Loose fitting, lightweight cotton clothes and cotton bed sheets are suggested. The elimination of heavy bedcovers may alleviate itching by decreasing body heat. Wool and some synthetic fabrics may be irritating. Distraction, music therapy, relaxation, and imagery may be useful to relieve symptoms. Topical steroids may provide relief when symptoms are related to a steroid-responsive dermatosis, but anticipated benefits must be weighed against the vasoconstrictive side effects.
Topical steroids have no role in the management of pruritus of unknown origin.
Topical steroids should not be applied to skin surfaces inside a radiation treatment field. Systemic medications useful in the management of pruritus include those directed toward the underlying disease or control of symptoms. Antibiotics can reduce symptoms associated with infection. Oral antihistamines may provide symptomatic relief in histamine-related itching. A higher dose of antihistamines at bedtime may produce antipruritic and sedative effects.