|
 |
|
|
|
For the itch that makes you twitch
Scratching like a dog at a flea circus? Lots of awful, itchy things can torture your skin and twist your mind -- mosquito bites (argh!), flea bites, welts, hives, rashes (ugh!), measles, chickenpox, poison oak (ouch!), various foods or perfumes, even simple dry skin (ow!).
Before you do any more damage by scratching down to the bone, try to relieve the itching. Some people swear by at-home remedies: cooling baking soda or oatmeal baths, ice, flaxseed poultices, ocean-water soaks, moisturizers, witch hazel spritzes, increased dosages of vitamin C, A, and E or zinc. If you want something strong and scientifically-proven, however, there are plenty of effective over-the-counter products you can use.
|
|
|
|
|
Prevention Better Than Cure
The best way to treat itching is to avoid the cause. Investigate why you may be itching. Wear protective clothing while in the woods to protect yourself from contact with poison oak and biting insects. Change your laundry detergent, moisturize skin regularly with a hypoallergenic cream or lotion, and avoid perfumes and jewelry that may cause a rash.
Old but Not Forgotten Remedies
Calamine lotion with or without phenol (1%) added is probably the granddaddy of all the anti-itch lotions. Calamine is a suspension of zinc oxide in water, with ferric oxide added. Calamine lotion works as an astringent to dry up oozing rashes (i.e., from poison oak) and promote healing. Safe and effective, it can be used in combination mixtures with corticoids, topical anesthetics, and antihistamines -- which may enhance its ability to reduce itching, pain, and inflammation.
More Modern Methods of Itch Relief
Antihistamine creams have been used for relief of itching for many years. Tripelennamine hydrochloride is an antihistamine that can soothe itching due to allergic reactions from such ailments as hives, bee stings, or the rash from contact with a poison plant. Taken internally or applied externally, it can cause drowsiness. It also should not be used for more than a week.
Another widely-used antihistamine is diphenhydramine, or Benadryl -- available on its own or as a combination product ingredient (for example with calamine, in the product Caladryl). Much like tripelennamine, diphenhydramine works to relieve allergies when taken internally. Its major side effect, severe drowsiness, has also led to FDA approval for its use as a sleeping aid.
Overuse Is Not Useful
Do not apply large amounts of the topical anesthetics whose names end in the suffix "-caine." These preparations are very strong and can be absorbed into the body through bruised or damaged skin. In rare cases, this can lead to serious reactions, including convulsions, paralysis, and cardiac arrest. This is a particular risk with children who may spread large amounts of a "-caine" preparation over their bodies to combat itching from such irritations as chicken pox. Use the preparations moderately and watch for signs of distress. It may be fatal if swallowed, so keep this and all medications away from children's reach.
|
|
|
|
|
Antihistamines
Reduce symptoms of itching by preventing the histamine from binding to its receptor, and through an anesthetic action. It is not recommended that the topical form be used for longer than seven days. Only three antihistamines are approved by the FDA for topical use.
Hydrocortisone
A topical corticosteroid useful for reducing inflammation and itch. It works by reducing your body's inflammatory response. Should not be used on broken skin or for extended periods of time, since it can thin the skin and slow wound healing. Also, prolonged use can lead to tolerance and reduced effectiveness of hydrocortisone.
Topical anesthetics
Extremely common components of anti-itch preparations. Pain and itch sensations are carried over the same nerves. Anesthetics work by suppressing sensory nerve transmission to lessen the perception of pain and itch. The higher concentrations are appropriate for use on intact skin, but lower concentrations are recommended for broken skin. Topical anesthetics should not be used for serious burns, burns that cover large portions of the body, or more than four times daily. Be aware that some people are allergic to these products. Use over broken skin may lead to toxic effects.
Counterirritants
Commonly used in ointments because they reduce pain sensations by stimulating alternate nerve sensations. In other words, they take your mind off the pain by causing a distracting cooling or heating sensation. Unfortunately, they also stimulate blood flow to the area, which can cause swelling, and they may irritate the already sensitive skin.
Astringents
Agents that dry tissues. May be helpful in relieving itching and pain because they also bind proteins and bacteria, preventing them from irritating the skin.
Skin protectants
Agents that prevent skin irritation by forming a physical barrier between the skin and the irritating agent. They also soothe and soften the skin, keeping it moisturized and reducing friction against the skin. In this way, they may offer some relief from itching and pain.
| Antihistamines | Ingredient | Description |
|---|
| Diphenhydramine | ? | A popular and effective antihistamine, it has a strong sedating effect. One of the three antihistamines available in topical form for OTC use. | | Pyrilamine | ? | Highly effective. Even at high doses, this drug is not likely to produce fatal toxic efffects. Not commonly found in OTC products. | | Tripelennamine | ? | Available as a topical antihistamine in OTC products to help relieve itchiness. | | Hydrocortisone | Ingredient | Description |
|---|
| Hydrocortisone | ? | An effective anti-inflammatory agent, hydrocortisone should be used with caution if the skin is broken because it may allow infections to develop. | | Topical Anesthetics | Ingredient | Description |
|---|
| Benzocaine | ? | One of the more popular topical anesthetics for the treatment of sunburn. It produces allergy in 1% of those who use it. But it's less toxic than lidocaine. | | Butamben Picrate | ? | Less toxic than other anesthetics; however, it is less effective in relieving pain. | | Dibucaine | ? | A more slowly absorbed anesthetic on intact skin. But it is readily absorbed through broken skin, increasing the likelihood of having a heart or brain effect. | | Dimethisoquine | ? | Related to the other "-caine" anesthetics, it helps dull pain. Not commonly found in OTC products. | | Dyclonine | ? | One of the safer anesthetics because it has fewer side effects. | | Lidocaine | ? | Another popular topical anesthetic for sunburn. It has a lower incidence of allergy, but produces more systemic toxic effects. | | Pramoxine | ? | Used as a local anesthetic, pramoxine hydrochloride has a low incidence of adverse side effects and exhibits less cross-sensitivity than most other local anesthetics (because it is not derived from lidocaine or procaine). | | Tetracaine | ? | A potent "-caine" type of anesthetic, tetracaine relieves itching and pain on both damaged and undamaged skin. In large doses, it could interfere with heart and nervous system functions. This drug provides long-lasting relief. | | Counterirritants | Ingredient | Description |
|---|
| Camphor | ? | At concentrations of 0.1% to 3.0%, camphor is used as a topical pain reliever and anesthetic. In concentrations over 3%, camphor induces relief of pain and discomfort by stimulating nerve endings. High doses are not recommended, as camphor is toxic. | | Phenol | ? | Phenol has a strong ability to kill or inhibit disease-causing bacteria and other microorganisms, and it is widely used as a disinfectant. It also has anesthetic properties that relieve pain and itching, and is useful as an acne remedy and as an antifungal agent that acts against athlete's foot. However, it is extremely toxic; concentrations over 2% can cause skin to peel and die and may even cause systemic poisoning when applied externally. It is especially dangerous when used to treat diaper rash. Recent studies suggest phenol may be carcinogenic. | | Benzyl Alcohol | ? | A local anesthetic, benzyl alcohol is effective in concentrations of 5% to 20% and may applied up to six times a day. | | Menthol | ? | Usually combined with other ingredients with antipruritic or analgesic properties, such as camphor. At low concentrations (0.1% to 1.0%) menthol is used as an antipruritic, but there are no controlled studies to attest to its efficacy. In higher concentrations it is used as a counterirritant. Menthol causes sensitization in certain individuals, although the sensitization index is low. Symptoms include urticaria, erythemia, and other cutaneous lesions, such as contact dermatitis. | | Astringents | Ingredient | Description |
|---|
| Aluminum Acetate | ? | When applied to the skin (as it should be) complications are rare or nonexistent. It is safe and effective in relieving poison ivy and other irritating skin conditions. It can be used as a soak or applied to a larger skin area as a wet dressing. | | Aluminum Sulfate | ? | This ingredient stings when applied to cuts, but does not cause skin irritation. Aluminum sulfate is used to make styptic pencils, and there is little or no incidence of side effects. | | Hamamelis Water | ? | Also known as witch hazel, this ingredient possesses astringent properties and may act as a hemostatic for small superficial wounds. | | Skin Protectants | Ingredient | Description |
|---|
| Allantoin | ? | Appears to be nontoxic, nonallergenic, and nonirritating when applied to the skin. Allantoin is considered safe and effective at concentrations of 0.5% to 2%. It is useful for treating diaper rash. | | Aluminum Hydroxide Gel | ? | Aluminum hydroxide gel works as an astringent and keeps bacteria and other noxious substances from reattaching to the skin. | | Calamine | ? | Calamine protects the skin by absorbing moisture and chemical irritants. It also has soothing properties. It is widely used and considered trouble-free. | | Cocoa Butter | ? | Soothing compund used to protect the skin. When applied, it prevents evaporation and keeps skin soft and pliable, which leads to less pain and irritation. Cocoa butter is safe and effective in concentrations of 50% to 100%. Use as often as needed. | | Dimethicone | ? | Dimethicone is judged to be remarkably free of toxicity. It repels water and forms an effective seal against irritants. It can also be used to treat diaper rash, but should not be used on puncture wounds or infected wounds. | | Glycerin | ? | In a 20% to 45% concentration (as recommended), glycerin will hold water to the skin so it stays moist and is not irritated by wind, air, and other drying forces. | | Petrolatum | ? | Petroleum-derived product used to help protect irritated tissues. It should not be used on puncture wounds, lacerated skin, or wounds that have become infected, as it can retard healing. Use as often as needed. | | White Petrolatum | ? | Petroleum-derived product used to help protect irritated tissues. It should not be used on puncture wounds, lacerated skin, or wounds that have become infected, as it can retard healing. Use as often as needed. | | Zinc Acetate | ? | Zinc acetate precipitates bacteria and other proteins out of solution, neutralizing their harmful effects. It is considered a safe skin protectant. | | Zinc Carbonate | ? | It has been widely used -- without reported toxicity -- to cover and protect the skin. It appears to absorb noxious and irritating substances. It hasn't been proven effective, but its wide acceptance may attest to its effectiveness. Not commonly found in OTC products. | | Zinc Oxide | ? | Zinc oxide is used to cover the skin and protect it from dryness and other harmful environmental stimuli. It also absorbs toxic substances and serves as a lubricant. This substance is extremely safe. It is particularly effective in treating diaper rash and prickly heat. |
|
|
|
|
|
FDA-Approved Uses
Pain and itch relievers
- For the temporary relief of itching associated with minor skin irritations and rashes due to eczema, insect bites, poison ivy, poison oak, or poison sumac, soaps, detergents, cosmetics, and jewelry.
Relieving Irritation- For itching and minor skin inflammation that do not break the skin, there are many OTC products available to relieve discomfort.
- Wash the affected area to remove any possible irritants that may be causing the itching or rash.
- Skin protectants--They are often incorporated into anti-itch ointments and are also available alone. If they are the only ingredient, you may apply to the affected area as needed. If they are in combination, you should follow the dosaging of the other ingredients.
- Astringents--They are often incorportated into anti-itch ointments and are also available alone. If they are the only ingredient, you may apply to the affected area as needed. If they are in combination you should follow the dosaging of the other ingredients.
- Topical anesthetics--These products applied over intact skin are non-toxic. They can be applied over the skin 3 to 4 times per day. Some are known to cause allergies. Consult a physician if using on children under 12 years of age.
- Hydrocortisone--Hydrocortisone should be used to reduce the swelling if there is skin inflammation. It takes longer to work than topical anesthetics. It may be used up to 4 times per day. Consult a physician if you intend to use hydrocortisone on a child under 2 years of age.
- Counterirritants--They may be used up to 4 times per day to relieve itching and irritation on unbroken skin. Consult a physician if you intend to use on a child under 2 years of age.
- Antihistamines--They can be applied to the skin up to 4 times per day for up to 7 days. Taken orally they are more effective at reducing itching. They are known to cause allergies if used topically for prolonged periods. Consult a physician if you intend to use on children under 2 years of age.
Don't Scratch- An important part of treatment is to not scratch the affected area.
- Scratching may damage skin, which can lead to secondary bacterial infection.
- Scratching also further irritates skin and will lead to further inflammation.
If the Rash Won't Go Away- If after 7 days your rash has not improved or has gotten worse, it's time to consult a physician.
|
|
|
|
|
Do Not Use If
- You are allergic to hydrocortisone, topical anesthetics, or counterirritants.
- You have open wounds.
- You plan to use over large areas of skin.
Be Aware
- These products should not be used for more than 7 days.
- Some people become sensitized to these products after prolonged use and develop systemic allergic reactions.
Consult A Physician
- If after 7 days, you do not experience improvement of your symptoms or your symptoms worsen, consult a physician.
Common Side Effects
Hydrocortisone
Topical anesthetics
Counterirritants
Astringents
- Allergy to any astringents
Antihistamines (topical)
Infrequent to Rare Side Effects
Hydrocortisone
- Allergic skin rash
- Skin irritation
Topical anesthetics
- Allergic skin rash
- Skin burning, itching, or stinging
Counterirritants
- Allergic skin rash
- Skin irritation
Astringents
- Plan to apply to wounds, lesions, broken, damaged, or sensitive skin
- Plan to apply near eyes or other mucous membranes
Antihistamines (topical)
- Allergic skin rash
- Mild skin irritation
Effects of Overdose
Hydrocortisone
Topical anesthetics
Counterirritants
Astringents
Antihistamines (topical)
What to Do in Case of Overdose
Hydrocortisone
- For external use only. If swallowed, immediately seek medical attention.
Topical anesthetics
- For external use only. If swallowed, immediately seek medical attention.
Counterirritants
- For external use only. If swallowed, immediately seek medical attention.
Astringents
- For external use only. If swallowed, immediately seek medical attention.
Antihistamines (topical)
- For external use only. If swallowed, immediately seek medical attention.
|
|
|
|
|
Websites, Organizations & Manufacturers
Sources & Further Reading
Government Sources
- 1. Food & Drug Administration. Federal Register 10/3/89.
Books
- 1. Covington, TR et al. Handbook of Nonprescription Drugs, Eleventh Ed. American Pharmaceutical Assoc. Washington, DC 1996.
- 2. Kastrup EK et al. Drug Facts and Comparisons. Facts and Comparisons.
- 3. Inlander, CB and Slamans, S. The Over-the-Counter Doctor. Cader Books. New York, NY 1997.
Find more books on health and wellness at  barnesandnoble.com.
| |
|
