Pruritus (Generalised)

The broad differential diagnoses are:

• skin disease

• systemic disease

• psychological and emotional disorders

Treatment The basic principle of treatment is to determine the cause of the itch and treat it accordingly. Itch of psychogenic origin responds to appropriate therapy, such as antidepressants for depression.

If no cause is found:

• apply cooling measures (e.g. air-conditioning, cool swims)

• avoid rough clothes

• avoid known irritants

• avoid overheating

• avoid vasodilatation (e.g. alcohol, hot baths/showers)

• treat dry skin with appropriate moisturisers (e.g. propylene glycol in aqueous cream)

• topical treatment:

  • – emollients to lubricate skin

  • – local soothing lotion such as calamine, incl. menthol or phenol

  • – pine tar preparations (e.g. Pinetarsol)

  • – crotamiton cream

  • – consider topical corticosteroids

• sedative antihistamines (not very effective for systemic pruritus)

• non-sedating antihistamines during day

• antidepressants or tranquillisers (if psychological cause and counselling ineffective)