Published on July 27, 2020
Reduce Chronic Itching (Pruritus) in Myeloproliferative Neoplasms
Comic book artist and myeloproliferative neoplasm (MPN) patient J.G. Jones described pruritus this way: “It sounds like nothing until you’ve had it and you’re on the floor curled up in a ball for an hour because of the itching.”
He’s right. Pruritus can be just as debilitating as chronic pain, according to a study in the Archives of Dermatology. Chronic itching was defined as anything lasting longer than six weeks.
What is Pruritus?
Pruritus is the medical term for skin itching. It is a common symptom of all three types of MPNs.
“I’ve certainly heard from many people here about the issue of itching,” said Patient Power host Dr. Susan Leclair in a 2015 interview with Dr. Stephen Oh, an associate professor in the Hematology Division at the Washington University School of Medicine in St. Louis. “…pruritus seems to be one of the major, I think it would be better to die kind of things than go through this again…It’s just a plain old quality-of-life kind of issue, but it’s so important to so many people.”
A survey of myeloproliferative neoplasm patients found that 81% of respondents suffer from pruritus. The symptom was present in 72%, 84%, and 85% of essential thrombocythemia (ET), primary myelofibrosis (MF), and polycythemia vera (PV) patients, respectively.
Tips for Managing the Intense Itch of Pruritus
Before you cut short all your nails or resort to wearing gloves at night (to avoid scratching — a no-no), check out these home remedies and tips on how to manage pruritus:
- Know what triggers your itching, such as hot showers, heavy clothing or dry skin, so you can take steps to prevent it.
- Avoid taking hot baths or showers. Use warm or cool water instead.
- Do not bathe too often. Bathing too much can dry out the skin. Use a baby wash or mild soaps like Cetaphil cleanser, Dove for Sensitive Skin, Oilatum, or Basis.
- Don’t rub your skin to dry off after bathing. Instead, pat it dry with a towel.
- If pruritus is related to dry skin, consider using emollient creams or lotions.
- Wear loose-fitting lightweight cotton clothing and use cotton bed sheets. Some fabrics, such as wool and synthetics, can cause itching.
- Keep your home cool and humid. Warm, dry air can cause skin to become dry and itchy.
- Wash sheets, clothes, and underwear in a mild soap or baby soap that contains no scents, dyes, or preservatives, such as Dreft, All Free Clear, Tide Free and Gentle. Adding vinegar (one teaspoon per quart of water) to the rinse water removes traces of detergent.
- Try to control stress. Stress and anxiety can exacerbate itching. Try meditation, visualization or other relaxation strategies. Use distraction techniques, such as listening to music or engaging in your regular activities.
- Get bloodwork done. Pruritus can be a symptom of high blood counts.
- Ask your doctor about itch-relieving medications. Oral antihistamines, such as diphenhydramine (Benadryl), hydroxyzine, doxepin, loratadine (Claritin), fexofenadine, and cetirizine (Zyrtec), can relieve itching. Topical corticosteroid medications applied directly to the skin can also help.
- Talk to your doctor about changing treatments. A Phase III trial reported in the New England Journal of Medicine demonstrated that itching was reduced by 95% in PV patients treated with ruxolitinib (Jakafi) compared to only 2% with standard therapy.
Bottom line: “One solution doesn’t fit all,” Dr. Jon Lambert, a hematologist from University College Hospital in London, said in an interview with Patient Power Co-Founder Andrew Schorr. “You need to have that discussion and come to a personalized management plan that suits you, understanding that sometimes it’s a matter of trying one thing, seeing if that works, if that doesn’t work, trying something different.”
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- Kini SP, DeLong LK, Veledar E, McKenzie-Brown AM, Schaufele M, Chen SC. The impact of pruritus on quality of life: the skin equivalent of pain. Arch Dermatol. 2011;147(10):1153–6. Epub 2011 Jun 16.
- Mesa RA, Niblack J, Wadleigh M, et al. The burden of fatigue and quality of life in myeloproliferative disorders (MPDs): an international Internet-based survey of 1179 MPD patients. Cancer. 2007;109(1):68-76.
- Vannucchi AM, Kiladjian JJ, Griesshammer M, et al. Ruxolitinib versus Standard Therapy for the Treatment of Polycythemia Vera. New England Journal of Medicine. 2015 Jan 29;372(5):426-35.
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