Treating generalized itching without a rash

For patients with generalized itching without a rash, the first step is to address skin dryness, also known as xerosis. Using a ceramide-containing moisturizer twice a day can help relieve the itching. Patients should also use mild, unscented soaps and moisturize when the skin is slightly damp after showering. Consider a workup for underlying conditions such as liver disease, thyroid dysfunction, diabetes, or kidney disease. Treatments for itch without a rash include antihistamines, topical steroids (although caution should be exercised), medications like antidepressants or opioid antagonists, phototherapy, and menthol-containing creams. Capsaicin and compounded topical neuromodulators may also provide relief, but should be used under medical supervision.