Airborne allergens also complicate the picture. Difficult cases may require allergy testing. Treatment starts with nonsedating antihistamines. Several of the newer products, like fexofenadine and loratidine, minimize drug interactions. While most infections tend to be painful, superficial infections in athletes may be itchy.
Most cases are gram-positive infections with staphylococci or streptococci.
Other bacterial infections that itch in their early stages include impetigo, often an infection with both Streptococcus and Staphylococcus organisms. If imidazoles cannot be used or application does not resolve the infection, a culture is advisable. Generalized pruritus can be caused by dermatologic conditions like pityriasis rosea and nonspecific viral exanthems. Nonspecific viral exanthems, which last days to weeks, frequently are widespread, maculopapular eruptions heralded by or associated with constitutional viral symptoms. Though both conditions tend to be self-limiting, they can be treated with antihistamines and topical antipruritics such as pramoxine or menthol and phenol moisturizers until symptoms abate.