Emollient and antipruritic effect of Itch cream in dermatological disorders: A randomized controlled trial

Topical therapy is one of the foundations of a dermatologist’s therapeutic armamentarium as it is used either for symptomatic relief, control, or cure of the underlying disease. Emollients provide symptomatic relief in xerotic skin diseases like ichthyoses, xeroderma, disorders of keratinization, and atopic dermatitis. They act by softening the stratum corneum by increasing its hydration. Currently marketed emollients often cause adverse effects like irritant or allergic contact dermatitis, cosmetic acne, and pigmentary disorders. Pruritus being the most common presenting symptom in xerotic disorders, systemic antipruritic drugs like antihistamines are routinely prescribed to patients. There are few effective yet safe topical antipruritic agents available for treatment of such clinical conditions and the availability of such an agent could be of immense value. Topical polyherbal formulations are the latest additions to the dermatologist’s repertoire of treatment. Scientific efforts to unearth their therapeutic utility and safety in some dermatological disorders have been documented. Itch cream, a topical proprietary polyherbal formulation, is marketed for its antipruritic and emollient properties in xerotic and pruritic skin disorders. It contains the following ingredients (v/w basis): Extracts of Turmeric 16% (Curcuma longa), Saffron 0.025% (Crocus sativus), Sandalwood 8% (Santalum album), Vetiver 0.5% (Veteveria zizanioides), Lata kasturi 0.1% (Abelmoschus moschatus), Mehendi 3% (Lawsonia inermis), Tulasi 3% (Ocimum sanctum), Yastimadhu 0.5% (Glycyrrhiza glabra), Turmeric oil 0.1%, Surasar 0.5%, and Swarna bhasma 0.00032% in a nongreasy cream base q.s. Reports on the therapeutic utility of many of these plants in skin disorders are available in the traditional medical literature. The present study was a prospective, unicentric, open label, randomized, controlled study conducted at the dermatology OPD of SSKM Hospital, Kolkata with prior approval from the Institutional Ethics Committee. The objectives were to assess the efficacy and safety of Itch cream as an emollient and topical antipruritic for symptomatic relief in various xerotic and pruritic dermatological disorders like atopic dermatitis, senile pruritus, and ichthyosis. Inclusion criteria: (a) children (2–12 years) of either sex with atopic dermatitis, ichthyosis vulgaris, and impetigo. (b) Adults (>12–70 years) of both sex with senile pruritus, ichthyosis vulgaris, or other xerotic diseases. Only cases with involvement of <30% body surface area were recruited. Exclusion criteria: (a) severe cases with >30% body surface area involvement; (b) cases concomitantly receiving/received the following medications: topical or Emollient and antipruritic effect of Itch cream in dermatological disorders: A randomized controlled trial