Many burn survivors suffer from chronic itching, medically known as pruritus. The itching after a burn injury is often so intense that it interferes with daily activities and quality of life. Many people also find it difficult to sleep due to the constant itching, and may require prescription sleeping medications in order to fall asleep and stay asleep through the night.
According to a study conducted by the University of Texas Southwestern Medical Center and published in Journal of Burn Care and Research, about 87 percent of burn patients experience intense itching during healing. The itching often begins within two weeks of the burn, and those whose burns take three weeks or more to heal are more likely to suffer from pruritus.
According to a study published in the medical journal Wounds, the itching typically peaks between eight weeks and six months after a burn occurs. It can remain at this level of intensity for several months, before resolving as the scarred skin matures. This may take between a year and 18 months.
Dr. Vincent Gabriel, assistant professor at the University of Texas Southwestern and clinical director for the North Texas Burn Rehabilitation Model System, said that burn victims are likely to suffer from itching for years after the injury.
Why do healing burns itch?
When burns destroy healthy skin, the oil glands in the skin also suffer damage. In many cases, the new skin that heals — even with minor burns — lacks the oil glands of healthy, mature skin. With full thickness burns or skin grafts, oil glands are typically absent entirely. This lack of oil glands means the skin cannot keep itself moisturized, leading to extremely dry scars and intense itching after a burn injury.
While many burn survivors experience some level of itching, certain triggers also exacerbate the problem. For this reason, it is a good idea to use unscented soap, laundry detergent, lotions, and sunscreen. You should also avoid additional skin damage from sun exposure, and avoid wearing any materials that rub against the new skin and cause additional symptoms.
Are there medical treatments for the itching?
There are medical treatments available to treat the pruritus often experienced by burn survivors, but not all treatments work for all people, and a combination is usually necessary to prevent the itching from interfering with quality of life.
In the study conducted by UT Southwestern, no single treatment earned an “excellent” rating, but three fell into the “good” category. These included:
- Prescription antihistamines, particularly cimetidine
- Colloidal oatmeal baths
- Pulsed dye laser therapy
The study from Wounds found that doxepin cream is often effective in relieving itching. This histamine blocking cream works topically, by blocking the skin’s histamine receptors. This prescription cream, however, is not for use over large areas of skin.
Other possibilities include:
- Other histamine blocking creams such as diphenhydramine
- Prescription gabapentin
- Sleeping pills to address inability to sleep
What else can I do to reduce itching after burns?
In addition to medications, burn survivors can do a few things at home to get some relief. For some people, a lukewarm bath or bath in colloidal oatmeal offers temporary relief.
Note: Ask your burn care team first as baths may dry out the skin.
You will also need to find a good moisturizer to keep the healing skin supple and moist. Discussing your individual needs with your doctor is the best place to start when looking for a good moisturizer. Most recommend unscented moisturizers that have a lower water content. They are thicker, remain on the surface of the skin longer, and last longer between applications.
Other tips to keep your healing skin moist include:
- Apply lotion frequently throughout the day
- Apply in thin layers, gently massaging the lotion into your skin
- Discontinue use and contact your doctor with any symptoms of irritation or an allergic reaction
- Never use petroleum-based ointments such as Vaseline or mineral oil on burn scars, as skin breakdown may occur
Note: Discuss this with your doctor as putting lotion on your burns could have side effects.
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