Table 1. Topical therapies for pruritus.

CKD - chronic kidney disease

Medication	Dose	Notes
Barrier repair creams/moisturizers/emollients	Not applicable	Low pH products may be particularly useful
Topical corticosteroids	Variable	Not directly antipruritic; may be useful in pruritus due to inflammatory skin dermatoses
Topical calcineurin inhibitors	Tacrolimus 0.03% and 0.1% ointment	Particularly useful in anogenital pruritus, may experience transient burning and stinging
	Pimecrolimus 1% cream
Doxepin	5% cream	Avoid in children, 20% to 25% risk of sedation
Menthol	1% to 3% cream or lotion	Useful in patients who report cooling as an alleviating factor
Capsaicin	0.025% to 0.1% cream	Particularly useful in neuropathic itch; may experience initial transient burning
Salicylic acid	2% to 6%	Useful in lichen simplex chronicus, avoid in acute inflammatory dermatoses and children
Local anesthetics	Pramoxine 1% to 2.5%	Useful for pruritus on the face and that associated with CKD
	Lidocaine patch 5%	Useful in neuropathic pruritus
	Eutectic mixture of lidocaine 2.5% and prilocaine 2.5%	Useful in neuropathic pruritus
	5% urea + 3% polidocanol	Both moisturizing and anesthetic properties, not available in the United States
	Ketamine 5% or 10% + amitriptyline 5% + lidocaine 5%	Compounded agent; may be useful for various forms of chronic pruritus