16.12 Itch in palliative care

Itch may be localized, or due to systemic disease. It can cause discomfort, frustration, poor sleep, anxiety and depression. Persistent scratching leads to skin damage – excoriation and thickening. Patients with itch usually have dry skin.


  • Use emollient/aqueous cream frequently (at least three times a day) as a moisturizer
  • Treat underlying causes - e.g. biliary stenting or drainage for cholestasis
  • Review medication to exclude a drug reaction, consider opioid switch
  • Keep nails short
  • Use loose fitting, cotton clothing and sheets and keep cool
  • Dry skin by patting rather than rubbing, then apply moisturizer
  • Avoid lanolin and perfumed products
  • Add an emollient to bath water and use aqueous cream as a soap-substitute

Refer also to Chapter 13: 13.6 Pruritis )

Topical agents

Systemic medication


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