Table 2.

Summary of interventions and the most appropriate indications

CLASS	INTERVENTION	INDICATION	LEVEL OF EVIDENCE^*
Nonpharmacologic therapies	Moisturization	All patients	III
	Cool environment	All patients	III
	Avoid irritants	All patients	III
	Break itch-scratch cycle	All patients	III
	Behavioural therapy, relaxation, stress reduction	All patients, but especially for atopic dermatitis and other chronic itch	II
Topical therapies	Corticosteroids	Inflammatory dermatoses	I
	Calcineurin inhibitors	Inflammatory dermatoses	I
	Capsaicin	Localized itch (eg, neuropathic)	III
	Menthol	Localized itch (eg, neuropathic)	III
	Pramoxine or eutectic mixture of lidocaine and prilocaine	Postburn, uremic, or neuropathic pruritus	II
	Doxepin	Atopic dermatitis	I
Systemic therapies	Nonsedating antihistamines	Urticaria, insect bite reactions, mastocytosis, drug reactions	I
	First-generation antihistamines	Nocturnal itch	III
	μ-Opioid receptor antagonists	Cholestatic pruritus, chronic urticaria, atopic dermatitis	I
	κ-Opioid receptor agonists	Opiate-induced pruritus, uremic pruritus	I
	SSRIs (paroxetine, fluvoxamine, sertraline)	Palliative care	I
	SSRIs (paroxetine, fluvoxamine, sertraline)	Atopic dermatitis, systemic lymphoma, solid carcinoma, uremic pruritus, cholestatic pruritus	II
	Doxepin	Atopic dermatitis, HIV-related pruritus, allergic cutaneous reactions, urticaria	II
	Anticonvulsants (gabapentin, pregabalin)	Uremic pruritus	I
	Anticonvulsants (gabapentin, pregabalin)	Neuropathic pruritus, idiopathic pruritus	II
	Ursodeoxycholic acid	Intrahepatic cholestasis of pregnancy	I
	Oral immunosuppressants (cyclosporine, azathioprine, mycophenolate mofetil)	Inflammatory dermatoses	I
	Corticosteroids	Inflammatory dermatoses	I

SSRI—selective serotonin reuptake inhibitors.
↵* Level I evidence requires at least 1 properly conducted randomized controlled trial, systematic review, or meta-analysis. Level II evidence includes other comparison trials, non-randomized, cohort, case-control, or epidemiologic studies, and preferably more than 1 study. Level III evidence includes expert opinion or consensus statements.