Chemocare.com

Care During Chemotherapy and Beyond

Itching



Other terms:  Pruritis

What is itching?

Itching can occur suddenly (acute), or over a period of time (chronic).  It may occur alone or in combination with other symptoms, and may be localized or generalized.  Itching may be associated with various types of cancers such as Hodgkin's disease, Lymphoma, Leukemia, Kaposi's sarcoma, AIDs, liver metastases, renal failure, and may be associated with some antibiotics.

Acute itching, during the infusion of chemotherapy could be an early sign of a hypersensitivity reaction.  Chemotherapy medications commonly associated with risk of allergic reactions include: L-asparaginase, paclitaxel, docetaxel, teniposide, procarbazine, and cytarabine. 

Itching can occur as chronic side effect of anti-cancer treatments including Proleukin® (Interleukin-2), Interferon (Intron®& Roferon®), radiation therapy, acute and chronic graft-versus-host disease (GVHD), and occasionally supportive growth factors including Neupogen®(G-CSF) and Leukine®(GM-CSF). 

Symptom Management: 
Things you can do:

Early intervention is important for both acute and chronic itching. 

Acute itching: 

  • It is important to notify your treatment nurse immediately if itching develops during an intravenous chemotherapy treatment. 
  • Medications used to treat allergic reactions may be given, including diphenhydramine (Benadryl®), epinephrine, and hydrocortisone.
  • The chemotherapy treatment may be temporarily stopped to allow medications to be given.
  • The chemotherapy treatment will be resumed once itching and other symptoms associated with the hypersensitivity reaction have resolved.
  • Your physician or nurse should be notified if itching or rash develop within 48 hours of beginning a new cancer treatment or antibiotic.  Early assessment and intervention will reduce the severity of symptoms, and ensure rapid improvement in symptoms.

Chronic itching:

  • It is important to notify your nurse or doctor if a rash or itching develops.  Early diagnosis and treatment of chronic side effects will allow your treatment to continue while reducing side effects and their impact on quality of life. 
  • Your health care team will want to evaluate the onset, pattern, severity, and duration of itching.  They will also want information regarding other medications you are taking, as these may be contributing to your symptoms.

Skin care: 
Good skin care is important to reducing itching and it's impact on quality of life.

  • Maintaining a cool room temperature
  • Use gently, hypoallergenic laundry detergents (i.e. Ivory Snow®or Dreft®).
  • Rinse bed linens twice to ensure that all soap residues have been removed.
  • Tepid baths and the use of mild soaps such as Neutrogena®or Basis®.
  • Addition of soothing or moisturizing bath products such as Aveeno® Oatmeal bath or Keri® bath.
  • Addition of bath oils if the skin is intact.
  • Taking showers instead of baths
  • Frequent application of lotions such as Nivea®, Aveeno®, Lubriderm®, Aquaphor®,  or Keri® lotion.
  • Cool compresses applied to area for 20 minutes as needed to provide soothing relief.

Adequate hydration:

  • Drinking plenty of liquids is very important in reducing dry skin or itching.
  • The use of a water bottle is a very handy way of having liquids easily accessible throughout the day.   Drink a minimum of 2 liters each day, especially water.

Drugs or treatments that may be prescribed by your health care provider:

  • Antihistamines:  These drugs block histamine receptors.  There are 2 types of histamine receptors that have differing actions, H1 receptors are part of the body's response that controls airway constriction, capillary dilation and constriction of veins.  By blocking these receptors it interferes with the production of symptoms such as redness, urticaria (hives), or shortness of breath.
    • Examples of antihistamines are: diphenhydramine (Benadryl®), hydroxyzine, and cyproheptadine.
  • Corticosteroids: Steroids work by decreasing inflammation and swelling.
    • Used as part of the treatment of an acute allergic reaction.
    • For itching that does not respond to other treatments your doctor may prescribe a steroid cream to be applied topically (directly to the skin).

When to notify your health care provider:

Seek emergency help immediately and notify your health care provider, it you experience the following symptoms:

  • Shortness of breath, wheezing, difficulty breathing, closing up of the throat, swelling of facial features, hives (possible allergic reaction).

Contact your health care provider within 24 hours of noticing any of the following so the following can be evaluated:

  • Skin rash
  • Itching
  • Hives
  • If itching does not improve (or worsens) following use of medications prescribed to treat.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.