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Therapeutic Strategies to Treat Chronic Itch

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Dr Asit Kumar Mittal, Udaipur    22 January 2019

  • Therapy of chronic itch has moved beyond antihistamines.
  • Most of chronic itch is nonhistaminergic.
  • There is a need to understand that chronic itch can arise out of dermatologic, systemic neuropathic and psychogenic causes and amultidimensional approach is often required.
  • There is no universally effective treatment for various kinds of itch, a combination of topical and systemic therapies addressing peripheral mediators is required. A top down approach should target brain and spinal cord.
  • Neural hypersensitization down regulation should be attempted with drugs like gabapentin and pregabalin.
  • Specific neuropeptides such as neurokinin-1 are a promising target.
  • Targeted biologic agents such as IL-31 inhibitors and IL-4 and IL-13 inhibitors may be useful in treating pruritis of inflammatory disorders.

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