Management of Post-Burn Pruritus
Summary
Post-burn pruritus is a frequent and distressing complication following cutaneous thermal injury, characterised by intense itching that persists throughout wound healing and scar maturation. Its pathogenesis comprises both pruritogenic and neuropathic components, driven by aberrant neuroimmune interactions, epidermal barrier disruption and peripheral nerve sensitisation. Clinical presentation varies from transient discomfort to chronic itch that severely impairs sleep, mood and rehabilitation. Management adopts a multimodal strategy, including meticulous moisturisation to restore barrier function, antihistamines to counter histaminergic pathways, and gabapentinoids or tricyclic antidepressants for neuropathic components. Topical agents such as capsaicin, lidocaine and emollient-based formulations may provide targeted relief. Emerging approaches encompass low-level laser therapy, physical modalities and psychological support to address central sensitisation and coping mechanisms. Individualised regimens, guided by severity and patient preference, aim to optimise quality of life and functional recovery across diverse healthcare settings.
Research from Nature Portfolio
Recent work has explored the role of neuromodulators in chronic itch beyond visible skin lesions. One investigation assessed the efficacy of a gabapentinoid in patients with chronic pruritus of unknown origin, demonstrating significant reduction in itch severity and altered C-fibre sensitivity following treatment. These findings underscore the importance of targeting neuronal thresholds in intractable itch and may inform adjunctive strategies for post-burn neuropathic pruritus.
Management of Post-Burn Pruritus publication trend
The graph below shows the total number of articles in management of post-burn pruritus across all publications each year (not limited to Nature Index journals).
Technical terms
Pruritus: An unpleasant sensation that elicits a desire to scratch.
Peripheral sensitisation: Increased responsiveness of cutaneous nerve endings to pruritogenic stimuli following injury or inflammation.
Neuropathic pruritus: Itch arising from dysfunction or damage of the nervous system rather than primary skin pathology.
Transepidermal water loss (TEWL): The passive diffusion of water through the epidermis, used as a measure of skin barrier integrity.
Gabapentinoids: A class of neuromodulatory agents acting on voltage-gated calcium channels to reduce neuronal excitability and relieve neuropathic symptoms.
References
- Evaluation of a Cosmetic Formulation Containing Arginine Glutamate in Patients with Burn Scars: A Pilot Study. Pharmaceutics (2024).
- Post-Burn Pruritus. International Journal of Molecular Sciences (2020).
- Role of burn severity and posttraumatic stress symptoms in the co-occurrence of itch and neuropathic pain after burns: A longitudinal study. Frontiers in Medicine (2022).
- Efficacy of pregabalin for the treatment of chronic pruritus of unknown origin, assessed based on electric current perception threshold. Scientific Reports (2020).
About these summaries
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