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Pruritus vulvae - Management
Basis for recommendation
Emollients
Sedating antihistamines
- The recommendation to use a sedating oral antihistamine at night is based on published expert opinion, as some women may be helped by oral antihistamines [Doxanakis et al, 2004; Bohl, 2005; DermNet NZ, 2010]. CKS identified no controlled trials that investigated the use of antihistamines for pruritus vulvae.
- If an antihistamine is considered appropriate, first-generation antihistamines (for example chlorphenamine and hydroxyzine) are more sedating than second-generation antihistamines, and may therefore be useful for night-time use [O'Donoghue and Tharp, 2005].
- Experts postulate that sedating oral antihistamines probably provide a reprieve from nocturnal scratching by inducing sedation, helping to break the itch-scratch-cycle [Weichert, 2004].
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