From the Guidelines
Cold compresses can help ease itching by reducing inflammation and numbing nerve endings that transmit itch sensations to the brain. The mechanism behind this relief is attributed to the cold temperature causing blood vessels to constrict, which decreases blood flow to the area and reduces the release of histamine and other inflammatory mediators that trigger itching 1. According to a practice parameter update in the Journal of Allergy and Clinical Immunology, cold compresses might help to reduce local pain and swelling, and can be used in conjunction with oral antihistamines and oral analgesics to alleviate itching and pain associated with cutaneous reactions 1.
To apply a cold compress effectively, it is recommended to wrap ice cubes in a thin towel or use a clean washcloth soaked in cold water, then apply it to the itchy area for 5-10 minutes at a time. It is essential to never place ice directly on skin as this can cause damage. For persistent itching, the cold compress can be reapplied several times daily, allowing the skin to return to normal temperature between applications. This method is particularly helpful for itching caused by insect bites, minor skin irritations, hives, or eczema flare-ups.
Key points to consider when using cold compresses for itching relief include:
- Applying the cold compress for 5-10 minutes at a time
- Allowing the skin to return to normal temperature between applications
- Avoiding direct contact between ice and skin
- Using cold compresses in conjunction with other treatments, such as oral antihistamines and oral analgesics, as needed 1.
From the Research
Mechanism of Itch Relief
- The mechanism of itch relief involves the activation of distinct peripheral and spinothalamic pathways, including a histaminergic pathway and a nonhistaminergic pathway mediated by protease-activated receptors (PAR)2 and 4 2.
- Topical antihistamines, such as diphenhydramine, have been widely used to relieve pruritus, but the evidence to support their use is mixed 3.
- Topical corticosteroids, such as hydrocortisone, are commonly used to treat inflammatory skin conditions and can provide relief from pruritus 4, 5.
Efficacy of Cold Compress
- There is no direct evidence in the provided studies to support the use of cold compress in easing itching.
- However, some studies suggest that topical formulations, such as hydrocortisone acetate 2.5% and pramoxine hydrochloride 1% lotion, can provide significant reduction in pruritus 5.
- Other studies have investigated the use of topical caffeine with hydrocortisone in the treatment of atopic dermatitis, suggesting that caffeine may be effective in elevating local levels of cyclic adenosine-3',5'-monophosphate by inhibiting phosphodiesterase 6.
Limitations
- The provided studies do not directly address the use of cold compress in easing itching, and therefore, no conclusive evidence can be drawn from these studies.
- Further research is needed to investigate the efficacy of cold compress in relieving pruritus and its underlying mechanism.