Chemotherapy, a common cancer treatment, can cause various side effects, including itching (pruritus). This sensation ranges from mild irritation to severe discomfort, affecting a person’s quality of life. Healthcare providers can often manage chemotherapy-induced itching.
Understanding Chemotherapy Itching
Chemotherapy can trigger itching through several mechanisms. Some drugs directly irritate nerve endings in the skin. Many chemotherapy agents also contribute to significant skin dryness (xerosis), which can cause or worsen itching.
Certain chemotherapy drugs may affect the liver, leading to cholestasis, a condition where bile flow is reduced. The accumulation of bile salts in the skin from cholestasis can cause intense, generalized itching. Some chemotherapy medications can also cause hypersensitivity reactions or inflammatory responses in the skin that manifest as itching.
Medications for Itch Relief
Healthcare providers offer several medication options to manage chemotherapy-induced itching. Antihistamines are frequently used. Sedating options like diphenhydramine and hydroxyzine can aid sleep, while non-sedating alternatives such as loratadine and cetirizine offer daytime relief. These medications block histamine, a compound involved in allergic reactions and itching.
Corticosteroids, available as topical creams or oral medications, reduce inflammation and relieve itching. Topical corticosteroids are applied directly to affected skin, while oral corticosteroids may be prescribed for widespread or severe itching due to their systemic anti-inflammatory action. For neuropathic itching, which stems from nerve damage, medications like gabapentin or pregabalin may be effective by modifying nerve signals.
For itching related to opioid use or specific chemotherapy pathways, opioid antagonists like naltrexone or naloxone are used; these agents block opioid receptors. If cholestasis causes itching, medications such as cholestyramine or rifampin may be prescribed; cholestyramine binds to bile acids, preventing reabsorption, while rifampin alters bile acid metabolism. Topical anesthetics, such as lidocaine cream, provide temporary localized relief by numbing the skin. Always discuss any medication for itching with a healthcare professional.
Home Remedies and Lifestyle Adjustments
Home remedies and lifestyle adjustments can provide comfort from chemotherapy-induced itching. Regularly moisturize skin with fragrance-free, hypoallergenic creams to combat dryness and maintain the skin’s barrier. Apply moisturizers immediately after bathing to seal in moisture. Use lukewarm water for baths and showers, rather than hot water, to prevent drying and irritation.
Adding colloidal oatmeal or baking soda to bathwater creates a soothing soak. Wear loose-fitting clothing made from soft, natural fibers, such as cotton, to allow skin to breathe and reduce friction that exacerbates itching. Keeping the skin cool, through methods like cool compresses or avoiding overheating, provides relief.
Avoid skin irritants, including harsh soaps, strong perfumes, and certain synthetic fabrics. Stay well-hydrated by drinking plenty of fluids to support skin health and moisture. Engaging in distraction techniques, such as mindfulness exercises or gentle activities, can shift focus from itching. These strategies complement medical treatments and contribute to overall comfort.
Seeking Professional Guidance
Communicate any itching experienced during chemotherapy with your healthcare team. Persistent or worsening itching, especially if it does not respond to initial remedies, warrants medical attention. Report itching that interferes with sleep, daily activities, or overall well-being.
Promptly evaluate new rashes, unusual skin changes, or any signs of infection such as redness, swelling, or pus. Unbearable discomfort requires immediate professional assessment. Maintaining open communication with oncologists or nurses ensures effective itch management.
Citations
Cholestatic pruritus: an update.
Chemotherapy-induced cutaneous toxicities: mechanisms, prevention, and management.
Management of pruritus in cancer patients.