How to Treat Itchy Skin without Rash
Management of Pruritus without Visible Skin Rashes
Aug 25, 2009
Just as it is difficult to ascertain the cause of generalized itching without skin rash, so it is to find satisfactory control of the itching in the absence of a definite diagnosis of the skin or systemic disease causing the itchy skin.
Following are the principles of management of generalized pruritus without visible skin rashes:
Treatment of Itchy Skin without Rash: General Measures
General measures for the management of generalized itching without skin rashes involve symptomatic treatment of the itching with anti-itch medications and keeping the skin moist and supple.
- Antihistamines, the anti-itch medications, help in some cases of generalized itchy skin without rashes, especially due to skin diseases. Generally, itching caused by systemic diseases like kidney or liver diseases and malignancies do not respond satisfactorily to antihistamine therapy. If the itching is severe and interfering with sleep, short acting antihistamines like chlorpheniramine or hydroxyzine is preferred as a bedtime dose, along with long acting antihistamines like cetrizine, levocetrizine or loratidine as a single morning dose.
- Patients are advised to take baths in lukewarm water with bath oil added to it and then apply an emollient cream immediately after bath to trap in the water. Reducing the dryness of the skin will help in relieving the itch, whatever be the cause.
- Drink lots of water and fresh juices (except mango and pineapple, which could actually make the itching worse).
- Avoid red meats, eggs and fried, spicy, fast foods. Eat more vegetables.
- Use cotton dresses; avoid too much sun exposure; avoid using woolen blankets.
- Avoid alcohol. Alcohol, even in moderate amounts can increase the itchiness, by increasing skin blood flow and sensitivity.
Management of Pruritus without Visible Skin Rashes: Specific Measures
- Finding the exact cause of the itchy skin and treating the cause of the pruritus sine materia is the specific treatment modality for generalized itching without visible skin rash.
- Treat skin diseases associated with dryness as above.
- If scabies is diagnosed, ant-scabetic medications should be applied to the whole family members.
- Phototherapy with PUVA or narrowband UVB is effective in relieving itching associated with kidney and liver diseases as well as in aquagenic pruritus and polycythemia vera.
- Dialysis relieves itching dramatically in patients with renal failure.
- Nolaxone, naltrexone, odansetrone, cholestyramine etc are useful in bile retention liver diseases, but ineffective in total biliary obstruction.
- Psychogenic pruritus is treated with anti-anxiety and antidepressant medications.
Other specific causes of generalized itching without visible skin rash is managed depending upon the diagnosis of the cause of generalized itching made through detailed history, clinical examination and extensive laboratory investigations.
Reference
- Pruritus, in Rook’s Textbook of Dermatology, 7th Edition, 2004
- Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology, Fifth Ed, 2005
Disclaimer
The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.
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