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Table 6 Chronic itch management

From: Multicentre consensus recommendations for skin care in inherited epidermolysis bullosa

General measures • Bathing in tepid water with syndet/oil cleanser and skin hydration with emollients
• Overheating and dry environment avoidance
• Relaxation techniques and patient education to cope with the vicious itch–scratch cycle
Therapeutic options • Short courses of topical mid-potency steroids
• Sedating antihistamines (e.g. hydroxyzine) and/or tricyclics with anti-H1 antihistaminic action (doxepin) as first-line treatment*
• Low-dose gabapentin (Neurontin®) or pregabalin (Lyrica®) as second-line treatment
  • Anti-inflammatory agents (e.g. cyclosporine, thalidomide or topical tacrolimus) to be cautiously considered as third-line treatment only in severe cases**
  1. * Data from randomized trials are lacking to support the efficacy of antihistamines in pruritic conditions other than urticaria.
  2. **Caution should be paid in using immunosuppressive drugs because of the carcinogenesis risk.