A 65 year old female is experiencing a flare-up of pruritus. Which of the client’s actions could aggravate the cause of flare-ups?
A. Sleeping in cool and humidified environment
B. Daily baths with fragrant soap
C. Using clothes made from 100% cotton
D. Increasing fluid intake
Correct Answer: B. Daily baths with fragrant soap
The use of fragrant soap is very drying to the skin hence causing pruritus. Avoid factors that may contribute to skin dryness such as overheating, hot baths, and soaps, shower and bath products. Use emollients for dry skin, including for washing, bathing, and showering.
Option A: A cool and humidified environment could help moisten the skin. Dry skin could be very itchy. Lay a cool flannel that has been soaked in an emollient cream on the skin or apply a cooled emollient that has been kept in the refrigerator.
Option C: Cotton is non-irritating and soft for the skin. Patting the skin instead of scratching and keeping nails short. Other interventions may include the use of behavior modification including habit reversal training, phototherapy, the use of systemic medications, which include antidepressants such as tricyclic and SSRIs, and anticonvulsants such as gabapentin and pregabalin.
Option D: Increasing fluid intake could make the skin supple and moist. Using anti-itch creams containing a moisturizer and additional ingredients such as crotamiton, lauromacrogols, menthol, and doxepin is possible. However, their use should be based on the classification as recent evidence does not support using these products for all types of pruritus.