Home > Adults > Dermatology >

Pruritis

Checked: 10-12-2024 by Vicky Ryan Next Review: 10-12-2026

Overview

Pruritis (itchy skin) can have a variety of causes. Most of these are associated with a rash and the cause can be easily identified and treated accordingly.

A diagnostic tool can be helpful if the cause is not clear, such as the one available on the PCDS website:

The Cunliffe (TP) General Dermatology Diagnostic Tool

Generalised itching with no primary skin lesions may suggest a systemic causes including cancer. A full history to identify red flag symptoms is vital in uncovering some more serious systemic pathology and guiding appropriate referral.

See also the following Remedy pages where appropriate:

Guidelines

Local Clinicians recommend using clinical guidelines provided by Primary Care Dermatology Society. In addition NICE (National Institute of Clinical Excellence) suggests a stepped approach to facilitate good clinical practice.

Pruritis without a rash

Pruritis ani

Pruritis vulvae

Pruritus vulvae | CKS | NICE

Pruritis in pregnancy

Itch in pregnancy | CKS | NICE

Management of widespread itch

Management of widespread itch - CKS | NICE

Please refer to the BNSSG Formulary for the latest prescribing guidance.

Referral

Most patients with pruritis can be managed in primary care using the guidelines above.

If there is diagnostic uncertainty consider using Dermatology Advice & Guidance.

Referral to the Sirona Community Dermatology Service can be considered if further education/treatments are needed, to optimise efficacy and compliance. A skin biopsy is sometimes required for diagnostic purposes and can be performed by the GPwER if indicated.

Referral to secondary care via eRS can also be considered (although waits can be long).

Resources

Information on Pruritis and self-care advice – British Association of Dermatology (For both Patients and Health Care Professional’s)

Home Page - British Association of Dermatologists

Itch scratch cycle- Habit reversal for some Patients and psychological support can improve Quality of life for Patients.

Atopic Skin Disease - online community for practitioners and patients

Dermatology Life Quality Index (DLQI) assessment.

Dermatology UK | Dermatology and Skin Health

Patient self care advice

Itchy skin - NHS

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.