Efficacy and onset of action of hydrocortisone acetate 2.5% and pramoxine hydrochloride 1% lotion for the management of pruritus: Results of a pilot study

Itch is the most common symptom among patients presenting to the dermatology clinic. Scratching can cause mechanical trauma to the skin, further damaging the epidermal barrier and its function. This damage can facilitate the introduction of microbes that complicate the presenting disease and its management. Pruritus has a negative influence on quality of life. Initiation of treatment that can safely and effectively manage pruritus may provide immediate benefits to the patient. A novel topical formulation of hydrocortisone acetate 2.5% and pramoxine hydrochloride 1% in a hydrophilic lotion base is indicated for the management of pruritus. However, the rate of onset of antipruritic effects has not been well studied. This single-center, open-label, pilot study involved 11 subjects age 18 and older. All subjects applied hydrocortisone acetate 2.5% and pramoxine hydrochloride 1% lotion four times daily for one day. Severity of itch as measured by the visual analog scale decreased significantly following one day of medication use. The change in mean visual analog scale from baseline was -2.16±2.78 (P=0.0275), representing a mean percentage reduction of 31.74±42.11 (P=0.0315). Topical application of hydrocortisone acetate 2.5% and pramoxine hydrochloride 1% lotion provides a significant reduction in pruritus as rated by patients using the visual analog scale with a single day of use. Early onset of action to decrease itch is expected to improve the patient's treatment experience and increase the level of long-term adherence.