13

13.3 Anti-pruritic preparations and topical local anaesthetics

Pruritus

Pruritus may be caused by systemic disease (such as obstructive jaundice, endocrine disease, chronic renal disease, iron deficiency, and certain malignant diseases), skin disease (e.g. psoriasis, eczema, urticaria, and scabies), drug hypersensitivity, or as a side-effect of opioid analgesics. Where possible, the underlying causes should be treated. An emollient (see section 13.2) may be of value where the pruritus is associated with dry skin. Pruritus that occurs in otherwise healthy elderly people can also be treated with an emollient.

Calamine lotion, aqueous cream

Crotamiton cream, lotion (Eurax^®)

Refer to guidance “Management of pruritus”, for oral antihistamines see section 3.4. See also the Pruritus: Generalised and localised Dermatology Referral and Management Pathway.

For information on the treatment of urticaria see the Urticaria Dermatology Referral and Management Pathway and the British Association of Dermatologists Guidelines for evaluation and management of urticaria in adults and children, December 2007. Ranitidine (see section 1.3) or montelukast 10mg tablets (see section 3.3) may be used in the treatment of chronic urticaria [unlicensed use ‘off-label’].