Multiple approaches and combined efforts may be needed to promote comfort and prevent alterations in the integrity of the skin. Patient Education and Elimination of Provocative Factors Patients and caregivers must be included in planning care and providing care to the extent possible. Education is an important aspect of symptom control. The intensity of the regimen and the techniques employed will vary according to etiologic factors and the degree of distress associated with the pruritus. Knowledge of factors that alleviate symptoms provides rationale for the development and implementation of effective and reasonable self-care interventions.
Adequate nutrition is essential to the maintenance of healthy skin.
An optimal diet should include a balance of proteins, carbohydrates, fats, vitamins, minerals, and fluids. Daily fluid intake of at least 3,000 cc per day is suggested as a guideline, but may not be possible for some individuals. If pruritus is thought to be primarily related to dry skin, interventions to improve skin hydration can be employed. The main source of hydration for skin is moisture from the vasculature of underlying tissues. Water, not lipid, regulates the pliability of the epidermis, providing the rationale for use of emollients.