The Antipruritic Effect of Topical Doxepin Cream in Patients with Atopic Dermatitis

Lee, Hee Jung; Park, Chang Ook; Lee, Ju Hee; Lee, Kwang Hoon

Abstract

BACKGROUND: Atopic dermatitis is associated with severe pruritus for which effective topical treatment is lacking. As a potent H1 and H2 antagonist, the antipruritic effect of topical doxepin has been demonstrated in eczematous dermatitis.
OBJECTIVE
We evaluated the efficacy and safety of topical 5% doxepin cream in relieving pruritus associated with atopic dermatitis.
METHODS
A total of 44 patients with atopic dermatitis, who had moderate to severe daily pruritus for at least 1 week, were enrolled in the double-blind, vehicle-controlled study. Randomly assigned 5% doxepin cream or vehicle cream was applied four times daily for 7 days trial.
RESULTS
Relief of pruritus was achieved in 85% of doxepin-treated patients and 57% of vehicle-treated patients by day 7. At each study visit, the physician's global evaluation for relief of pruritus showed significant improvement in the doxepin treatment group (p < 0.01). Visual analogue scales for pruritus severity and pruritus relief showed similar improvements in the doxepin-treated group. The most common adverse effects reported included localized erythema, xerosis (doxepin group, n=5; vehicle group, n=3) and drowsiness (doxepin group, n=2; vehicle group, n=0).
CONCLUSION
Topical doxepin is effective in reducing pruritus in patients with atopic dermatitis. It has apparently a short-term low risk of major side effects or sensitization.