Several factors can cause skin itchiness (also known as pruritus). Skin itch is commonly associated with eczema (dermatitis), psoriasis, chickenpox, insect bites, hives and other conditions. Several effective creams to stop itching can be purchased from supermarkets, pharmacies and online. Sale of some anti-itch creams is restricted to pharmacies only. This post summarises the use, availability and effectiveness of different anti-itch creams. I reviewed anti-itch creams based mainly on two factors: short terms management of skin itchiness for example, with the use of steroid, antihistamine and local anaesthetic creams. I also reviewed creams with and without an active ingredient(s), which are usually recommended for long-term management of skin itchiness. Lastly, I touch on the management of skin itchiness with a combination treatment of a topical product(s) and oral antihistamines.
Do I need to see a GP about my skin itchiness?
Generally, skin itchiness is a mild condition. It can be managed with products which are available over the counter. However, some group of people should see their GP when skin itchiness is experienced:
- Pregnant women who experience skin itchiness, which can be a sign of a liver condition called intrahepatic cholestasis of pregnancy (ICP)
- Patients with ongoing symptoms
- Severe itchiness of the skin
- Other symptoms present, for example, jaundice (yellowing of the skin and whites of the eyes)
- Signs of infection: skin redness, swelling & puss present, for which a GP may prescribe antibiotic cream or oral antibiotic.
- Skin itchiness caused by drugs.
How is skin itch managed?
Skin itch caused by skin dryness is initially managed with topical emollients applied to the skin. Broadly, emollients are divided according to their composition, in particular, the oil to water ratio:
- Ointments: more greasy than creams due to higher content of oils, but generally are better at relieving dry skin than creams and lotions.
- Creams: optimal amount of oil vs water, but in higher oil amounts than lotions.
- Lotions: contain the least amount of oils and higher amounts of water with non-greasy consistency.
Ointments, creams and lotions can be used as soap substitutes.
The NICE guide recommends using emollients with an active ingredient such as menthol 0.5% or 1% menthol in aqueous cream or crotamiton cream (Eurax cream) if emollients failed to stop the itching of the skin. NICE sets treatment recommendations for doctors and other healthcare professionals in the UK.
Further recommended the management of skin itchiness involves the use of sedative antihistamines such as hydroxyzine or chlorphenamine (NICE, 2016).
Creams to stop itching – short term management with steroid creams
Localised, short episodes of skin itchiness seem to be more easily controlled, than management of long-term itchiness of unknown cause (Elmariah & Lerner, 2011), which can be challenging. Certain products reviewed in this post have a limit on the treatment duration when used over the counter, without the supervision of a doctor.
Over the next few paragraphs, I will review the use of steroid creams (also known as a topical corticosteroid), which are available over the counter from pharmacies. Topical (applied to the skin) steroid should be used to relieve inflammation and skin itchiness caused by skin conditions, for example, eczema and psoriasis. Steroid creams should not be used to control chronic itch of extended duration (Patel & Yosipovitch, 2010).
Steroid creams – the effectiveness as an anti-itch creams
Steroid creams are effective in controlling and treating conditions associated with skin dryness and inflammation. Topical steroids are not directly classified as anti-itch medicines; however, it is thought that reduced skin itchiness comes from controlling skin inflammation (ibid). When used correctly, topical steroids are safe, effective and do not commonly cause side effects (Das & Panda, 2017).
1. Hydrocortisone cream
Hydrocortisone cream is a pharmacy-only medication which is used for the treatment of different conditions associated with itchiness, irritation and redness, for example, eczema, contact dermatitis, and insect bites. Pharmacy-only medicines can only be purchased from pharmacies, including online chemists.
Hydrocortisone is classified as a mild steroid. A mild steroid is of lowest potency out of whole steroid group. The scale of steroid potency includes:
- potent, and
- very potent steroid creams.
Most steroid creams are prescription-only medicines except for hydrocortisone 1% and clobetasone cream (Eumovate), which is reviewed in the next paragraph.
What form of itchiness is hydrocortisone cream suitable for?
Hydrocortisone cream is most suitable for:
- Contact dermatitis – rash, redness and itchiness of the skin in response to an allergen.
- Insect bites
- Heat Rash (Prickly Heat) – steroid cream should only be applied to a small area.
- Psoriasis – scalp kin condition characterised by the presence of plaques
Hydrocortisone – restrictions on the use
When purchased over the counter hydrocortisone cream can only be used up to 7 days by adults and children over ten years of age. Steroid creams should not be applied on broken, infected skin or large areas of the skin. Steroid creams should not be applied on the face unless a doctor supervises the treatment.
For more details, read product information leaflet or speak to your pharmacist. Always follow the directions from your GP.
2. Clobetasone (brand name: Eumovate cream)
Clobetasone (brand name: Eumovate) is the second steroid cream on the list, which is available over the counter. Clobetasone belongs to a moderate group of steroid creams; however, it is the strongest over the counter steroid cream, which can be purchased without a prescription. Clobetasone can be used to help with itchiness, but only if the rash is present.
What form of itchiness is clobetasone best for?
Clobetasone has a narrow licensed use. It can be used to manage the symptoms (including itchiness) of:
- Dermatitis, including allergic dermatitis
Clobetasone – restrictions on the use
Similar restrictions which apply to hydrocortisone cream apply to clobetasone cream. The treatment should be limited to 7 days. Only children over 12 years of age and adults use clobetasone cream. Clobetasone cream should not be used on broken, infected or inflamed skin. Clobetasone should not be applied to large areas.
For more details, read product information leaflet or speak to your pharmacist.
Clobetasone cream should not be used to treat acne or rosacea.
3. Daktacort cream
Over the counter Daktacort cream is known as Daktacort Hydrocortisone Cream. Daktacort cream is another pharmacy-only medicine. It contains a combination of miconazole (an antifungal drug) and hydrocortisone 1% (steroid).
What type of skin itchiness can Daktacort cream help with?
Daktacort cream is useful in the treatment and management of skin itchiness caused by fungal infections.
- The treatment of Athlete’s foot, which is characterised by itching between the toes and other symptoms
- treatment of candidal intertrigo, fungal infection present between the fold of the skin, for example, sweat rash, with different symptoms present for example itchy lesions (red spots).
- Other fungal infections, which are sensitive to miconazole, for instance, jock itch (groin area)
- Dactacort has also antibacterial properties and is one of few over the counter creams licensed for bacterial infections
Daktacort cream – restrictions on use
Over the counter Daktacort cream contains hydrocortisone 1% cream, and with this similar usage restrictions apply:
- Limit on the duration of the treatment – 7 days
- No application on broken skin or large areas
- No application on face, eyes, and mucosal areas
- Age restrictions: Adults and children over twelve years of age
Read more about over the counter antifungal creams in my separate post.
Creams to stop itching – long term management with anti-itch creams and lotions
We are moving away from steroid cream to a broad group of emollients which include:
- ointments and
Emollients can generally be used regularly to stop the dryness of the skin and prevent itchiness of the skin.
Moisturising creams can be used alongside steroid creams to manage conditions characterised by itching. When both steroid and moisturising ‘anti-itch’ cream is applied, one should not apply creams at the same time. It is recommended to use steroid cream 30 minutes after an emollient (NICE, 2018).
4. Menthol 2% in Aqueous Cream
Use of menthol to stop itchiness of the skin is recommended as one of the treatment options by NICE guide on the management of skin itchiness when emollients with active ingredients are considered.
Menthol has been used as an anti-itch cream for a very long time. When applied to the skin, menthol produces a cooling sensation. Cooling of the skin (without reducing the skin temperature) helps to stop skin itchiness. Menthol included in cream vary in percentage, but usually range from 0.5% to 3%, as higher concentrations of menthol can cause skin irritation (Patel & Yosipovitch, 2010).
Where can you buy menthol cream from?
Menthol 2% in aqueous cream can be purchased online (see, most pharmacies do not stock it as this cream is not commonly prescribed.
In addition to the management of itchy skin, menthol 2% in aqueous cream can be used for irritated skin due to sunburn, eczema and in response to contact with allergens.
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5. Dermacool One Percent Menthol in Aqueous Cream
Dermacool represents the same combination as the above anti-itch cream with a lower amount of menthol – 1% in aqueous cream. The recommended use of Dermacool One Percent cream is symptomatic management of itchy skin conditions, irritation, swelling and itching caused by insect bites. Dermacool 1% anti-itch cream. Overall, Dermacool 1% has some great reviews on Amazon.co.uk
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6. Lanacane medicated cream for skin itchiness
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What is Lanacane used for?
Lanacane cream can be used to manage localised skin conditions characterised by minor pain, irritation, and skin itching. Lanacane cream can be used to help with symptoms of insect bites, nettle sting, and external genital and anal itching. Lanacane is used as short-term relief of the above conditions with a recommended treatment duration of up to 7 days.
What is the active ingredient found in Lanacane cream?
Lanacane is the only cream available over the counter, which contains benzocaine (local anaesthetic), for the management of skin itching and irritation of dry skin. Other local anaesthetic creams available without prescription are often used to numb the skin before minor skin procedures.
Topical anaesthetics are ‘only marginally effective‘ as anti-itch preparations (BNF, 2020).
Where can you buy Lanacane cream from?
Lanacane cream can be purchased in supermarkets and pharmacies. This product is available for self-selection by customers. Not all retailers may stock Lanacane cream. It would be quicker and much easier to order Lanacaine online, including Amazonc.co.uk stock Lanacaine cream (link above).
7. Eurax cream
Eurax cream is a general sale item, which can be purchased in pharmacies and supermarkets. Eurax is a popular cream to stop itchiness associated with many different conditions, including:
- Allergic rashes
- Hives, nettle rash
- Insect bites and stings
- Heat rashes
- Personal itching
An interesting licensed use for Eurax cream is the treatment of scabies and itchy skin infestation in the skin.
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Eurax cream is a popular choice on Amazon.co.uk with many positive reviews on its effectiveness.
Eurax cream contains 10% crotamiton. It can be used by adults and children over three years of age. When used to stop skin itchiness, Eurax can be used every day.
Eurax cream also comes as a combination product with a hydrocortisone cream: Eurax HC bringing additional benefit of a steroid to the treatment. Steroid included in Eurax HC is hydrocortisone 1%. Eurax HC is a pharmacy-only medication.
Can Eurax stop the itching of the skin?
Eurax has been a popular treatment choice to relive skin itchiness, despite little evidence published so far to support its effectiveness. Crotamiton showed to affect histamine-induced skin itchiness (Sekine et al., 2012). Histamine is a compound which is realised during an allergic reaction, which contributes to skin itchiness, redness and skin rash. Crotamiton also weakly affect serotonin, another compound which has its role in the transfer of the information (about itchiness) to the brain (Saltsman, 2014).
8. Antihistamine creams[amazon box=”B00U375M94″ image_alt=”Anthisan Bite and Sting Anti-itch Cream” image_title=”Anthisan Bite and Sting Anti-itch Cream” link_title=”Buy Anthisan cream on Amazon.co.uk”]
Antihistamine creams stop itching of the skin associated with insect bites and nettle rash, characterised by skin itchiness. Two antihistamine creams can be purchased over the counter in the UK:
- Anthisan Cream (contains 2% Mepyramine maleate)
- Histergan Cream (contains 2% diphenhydramine hydrochloride), also marketed as Lloyds Pharmacy Antihistamine Cream, Boots Skin Allergy Relief 2% w/w Cream and Vantage Antihistamine 2.0% w/w Cream (all of them are the same product)
Antihistamine creams have different restrictions on the use, for example:
- Histergan cream can be used only for a short time – no more than three days with by adults and children over six years of age
- Anthisan cream is licensed in adults and children over two years of age with the treatment also limited to three days.
- Topical antihistamine creams should not be used to help manage the symptoms of eczema.
Effectiveness of antihistamine creams to stop itching
Both Anthisan and Histergan creams contain histamine as an active ingredient. When taken in the form of tablets, antihistamines are effective in controlling some symptoms of allergies. Although widely used for the treatment of skin itchiness associated with insect bites, there is little evidence in the literature to support their effectiveness (Eschler & Klein, 2010).
9. Calamine lotion and cream
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Calamine lotion and cream are mostly known and used in the management of chickenpox symptoms, mainly skin itchiness. Additionally, calamine lotion and cream can be used to relief of mild symptoms of sunburn and other minor skin conditions associated with skin itchiness.
Does calamine lotion or cream stop itching?
Application of calamine as the anti-itch product is based on historical use, with little evidence to support their effectiveness. Nevertheless, the cooling and soothing effect of calamine lotion and cream cannot be undermined. When it comes to symptomatic management of chickenpox, few alternative options to calamine exist to help with skin irritation and itchiness.
10. Dermol cream and lotion
Dermol cream and lotion are pharmacy-only products used in the management of skin conditions characterised by dryness and itchiness, especially eczema and dermatitis. Dermol products are classified as antimicrobias, due to two active common antiseptic ingredients – benzalkonium chloride and chlorhexidine dihydrochloride.
Dermol cream and lotion can be used daily to manage dry and itchy skin. Both products can also be used as soap substitutes.
Where can you buy Dermol cream or lotion from?
Dermol cream and lotion are classified as pharmacy-only medicines. With this, their sale is restricted to pharmacies and online chemists.
11. E45 Itch relief cream
E45 itch relief cream contains two active ingredients lauromacrogols and urea. E45 Itch relief cream is used in the management of skin itchiness, eczema and dermatitis.
Urea plays a primary role in skin hydration, whereas lauromacrogols have properties of local anaesthetics and primarily stop the itching of the skin.
Effectiveness of E45 Itch relief cream
There is not enough information to review the effectiveness of E45 itch relief cream in the management of dry skin and skin itchiness. Urea has been used as a component in skin products for many years. Urea improves skin dryness and skin barrier function (Lodén, 2012). Urea is a potent emollient, making it a useful and effective ingredient in the treatment of many conditions characterised by skin dryness.
Lauromacrogols have local anaesthetic properties, relieves and soothes itchy skin. There is little information in research journals on the effectiveness of lauromacrogols in managing skin conditions.
Nevertheless, E45 Itch relief cream is a popular choice on Amazon.co.uk It is also possible to buy E45 Itch relief in supermarkets. Larger tubs of E45 Itch cream may be available from pharmacies only, although there is no restriction for this item to be sold in pharmacies.
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12. Balneum Plus cream
Balneum Plus cream contains the same active ingredient as E45 Itch relief cream – lauromacrogols and urea. Balneum Plus cream is best suited for management of eczema, skin itchiness and dermatitis where skin hydration and the anti-itch effect is required.
Urea provides for hydration of the skin, whereas lauromacrogols reduce skin itchiness due to its local anaesthetic effect.
Where to get Balneum Plus cream?
Balneum Plus cream is usually stock by pharmacies rather sold off the shelf in supermarkets. Alternatively, Balneum Plus can be purchased online. Balneum Plus cream has good reviews on Amazon.co.uk
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Emollients for dry and itchy skin
Skin itchiness caused by dry skin can be reduced with the use of emollients (creams, lotions and ointments). There plenty of different brands of emollients available in the UK. There is no evidence to suggest that one emollient is better than another. Below are some common brands of emollients prescribed in the UK:
13. Aveeno range for dry and irritated skin
For many of its products, Aveeno range has some fantastic reviews and a high 5-star rating on Amazon.co.uk in a creams category. Aveeno cream is fragrance-free and is made of finely milled oatmeal. Aveeno cream is suitable for adults and babies from 3 months of age.
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For very dry and irritated skin, Aveeno Skin Relief offers a combination of oat complex and shea butter, which provides prolonged hydration of the skin.
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14. Diprobase cream
Diprobase cream is another popular product used in the management of eczema, dry skin and dermatitis. Diprobase is suitable for all ages.
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15. Cetraben Cream
Another fragrance-free formulation, for adults and children over one year of age, which stop the itching of the skin and hydrates it.
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16. Epaderm cream
Epaderm cream is typically used in the management of dry skin, eczema and psoriasis. It is fragrance-free and SLS free formulation. SLS (sodium lauryl sulphate) can cause skin irritation.
17. Epimax cream
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Can antihistamine stop the itching of the skin?
I briefly mentioned at the beginning of the post that a GP might prescribe some drugs to stop the itching of the skin. Some antihistamines, which can be bought over the counter, can be used to help with skin itchiness, for example, chlorphenamine (brand name: Piriton). Chlorphenamine is a sedative antihistamine. Piriton tablets and liquid are restricted to symptomatic relief of itch caused by chickenpox only. GP may however suggest to use chlorphenamine temporarily to see if any benefit is achieved.
Other sedative antihistamines available over the counter can be used to stop itching caused by stings, or contact dermatitis (for example, Histergan tablets – contain diphenhydramine hydrochloride) or itchiness caused by urticaria (for example Phenergan tablets – contain promethazine hydrochloride).
Oral antihistamines can be used alongside topical treatment.
Are oral antihistamines effective as add-on therapy to stop itching?
There is little evidence to support the use of oral antihistamines as anti-itch medicines on their own or as add-on therapy alongside topical anti-itch creams. Oral antihistamines have little effect in controlling pruritus (skin itchiness) caused by conditions associated with itch, for example, eczema (Matterne et al., 2019). An oral antihistamine may provide some value in the treatment of urticaria (rash on the skin, which may itch).
Sedative antihistamines may be beneficial in patients who experience itch at night, mainly due to drowsiness they cause. Likewise, non-sedative antihistamine (for example, loratadine or cetirizine) may provide some value during the daytime to manage skin itching (Patel & Yosipovitch, 2010).
Conclusion – What is the best anti-itch medicine?
There is no definite answer to the above question. I reviewed several creams which can be used in the management of dry skin conditions and associated skin itchiness. The skin itch, of a known cause, for example, eczema can be successfully managed with over the counter emollients with steroid creams used as add-on therapy to control flare-ups of these conditions. Steroid creams are effective and fundamental to the management of many conditions associated with skin dryness and itch. Steroid creams may also be valuable in controlling skin itchiness caused by insects bites.
Local anaesthetic and antihistamine creams may provide some role in the management of itchiness; however, their use is time-limited, which means neither of them should be used to manage chronic skin itchiness.
Several products containing active ingredients can be used to stop itchiness. The menthol in aqueous cream and a combination of lauromacrogols and urea (for example Balneum Plus cream) are promising creams, based on the reported effectiveness of the active ingredient to stop the itching of the skin.
There is not enough evidence to support the effectiveness of oral antihistamines as add-on therapy to control pruritus, although some antihistamine may provide some relief when taken at night. A GP may prescribe a different oral antihistamine on a trial basis to investigate any possible benefits to the treatment.
What is the best anti-ich cream that you have used? Please leave a comment below.
BNF (2020). Topical local antipruritics. Available at: https://bnf.nice.org.uk/treatment-summary/topical-local-antipruritics.html Accessed on 08/12/2020
Das A, Panda S. Use of Topical Corticosteroids in Dermatology: An Evidence-based Approach. Indian J Dermatol. 2017;62(3):237-250. doi:10.4103/ijd.IJD_169_17 Available at: https://dx.doi.org/10.4103%2Fijd.IJD_169_17 Accessed on 08/12/2020
Elmariah, Sarina B, and Ethan A Lerner. “Topical therapies for pruritus.” Seminars in cutaneous medicine and surgery vol. 30,2 (2011): 118-26. doi:10.1016/j.sder.2011.04.008 Available at: https://dx.doi.org/10.1016%2Fj.sder.2011.04.008 Accessed on 03/12/20
Lodén (2012). The Use of Urea in the Treatment of Dry Skin. Available at: https://link.springer.com/chapter/10.1007/978-3-642-27606-4_33 Accessed on 06/12/2020
Matterne U, Böhmer MM, Weisshaar E, Jupiter A, Carter B, Apfelbacher CJ. Oral H1 antihistamines as ‘add-on’ therapy to topical treatment for eczema. Cochrane Database Syst Rev. 2019;1(1):CD012167. Published 2019 Jan 22. doi:10.1002/14651858.CD012167.pub2 Available at: https://dx.doi.org/10.1002%2F14651858.CD012167.pub2 Accessed on 08/12/2020
NICE (2016). Scenario: Management of widespread itch. Available at: https://cks.nice.org.uk/topics/itch-widespread/management/management-of-widespread-itch/ Accessed on 05/12/2020
NICE (2018). Corticosteroids – topical (skin), nose, and eyes. Scenario: Topical treatment. Available at: https://cks.nice.org.uk/corticosteroids-topical-skin-nose-and-eyes#!scenario Accessed on 28/07/2020
Eschler DC, Klein PA. An evidence-based review of the efficacy of topical antihistamines in the relief of pruritus. J Drugs Dermatol. 2010 Aug;9(8):992-7. PMID: 20684150. Available at: https://pubmed.ncbi.nlm.nih.gov/20684150/ Accessed on 07/12/2020
Patel, Tejesh, and Gil Yosipovitch (2010). “Therapy of pruritus.” Expert opinion on pharmacotherapy vol. 11,10 (2010): 1673-82. doi:10.1517/14656566.2010.484420 Available at: https://dx.doi.org/10.1517%2F14656566.2010.484420 Accessed on 08/12/2020
Saltsman Kirstie (2014). Serotonin Drives Vicious Cycle of Itching and Scratching. Available at: https://www.niams.nih.gov/newsroom/research-briefs/serotonin-drives-vicious-cycle-itching-and-scratching Accessed on 04/12/2020
Sekine R, Satoh T, Takaoka A, Saeki K, Yokozeki H. Anti pruritic effects of topical crotamiton, capsaicin, and a corticosteroid on pruritogen-induced scratching behavior. Exp Dermatol. 2012 Mar;21(3):201-4. doi: 10.1111/j.1600-0625.2011.01433.x. PMID: 22379965. Available at: https://doi.org/10.1111/j.1600-0625.2011.01433.x Accessed on 04/12/2020