Itch Without Rash
Introduction
Itch without rash usually has a simple cause that is not serious - most commonly, it is due to xerosis (dry skin).
- Known causes, in approximate order of incidence are listed in tablet below.
Management
For itch without rash that has a definite cause, the itch typically resolves when the cause is treated or removed.
- Treating dry skin
- Treating scabies
- Removing irritants
- A trial of stopping or changing a drug can be useful
Itch without rash in children is often caused by dermographism; initial therapy is an oral antihistamine.
- Less-sedating antihistamines and sedating antihistamines (for sleep disturbance associated with itch) can be used.
If the cause of the itch is dry skin or is not known, improve the skin condition by
- Using a soap substitute
- Avoid long, hot showers and baths, especially elderly patients with dry skin.
- After bathing, avoid rubbing the skin to dry. Instead, pat the skin dry with a towel.
- Apply moisturizer several times a day, especially after bathing.
In addition, general measures such as cooling the skin (e.g. with a cool bath, storing emollients in the fridge before use, using an emollient containing menthol) can reduce itch.
If required, topical corticosteroid or oral antihistamine can be used.- If these treatments are still not successful, refer the patient for dermatologist advice and specialist treatments (e.g. ultraviolet B phototherapy).
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