include: