From the Guidelines
For nighttime pruritus in the hospital setting, I recommend applying a topical antipruritic agent containing menthol 0.5% or a topical corticosteroid such as mometasone furoate 0.1% ointment to affected areas. This is based on the most recent guidelines from the Annals of Oncology 1, which suggest that these treatments can be effective for mild-to-moderate pruritus.
Key Considerations
- The use of lotions containing urea or polidocanol may also be beneficial in soothing pruritus 1.
- It is essential to apply adequate measures to prevent or treat skin dryness, as pruritus may occur due to dry skin 1.
- For patients with severe pruritus, other treatment options may be necessary, but the guidelines suggest starting with topical treatments 1.
Treatment Approach
- Apply a topical antipruritic agent or corticosteroid to affected areas, ideally in the evening to help alleviate nighttime symptoms.
- Consider using a moisturizing cream to maintain skin hydration and prevent dryness.
- Monitor the patient's response to treatment and adjust as necessary to ensure effective management of pruritus.
From the FDA Drug Label
PRINCIPAL DISPLAY PANEL - 28.4 g Tube Carton TopCare health ™ MAXIMUM STRENGTH • OUR PHARMACISTS RECOMMEND • NDC 36800-099-02 Hydrocortisone 1% Cream ANTIPRURITIC (ANTI-ITCH) Intensive Healing Formula † NET WT 1 OZ (28.4 g) Purpose Anti-itch
For pruritus at night in a hospital setting, hydrocortisone 1% cream can be considered as an option, given its antipruritic (anti-itch) properties 2 and anti-itch purpose 2.
- Key points:
- Hydrocortisone 1% cream is an option for pruritus.
- It has antipruritic properties.
From the Research
Pruritus Treatment Options
To manage pruritus at night in a hospital setting, several treatment options can be considered:
- Topical corticosteroids, such as hydrocortisone 1% cream, can provide relief from itching 3
- Ceramide-containing creams or lotions with 1% pramoxine hydrochloride, like CeraVe Itch Relief Cream, can offer rapid and long-lasting relief from itching 3
- Moisturizers with a lamellar structure containing synthetic pseudo-ceramides can help alleviate atopic dermatitis and reduce itching 4
- Non-pharmacologic therapies, including frequent moisturization, can improve symptoms of pruritus 5
Considerations for Pruritus Management
When managing pruritus, it is essential to:
- Conduct a thorough skin examination to identify primary and secondary skin lesions 6
- Consider trigger avoidance, liberal emollient use, and limiting water exposure 6
- Evaluate for systemic causes of pruritus, including malignancy in older patients with chronic generalized pruritus 6
- Consider consultation with a specialist if the evaluation for multiple etiologies of pruritus is ambiguous 6
Night-Time Itch Relief
For night-time itch relief, ceramide-containing 1% pramoxine cream can provide all-night relief, with 87.5% of patients agreeing to this effect 3