Topical therapy

Topical therapy offers important intervention possibilities for the treatment of pruritus. Dry skin promotes pruritus. Therefore, an efficient re-fattening, hydration and stabilization of the physiological skin barrier should take place as basic therapy. This reduces the strength of the pruritus, which counteracts a further chronification of the symptom and increases the quality of life.

There are a number of ointments, creams, gels and lotions that can help to relieve pruritus for a short time.

Topical Creams are semisolid emulsions of oil usually designed to absorb into the skin. They are often water based, white, and non-greasy. They should be stored in cool places and the containers should be tightly closed to prevent evaporation.

Topical Ointments are emulsions of water droplets suspended in oil that do not absorb. They are oil based and appear greasy and clear. Although messy, they provide an occlusive dressing and allow for maximum penetration of the medicine.

Topical Lotions are suspensions of powder in water. They may require shaking before application. After the lotion is applied, the water evaporates and leaves a fine powder on the skin. Immediate itch relief occurs as the water evaporates and the skin cools.

Topical Gels are semisolid emulsions, clear, and often sticky. Some gels are alcohol based and may cause dryness.

Emollients are a type of topical treatment typically used as the first line of therapy for patients with chronic itch. Many cases of chronic itch cause a breakdown of the barrier function of the skin, and emollients help restore this function. Emollients contain substances, such as lipids, that seal in moisture and allow the skin to restore itself; it is typically suggested that patients apply emollients immediately after bathing.

Low pH cleansers and moisturizers also assist in restoring the barrier function of the skin by maintaining the acidic pH of the skin’s surface and reducing the irritative effects of pruritus.

Cooling agents can also assist in relieving the effects of chronic itch. These over-the-counter treatments contain substances like menthol, camphor, or phenol, which provide cold therapy, a treatment method that can minimize the itch sensation.