Home > Health & Wellness > Health Library > 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.
Pruritus is an itchy feeling that makes you want to scratch your skin. It may occur without a rash or skin lesions. It's a symptom of a condition or disease. Pruritus can be caused by cancer, cancer treatments, and conditions related to cancer. It also may be caused by an infection, dry skin, reaction to a drug, or a disease or condition that is not cancer.
The skin is the largest organ of the body. The most important job of skin is to protect against heat, sunlight, injury, and infection. The skin is also important to self-image and your ability to touch and be touched.
Pruritus can be very uncomfortable and scratching may cause breaks in the skin, bleeding, and infection. If your skin feels itchy, let your doctor know so it can be treated and relieved.
Certain cancers and blood disorders are likely to cause pruritus.
These include the following:
Certain cancer treatments may cause pruritus.
Cancer treatments that may cause pruritus include the following:
When chemotherapy causes pruritus, it may be a sign that you are sensitive to the drugs being used. Anticancer drugs that commonly cause itching include the following:
The way you react depends on the drug, the dose, and whether you are allergic to it. Itching caused when drugs are given by infusion usually occurs only near the place where the needle was inserted and often stops on its own 30 to 90 minutes after the infusion ends. It's important to report itching caused by chemotherapy to your doctor because your reactions can get worse each time the same drug is used.
Radiation can kill skin cells and cause dryness, burning, and itching as the skin peels off. Broken skin may become infected by scratching. If your skin is severely damaged, radiation treatments may have to be stopped for a while to give your skin time to heal. This can affect how well your cancer treatment works. Your doctor will try to keep your skin healthy so you can continue treatment. Some types of radiation cause fewer side effects than others.
Radiation therapy and chemotherapy together
The side effects of radiation therapy and chemotherapy given together can be more severe than the side effects when each is given alone.
Several biologic therapy drugs may cause itching. This is most common with drugs called interferons.
Bone marrow transplant
Graft-versus-host disease (GVHD) can occur after a bone marrow transplant. In some patients, GVHD may cause dry skin and an itchy rash. In severe cases, it can progress to scleroderma, which is a hardening and thickening of the skin. Muscles and tendons can also harden and make joints stiff. This complication of scleroderma is called contracture.
Drugs for supportive care
Some of the drugs used to prevent or treat cancer symptoms may cause pruritus, including the following:
Pruritus can be a symptom of infection.
Itching around the anus or vulva might be caused by infections with Trichomonas or fungi, nearby tumors, hemorrhoids, tears in the anus, or fluids draining from wounds.
Finding the cause of the itching is the first step in relieving pruritus.
Since pruritus is a symptom of a disease or condition, finding and treating the cause is the first step in bringing you relief.
A physical exam and a blood test are done to assess pruritus.
The following tests and procedures may be done to find the problem that is causing the itching:
A history of your health habits and past illnesses and treatments will also be taken, including the following information:
Treatment of pruritus in cancer patients involves learning what the triggers are and taking steps to avoid them.
It is important for you and for caregivers to know what triggers itching, such as dry skin or hot baths, so you can take steps to prevent it. You may need more than one type of treatment to relieve or prevent pruritus, protect your skin, and keep you comfortable.
Self-care, drugs, and comfort measures may all be used to treat pruritus.
Self-care includes avoiding pruritus triggers and taking good care of your skin:
Your doctor may prescribe an antibiotic if your pruritus is caused by an infection. You may also be given an oral antihistamine to relieve itching, with a larger dose at bedtime to help you sleep. For pruritus that is not related to radiation, you may use a mild corticosteroid on your skin, to relieve itching. Corticosteroids should not be used if the cause of pruritus is unknown.
Other drugs that may be used if other treatments do not work to control pruritus include sedatives and antidepressants. Antidepressants can have strong antihistamine and antipruritic effects.
Talk with your doctor about medicines you take that may be causing pruritus, such as opioids, morphine, or antibiotics. Changing to a different drug may stop the itching.
Comfort measures and acupuncture
The following may help relieve itching:
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National Cancer Institute: PDQ® Pruritus. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://www.cancer.gov/about-cancer/treatment/side-effects/skin-nail-changes/pruritus-pdq. Accessed <MM/DD/YYYY>.
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Last Revised: 2014-02-05
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