Scratching the surface—Managing the itch associated with burns: A review of current knowledge

The problems of itch in burns patients are well recognised, however none of the current standard therapies are very effective. The standard therapies include: antihistamines which are only effective in about 20% of patients and emollients which have limited effects.We review the current literature on the molecular mechanisms of itch and neuronal itch pathways, which supports the predictable lack of effect of anti-histamines. The published studies on therapeutic options to treat itch in burns are discussed and in addition we review the work on the treatment of itch in other pathological states.Finally a treatment algorithm is proposed stratifying possible therapeutic options to assist in the management of burns patients distressed by intractable itch.