polidocanol and Pruritus

Itch management can be particularly complicated in some small areas like the scalp or the anogenital region for many reasons: the frequently poor diagnosis of the causes of itch in these areas, the dense innervation of these areas, and the symbolic value of these areas for the human psyche. The diagnosis of itchy scalp is easier than that of anogenital pruritus. Clinical examination and a careful inventory of all diseases of the patient and of the local environment are necessary. Localized treatments are frequently used at both sites, whereas specific pharmaceutical formulations are necessary for the pilose or the mucous environment. Nonetheless, systemic treatments or psychological interventions can be very useful.

Topics: Antifungal Agents; Candidiasis; Carcinoma in Situ; Dermatitis, Seborrheic; Female; Genital Diseases, Male; Hemorrhoids; Humans; Keratolytic Agents; Lichenoid Eruptions; Male; Polidocanol; Polyethylene Glycols; Pruritus; Pruritus Ani; Pruritus Vulvae; Psoriasis; Scabies; Scalp Dermatoses

Pruritus is associated with various skin diseases, dry skin, and with it an impaired skin barrier function. The study objective was to investigate short-term and long-term effects of two emollients on symptoms and skin barrier functions in xerotic eczema. Randomized, double-blind, study enrolling females/males, with bilateral itching. Two emollients, containing lactic acid and refined almond oil with/without polidocanol were administered on left versus right body sides. Itching severity, skin moisture, lipid content, and pH were assessed on Day 1, within 30-120 min after first administration, and on Days 7 and 14, and compared with baseline assessments. Severity of itching decreased 30 min after first administration of both emollients compared with baseline (p < .0001) and reached a maximum reduction of 63% (p < .0001) and 69% (p < .0001) on Day 14. Skin moisture and lipid content increased after first application, and further ameliorated within 14 days of treatment (p < .0001). Both emollients were tolerated well, and only a few adverse events were reported. This study confirmed the clinical efficacy of the two study emollients to substantially reduce itching already after first administration, and restore skin barrier integrity and thus should be considered as therapeutic approach for xerotic eczema.

Topics: Administration, Cutaneous; Adolescent; Adult; Aged; Double-Blind Method; Drug Administration Schedule; Eczema; Emollients; Female; Humans; Lactic Acid; Male; Middle Aged; Plant Oils; Polidocanol; Pruritus; Skin; Switzerland; Time Factors; Treatment Outcome; Young Adult

Polidocanol is a local anaesthetic and antipruritic compound that is used in the treatment of itching skin conditions such as eczema. Its mechanisms of action are largely ill defined. This study has compared the antipruritic efficacy of topical polidocanol in histamine-induced itch and a histamine-independent, cowhage-induced model of pruritus. Polidocanol (3%) or vehicle was applied topically under occlusion for 1 h to the forearms of 45 healthy volunteers before itch was provoked by rubbing in 40-45 spicules of cowhage or skin prick testing with 10 mg/ml histamine. Itch was recorded at 1-min intervals for 30 min on a 100-mm visual analogue scale. Polidocanol significantly reduced the area under the curve for cowhage-induced itch by 58% (P < 0.05), but had no significant effect on histamine-induced itch. This result underlines the importance of histamine-independent itch models in the development of topical antipruritic agents.

Topics: Adult; Antipruritics; Double-Blind Method; Female; Histamine; Humans; Male; Middle Aged; Mucuna; Polidocanol; Polyethylene Glycols; Pruritus; Receptor, PAR-2; Receptors, Thrombin; Young Adult

Dry, itchy and inflamed scalp conditions are common and often associated with diseases such as atopic dermatitis or psoriasis. To improve these symptoms, we investigated the efficacy of a new tonic containing the active ingredients urea, lactate, polidocanol, and Glycyrrhiza inflata root extract, containing licochalcone A.. 30 subjects with dry and itchy scalp conditions underwent a randomized half-head study for 4 weeks, applying the leave-on tonic three times a week on one side of the scalp. Tonic effects on skin hydration, itching, lipids, microinflammation, and substantivity of tonic compounds were determined using corneometry, middle-infrared spectroscopy, direct analysis in real-time mass spectrometry, and enzyme-linked immunosorbent assay. Volunteers performed a self-assessment; changes in scalp condition were documented by in vivo microscopy.. After tonic treatment, scalp moisture was significantly increased, whereas scalp itching and tautness were significantly reduced. Results also demonstrated a high substantivity of urea and lactate on the scalp, an increase in triglyceride, and a decrease in free fatty acid levels. The amount of total lipids was unchanged. Analyses of scalp wash-ups verified a significant reduction in important pro-inflammatory markers.. Due to the actives urea, lactate, polidocanol, and the anti-inflammatory licochalcone A, the new scalp tonic exhibited excellent performance in alleviating scalp dryness, itching, microinflammation, and in normalizing disturbances of scalp lipids.

Topics: Chalcones; Cytokines; Glycyrrhiza; Humans; Lactic Acid; Lipid Metabolism; Plant Extracts; Plant Roots; Polidocanol; Polyethylene Glycols; Pruritus; Scalp; Scalp Dermatoses; Urea

Topics: Administration, Topical; Detergents; Humans; Male; Middle Aged; Polidocanol; Polyethylene Glycols; Pruritus; Urea; Urticaria Pigmentosa

In an open multicentre drug monitoring survey, 1611 patients with atopic dermatitis, contact eczema, dry eczema, psoriasis and pruritus were treated with a preparation containing 5% urea and 3% polidocanol (laurylmacrogol). To monitor the course of treatment, three examinations were performed, one at the start of therapy and two more at intervals of approximately two weeks. A marked improvement in the status of the skin was observed during treatment. A marked regression occurred in the principal signs of dry skin--scaling, dryness and roughness. Troublesome itching was also greatly reduced. Almost half of the patients (48.9%) were free of itching at the end of the observation period. Adverse drug effects arose in only 2.8% of cases, and were mostly smarting, itching and irritation. No intolerance reactions were observed in children under six years. At the end of the observation period the skin status was judged, by both the doctors and the patients as 'good' or 'very good' in almost 90% of cases. Furthermore, the assessment with regard to the regression of itching was almost identical.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child, Preschool; Dermatitis, Atopic; Drug Combinations; Eczema; Female; Humans; Infant; Male; Middle Aged; Polidocanol; Polyethylene Glycols; Product Surveillance, Postmarketing; Pruritus; Psoriasis; Urea

Polidocanol is a sclerosing solution that is highly valued by clinicians and patients for its painlessness, high efficacy, excellent safety profile, low incidence of side effects, and for the rarity of its allergic reactions. Previous estimates of the incidence of allergic reactions have ranged from 0 to 0.06%.. Improved recognition of systemic allergy to polidocanol is desirable for both clinicians and for patients. We have attempted to describe two cases recently observed in our population and to provide an improved upper-bounds estimate for the true population incidence of allergy to polidocanol.. We report two recent cases of mild systemic allergic reaction to polidocanol in a population of 689 exposed patients, for an observed incidence of 0.3% in our patient population. We have calculated a 95% confidence upper-bound estimate of 0.91% for the incidence of polidocanol allergy in the general population.. Allergy to polidocanol may be more common than previously recognized. Careful questioning of previously treated patients and more prolonged observation of patients after treatment may yield a larger number of recognized cases.

Topics: Adult; Drug Eruptions; Female; Humans; Polidocanol; Polyethylene Glycols; Pruritus; Sclerosing Solutions; Urticaria; Varicose Veins

Topics: Humans; Polidocanol; Polyethylene Glycols; Pruritus