In recent years, clinical research has made great progress. Many patients can be offered treatment with drugs – based on current guidelines and experience. Topical glucocorticoids or calcineurin inhibitors, topical Capsaicin, non-sedating antihistamines, Gabapentinoids, µ-opioid receptor antagonists, Antidepressants and UV phototherapy are now used in the treatment of chronic pruritus. In most cases, these therapies must be carried out over a longer period of time in order to be effective.
Topical corticosteroids: The most common topical treatments involve topical corticosteroids. These anti-inflammatory agents come in different strengths. As you move up in strength, there is greater chance the agent will work, but there is also a greater risk of side effects. These side effects include atrophy of the skin, which may lead to skin fragility, easy bruising, and stretch marks. Other side effects include acne, folliculitis, rosacea, reduced wound healing, excess hair growth, and allergic reactions. For a complete list of side effects, make sure to read the pharmacy pamphlet.
Topical anesthetics, such as pramoxine and EMLA cream affect both pain and itch receptors. In many cases, these anesthetics are combined with cooling agents to amplify their efficacy.
Topical antihistamines are thought to block histamine release and decrease itch. Their use, however, is limited by the high number of allergic reactions.
Bathing agents such as rice bran broth, hot water for psoriasis, miscible bath oils or vegetable oils, colloidal oatmeal baths, tar baths and sodium bicarb baths can also assist in soothing the sensation of itch.