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Severe itching in the patient with burns
M Vitale1, C Fields-Blache, A Luterman
1University of South Alabama Burn Center, Mobile.
The Journal of Burn Care & Rehabilitation
|July 1, 1991
Summary
Post-burn itching is common, affecting 87% of patients. Antihistamines provided partial relief for most, but no single drug was superior for managing this persistent symptom.
Area of Science:
- Dermatology
- Clinical Pharmacology
Background:
- Persistent itching (pruritus) is a common and distressing symptom for burn survivors after hospital discharge.
- Factors influencing post-burn pruritus and the efficacy of common antihistamines require further investigation.
Purpose of the Study:
- To determine the incidence and severity of itching in discharged burn patients.
- To identify predictors of post-burn pruritus.
- To evaluate the effectiveness of Benadryl, Atarax, and Polyhist Forte in alleviating itching.
Main Methods:
- Prospective study of adult burn patients discharged to an outpatient clinic.
- Randomized, monthly rotation of three antihistamine agents: Benadryl, Atarax, and Polyhist Forte.
- Itching severity assessed using a visual linear analogue scale.
Main Results:
- Eighty-seven percent of patients reported itching, with an average severity of 7.6/10.
- Itching varied by body area, with 100% of leg burn patients and 70% of arm burn patients experiencing symptoms; facial burns did not cause itching.
- Antihistamines provided complete relief in 20%, partial relief in 60%, and no relief in 20% of patients, with no significant difference between the agents.
Conclusions:
- Post-burn pruritus is highly prevalent and can be severe.
- While antihistamines offer partial relief for many, they are not universally effective, and no tested agent demonstrated superiority.
- Burn size and wound healing time were significant factors, and symptom location influenced itch intensity.