Fletcher Allen, a Vermont university hospital and medical center, serves all of
Vermont and the northern New York region. Located in Burlington, Fletcher Allen is a regional, academic healthcare center and teaching hospital in alliance with the University of Vermont.
Pruritus (PDQ®): Supportive care - Patient Information [NCI]
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.
This patient summary on pruritus is adapted from a summary written for health professionals by cancer experts. This and other credible information about cancer treatment, screening, prevention, supportive care, and ongoing clinical trials is available from the National Cancer Institute. Pruritus (itching) is a side effect of some cancer therapies and may be a symptom of some types of cancers. This brief summary describes pruritus, its causes and treatment.
This summary is about pruritus in adults with cancer.
Pruritus is an itching sensation that triggers the desire to scratch. It is a distressing symptom that can cause discomfort. Scratching may cause breaks in the skin that may result in infection. Pruritus can be related to anything from dry skin to undiagnosed cancer. It can occur in people who have cancer or in those who have received cancer treatment.
Pruritus may occur in some people with cancer but not in others. However, the following persons with cancer may be at a higher risk for developing pruritus:
- Persons with various malignant diseases that are known to produce symptoms of pruritus, including, but not limited to AIDS -related Kaposi sarcoma, Hodgkin lymphoma and other lymphomas, leukemias, adenocarcinomas, and cancer of the stomach, pancreas, lung, colon, brain, breast, and prostate. Pruritus tends to disappear when cancer is cured or in remission. It may reappear when the disease recurs.
- Persons who have had chemotherapy. Usually the itching subsides within 30-90 minutes and does not require treatment. The development of pruritus may be a sign that the patient is especially sensitive to the chemotherapy drug.
- Persons who have had radiation therapy. Radiation can kill skin cells and cause burning and itching. As the skin peels off, scratching can damage it further, which creates the potential for infection. Treatment may need to be interrupted to allow the skin time to heal.
- Persons who have had radiation therapy plus chemotherapy. The combined effects of these drugs can cause an increased skin reaction.
- Persons who have had biological response modifier therapy (a treatment to try to improve the body's natural immune response to disease).
- Persons who have had bone marrow transplantation. Patients may experience changes in skin condition that include dryness, itching, and rashes.
Drugs given at any time during cancer treatment may cause pruritus. Itching may be caused by sensitivity to the drug, or the drug may interfere with normal nerve function.
Pruritus can be a symptom of infection. The infection may or may not be related to cancer treatment. Infections involving itching may be caused by a tumor, fungus, discharge from a wound, or drainage after surgery.
Pruritus is a symptom, not a diagnosis or disease. If you feel itching, let your doctor know. The doctor will ask for your medical history and give you a thorough physical examination. This assessment will enable the doctor to discover the problem that is causing the itching and find the best treatment for it.
Maintaining healthy skin may relieve pruritus. Good skin care includes adequate nutrition and daily fluid intake, protection from the environment, and cleansing practices that don't dry the skin.
Some specific factors that may relieve itching are the following:
- Moisturizing creams and lotions. These water-containing products form films over the skin surface and encourage the production of moisture beneath the film. This prevents dryness, which can cause itching. These products should be carefully chosen for each person's needs. Some ingredients, such as petrolatum, lanolin, and mineral oil can cause allergic reactions in some people.
- Powders, bubble baths, and cornstarch. These products should be used with caution because they can irritate the skin and cause itching. Cornstarch is an effective treatment for itching that is associated with dry skin due to radiation therapy but should not be applied to moist surfaces, to areas with hair, sweat glands, skin folds, or to areas close to mucosal surfaces, such as the vagina or rectum. When cornstarch becomes moist, it can promote fungal growth. Some powders, such as those that contain talcum and aluminum, can cause skin irritation during radiation therapy and should be avoided when you are receiving radiation treatment. Alcohol or menthol, which are found in some creams and over-the-counter lotions, may also produce skin reactions. Topical steroid creams may reduce itching but may cause thinning of the skin and can make it more prone to injury.
- Tepid baths. Baths that are moderately warm and last no longer than one half hour every day or every two days can help relieve itching. Frequent bathing can aggravate dry skin, and hot baths can promote itching.
- Mild soaps. Mild soaps contain less soap or detergent that can irritate skin. Oil can be added to the water at the end of a bath or applied to the skin before drying.
- A cool humid environment. Heat can cause itching. Your skin loses moisture when the humidity is low. A cool, humid environment may prevent your skin from itching.
- Removal of detergent residue. Residue left on clothing by detergent and fabric softeners may aggravate pruritus. The irritation can be reduced by adding vinegar (one teaspoon per quart of water) to the laundry rinse cycle or by using a mild laundry soap that is sold for washing baby clothes.
- Cotton clothing and bed sheets. Body heat, wool, and some synthetic fabrics can aggravate itching. It may be helpful to wear loose-fitting, lightweight cotton clothing and to use cotton bed sheets.
In addition to the skin-care factors, medications applied to the skin or taken by mouth may be necessary to treat pruritus. Antibiotics may relieve itching caused by infection. Antihistamines may be useful in some cases of pruritus. Sedatives, tranquilizers, and antidepressants may be useful treatments. Aspirin seems to have reduced itching in some patients but increases it for others. Aspirin combined with cimetidine may be effective for patients with Hodgkin lymphoma or polycythemia vera.
Interrupting the itch-scratch-itch cycle, an increase in itching that can result from the process of scratching, may also help to alleviate pruritus. The cycle may be broken by applying a cool washcloth or ice over the affected area. Rubbing the skin and applying pressure or vibration to the skin may also help. Other methods that may be useful in relieving symptoms include distraction, music therapy, relaxation, and imagery techniques.
Changes to This Summary (08 / 03 / 2011)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Editorial changes were made to this summary.
About This PDQ Summary
Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.
PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government's center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.
Purpose of This Summary
This PDQ cancer information summary has current information about the pathophysiology and treatment of pruritus. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
Reviewers and Updates
Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Supportive and Palliative Care Editorial Board.
Clinical Trial Information
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Clinical trials are listed in PDQ and can be found online at NCI's Web site. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
Permission to Use This Summary
PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as "NCI's PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary]."
The best way to cite this PDQ summary is:
National Cancer Institute: PDQ® Pruritus. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://cancer.gov/cancertopics/pdq/supportivecare/pruritus/Patient. Accessed <MM/DD/YYYY>.
Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 2,000 scientific images.
The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Coping with Cancer: Financial, Insurance, and Legal Information page.
More information about contacting us or receiving help with the Cancer.gov Web site can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the Web site's Contact Form.
Questions or Comments About This Summary
If you have questions or comments about this summary, please send them to Cancer.gov through the Web site's Contact Form. We can respond only to email messages written in English.
Get More Information From NCI
For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 a.m. to 8:00 p.m., Eastern Time. A trained Cancer Information Specialist is available to answer your questions.
The NCI's LiveHelp® online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 8:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.
Write to us
For more information from the NCI, please write to this address:
|NCI Public Inquiries Office|
|9609 Medical Center Dr.|
|Room 2E532 MSC 9760|
|Bethesda, MD 20892-9760|
Search the NCI Web site
The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. For a quick search, use the search box in the upper right corner of each Web page. The results for a wide range of search terms will include a list of "Best Bets," editorially chosen Web pages that are most closely related to the search term entered.
There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.
The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237).
Last Revised: 2011-08-03
If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.
Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.