13.3 Topical local anaesthetics and antipruritics
Topical antipruritics
Emollient preparations may be useful for pruritus due to dry skin; sedating oral antihistamines may be helpful for itch (see section 3.4.1)
| 1st |  |
CROTAMITON is useful for pruritus associated scabies | ||
| 2nd | 1% MENTHOL in AQUEOUS cream |
Topical local anaesthetics
Topical local anaesthetics may be absorbed through mucosal surfaces. Local anaesthetics may occasionally cause sensitisation.
| 1st | TETRACAINE (AMETOP) gel | ||||
| 2nd | |
LIDOCAINE/PRILOCAINE (EMLA) cream |
Chronic urticaria (see section 3.4.1 of the BNF)
When treating chronic urticaria, long acting, non-sedating antihistamines need to be given regularly and in sufficient dosage to prevent the urticaria. If standard (hay fever) doses do not control symptoms, the dose may need to be increased above those recommended by the manufacturer, these regimens are recommended by dermatologists (see BAD guidelines) however, unlicensed e.g. cetirizine 10-40mg daily, fexofenadine 180-720mg daily.
| 1st | |
FEXOFENADINE 180mg | ||
| 2nd | |
CETIRIZINE | ||
| 2nd | |
LORATADINE | ||
|
DESLORATADINE | |||
| CHLORPHENAMINE or HYDROXYZINE may be added at night if sleep is disturbed by itching. Cimetidine or ranitidine may also be added for resistant cases. |
