OTCs Today
Mary Warner
Itchy skin, also known as pruritus, can be caused from many skin conditions, including eczema, dermatitis, and psoriasis; allergies; diseases such as shingles; or hormonal changes in pregnancy or menopause. Regardless of the cause, itchiness can be intense and last for a long period of time. As a patient rubs or scratches the area, the itchiness increases, leading to an itch–scratch cycle that can be hard to break. Fortunately, multiple skin treatments are available to relieve the itch.
According to the American Academy of Dermatology, the first step in soothing an itch is to apply a cold, wet cloth or ice pack to the skin that itches for about 5 to 10 minutes or until the itch subsides. If the itch returns, patients can apply one of the many topical creams that contain an anesthetic, a cooling agent such as menthol, or hydrocortisone.
Anti-itch options
A variety of nonprescription anti-itch creams and ointments are available (see table). Some contain pramoxine hydrochloride, a topical anesthetic that minimizes the itching sensation. Others contain cooling agents, such as menthol or calamine, that also minimize the sense of itching or distract the patient’s mind from the itch. Astringents such as aluminum acetate are also effective in relieving itches for some patients.
For itches that don’t respond to anesthetics, cooling agents, or astringents, hydrocortisone cream or antihistamines such as diphenhydramine hydrochloride can be useful. Topical steroids relieve the itch by decreasing inflammation, while antihistamines block histamine released by the immune system to reduce itching and swelling. However, it’s important to use either of these sparingly for no more than 14 days to avoid resistance that can develop with regular use.
What to tell your patients
Ensure that patients understand that itchy skin is common in older adults, as skin tends to become drier with age, and that anti-itch creams are not a cure but only offer temporary relief. If skin itching comes on or worsens quickly, seeking advice from a primary care provider is advised to rule out itching caused by medical conditions, such as anemia and thyroid disorders. Moisturizing the skin regularly, using gentle cleansers, and taking oatmeal baths along with using anti-itch creams can provide short-term relief. Stress that long-term relief from itching requires identification of the root cause of the itch.
For further information, please see the newly revised 21st edition of the Handbook of Nonprescription Drugs, available in the bookstore at pharmacist.com, or APhA OTC, APhA’s new interactive resource on nonprescription medications at www.pharmacylibrary.com/aphaotc. ■