Itching (Pruritus)
Itching (Pruritus)
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ICD 10 code: L29.0-3/L29.8-9
DESCRIPTION
Itching may be:
- Localised or generalised
- Accompanied by obvious skin lesions or skin conditions e.g. chicken pox
- Accompanied by many systemic diseases, e.g. hepatitis
- Caused by scabies and insect bites
GENERAL MEASURES
- Diagnose and treat the underlying condition
- Trim fingernails
- Avoid scratching
MEDICINE TREATMENT
- Calamine lotion, apply when needed
For pruritus associated with dry skin:
- Emollient, e.g.:
- Emulsifying ointment (UE)
If pruritis is severe and requires short term control:
Children
- Chlorphenamine, oral, 0.1 mg/kg/dose 6–8 hourly. See: dosing table
Adults
- Chlorphenamine, oral, 4 mg, 6–8 hourly
LoE:IVb1
Note:
Chlorphenamine is sedating and may only be required in the evening for mild cases.
If pruritis is severe and requires long term control, e.g. for chronic pruritus:
Children: 2–6 years of age
- Cetirizine, oral, 5 mg once daily. See: dosing table
Children > 6 years of age and adults
- Cetirizine, oral, 10 mg once daily
REFERRAL
- No improvement after 2 weeks
- Underlying malignancy or systemic disease suspected
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Version 1.0_07 November 2024
Chapter 5: Skin Conditions_5.2 Itching (Pruritus)