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UntitledPhoenix Society for Burn Survivors - Burn Support News 2008 Fall Issue
How to Beat the Itch
MICHAEL D. PECK, MD, SCD
DIRECTOR OF INTERNATIONAL OUTREACH
Almost all of my patients complain of itching at one time or particularly on the legs, long past the time when the scars are another. For some, itching starts right away, as soon as the burn starts to heal. For others, it may wait until one or two months Topical medications are helpful in some patients.
have gone by. Many patients are troubled by the itching at work Hydrocortisone ointment can be purchased without a or school, and many others cannot sleep well at night. For an prescription, as can Benadryl ointment. Unfortunately, I have unfortunate few, itching can be so severe as to cause major had little success with either. More effective are the local anesthetics, such as Nupercainal or Preparation H. These If I could offer any simple solutions to this problem, my ointments, found under the hemorrhoidal preparations in the patients and I would be much less frustrated. Unfortunately the drugstore, have local painkillers that are safe to use on the skin.
only certainty I can offer is that, first, itching is a normal Some patients have also told me that the local application of response to healing and, second, it will go away with time. This cold helps; try a bag of frozen vegetables (such as peas or corn) latter statement is rarely received with enthusiasm, and over the pressed up against the area of discomfort, particularly before years my patients and I have found a few methods that lead to temporary and partial relief. Understand first of all that itching Systemic medications (taken by mouth) are the next step.
is defined as “an uneasy sensation of the skin that inclines the Benadryl can be purchased over the counter, either as pills for person to scratch.” This is subjective, for nobody can tell you adults or elixirs for children. Ataraz and Periactin are also how itching feels, nor how severe your symptoms are. It is also commonly prescribed, and like Benadryl, are histamine blockers.
an uncomfortable sensation that falls somewhere between a Histamine is one of the chemical mediators released from cells in tickle on the one hand and a pain on the other. The nerve fibers the burn scar, called mast cells that are chronically stimulated responsible for the itch sensation have their endings right at the during the final maturation phase of healing. The problem with junction between the two layers of skin, the dermis and the the older histamine blockers like Benadryl is that they commonly epidermis. These nerve fibers are identical to those that conduct cause drowsiness. The newer generation of histamine blockers, pain messages. So, in truth, itching is a variant of pain.
familiar to those of us with allergies, includes such drugs as The first step in treating itching is keeping the skin moist. Dry Seldane and Claritin which do not cause drowsiness in most skin, especially dry burned skin, is a common cause of itching.
people. Recently we have had good success with Claritin 10mg This problem can be easily prevented by applying skin moisturizers on a regular basis, often several times a day. We use creams that More severe symptoms require the treatment supervision of a are simple in composition, avoiding those with perfumes or other physician. Some patients require oral steroids such as prednisone additives. Lotions should also be avoided because they contain for relief, but steroids have many side effects and should be used alcohol to liquefy them, and alcohol can dry the skin. Vitamin E, with caution. Tricyclic antidepressants such as Elavil can also be aloe vera, and other natural ingredients are not helpful in my helpful. Again, these drugs are by prescription only, and should experience, but neither are they harmful (although they only be used with appropriate supervision.
significantly increase the price of the moisturizing cream!). Cocoa Finally, there are many nonpharmacologic approaches to pain butter is one of my favorites, especially the solid stick form. Crisco and itch management. Acupuncture, aromatherapy, hypnosis, shortening (in the tub, not the oil) is also very effective.
meditation, and many other techniques may offer relief. We The second step is ensuring that pressure garments are applied have had experience with scar massage therapy by a licensed appropriately by a professional. Many burn centers advocate massage therapist, and have documented in prospective studies pressure garments to minimize scar formation, but in addition that scar massage reduces itching discomfort.
they can also provide relief of local symptoms of discomfort in Management of burn scar itching continues to be a challenge the burn scars. By squeezing the scars and reducing the amount for health care providers. If you have stumbled upon treatment of blood in the vessels and fluid in the tissue, pressure garments or technique that has been successful for you, please contact me can make burn scars, especially on the extremities, easier to live in care of the Phoenix Society so I can share your findings with with. Some of our patients continue to use their garments,
Dietary silicon intake is positively associated with bone mineral density in men and premenopausal women of the framingham offspring cohort
JOURNAL OF BONE AND MINERAL RESEARCH Volume 19, Number 2, 2004 Published online on December 16, 2003; doi: 10.1359/JBMR.0301225 © 2004 American Society for Bone and Mineral Research Dietary Silicon Intake Is Positively Associated With Bone Mineral Densityin Men and Premenopausal Women of the Framingham Offspring CohortRavin Jugdaohsingh,1,6 Katherine L Tucker,2,6 Ning Qiao,2 L Adrienne Cuppl