Pruritus
Dermatology Pathways: Pruritus BAD Patient Information: Pruritus
Emollients should be considered first line treatment, see emollient choices in the Eczema section of the formulary. Anti pruritics should be considered when an emollient has been ineffective in relieving symptoms.
For itch associated with chickenpox. Also available via Pharmacy First.
Crotamiton is useful for pruritus persisting after treatment of scabies.
Prescribing Notes:
- Pruritus may be caused by systemic disease, skin disease or as a side-effect of medication. Where possible the underlying cause should be identified and treated.
- 1% menthol in aqueous cream is useful for patients with non-specific itch or for symptomatic treatment of hives in urticaria.
- Sedating oral antihistamines may also be helpful for itch (see Oral antihistamines for the treatment of pruritis pathway and also allergy recommendations in the Respiratory chapter of the formulary).
History Notes
27/05/2026
Regional formulary chapter launched.
Oral antihistamines can be used in combination with topical treatments.
Sedating antihistamine can be helpful for troublesome nocturnal itch. Avoid in the elderly, chlorphenamine has strong anticholinergic effects – see prescribing notes.
Sedating antihistamine can be helpful for troublesome nocturnal itch. Avoid in the elderly, hydroxyzine has strong anticholinergic effects – see prescribing notes.
Prescribing Notes:
- Pruritus may be caused by systemic disease, skin disease or as a side-effect of medication. Where possible the underlying cause should be identified and treated.
- Emollient preparations may be useful for pruritus due to dry skin.
- Sedating antihistamines such as chlorphenamine and hydroxyzine have strong anticholinergics effects and should be avoided in the elderly. Further information about anticholinergic burden can be found in the Scottish Government Effective Prescribing & Therapeutics Division Polypharmacy Guidance.
History Notes
27/05/2026
Regional formulary chapter launched.
Emollients should be considered first line treatment, see emollient choices in the Eczema section of the formulary. Anti pruritics should be considered when an emollient has been ineffective in relieving symptoms.
For itch associated with chickenpox. Also available via Pharmacy First.
Crotamiton is useful for pruritus persisting after treatment of scabies.
Prescribing Notes:
- Pruritus may be caused by systemic disease, skin disease or as a side-effect of medication. Where possible the underlying cause should be identified and treated.
- 1% menthol in aqueous cream is useful for patients with non-specific itch or for symptomatic treatment of hives in urticaria.
- Sedating oral antihistamines may also be helpful for itch (see Oral antihistamines for the treatment of pruritis pathway and also allergy recommendations in the Respiratory chapter of the formulary).
History Notes
27/05/2026
Regional formulary chapter launched.
Prescribing Notes:
- Pruritis without an underlying cause is uncommon in children. The underlying cause should be identified and treated, consider diagnosis and seek specialist advice if required. Regular oral antihistamines are rarely indicated.
- Emollient preparations may be useful for pruritus due to dry skin.
History Notes
27/05/2026
Regional formulary chapter launched.