Practical tips for preventing post-bath itching with polycythemia vera
Fact-checked by Polycythemia vera (PV) is a chronic, slow-growing blood cancer that causes your bone marrow to produce too many red blood cells. Some people with PV also have elevated levels of white blood cells and platelets, which help your blood to clot.
Aquagenic pruritus, or water-induced itching, is a common symptom of PV. The itching can be intense and may make everyday activities, such as bathing or showering, uncomfortable or disruptive.
Making small changes to your bathing and skin care routines may help ease symptoms. The following tips may help you prevent or manage post-bath itching with PV.Â
Why does bathing cause itching in PV?
PV pruritus, or itching, can be triggered by contact with water, making it likely to occur during bathing or showering. The itching typically starts in the first 10 minutes after contact with water, and is often one of the earliest signs of PV.
It most commonly affects the chest, back, arms, and legs. While it does not cause any skin changes, some people describe the symptom as unbearable.
Water at any temperature can trigger aquagenic pruritus, but most people report that warm water causes worse symptoms.Â
The cause of aquagenic pruritus is not fully understood. Research suggests that certain mutations in the JAK2 gene, which are found in most people with PV, may increase activation of certain immune cells, allowing the release of itch-related chemicals that contribute to these sensations. Â
However, the exact mechanism linking JAK2 mutations to aquagenic itching is not fully understood.Â
Modifying your bath and shower routine
Aquagenic pruritus can make bathing or showering uncomfortable and stressful. Small changes to your routine may help ease itching and other symptoms.
Among safe bathing tips for PV are:
- showering or bathing in lukewarm water
- avoiding sudden changes in water temperature
- taking shorter or less frequent baths or showers
- using mild, fragrance-free bathing products
- keeping the room relatively cool while bathing
Some people may also find that adding baking soda to bathwater helps ease itching. Talk with your care team about strategies that may be appropriate for you.Â
Post-bath skin care strategies
Even after changing your bathing routine, you may experience itching or other uncomfortable sensations after water exposure. Post-shower skin care for PV may help ease your symptoms.
Strategies you can try include:
- gently patting your skin dry instead of rubbing it
- applying a mild, fragrance-free moisturizer after bathing
- avoiding skin care products that irritate your skin
- wearing loose-fitting, breathable clothing, especially after bathing
- keeping your home relatively cool to help limit sweating
- drinking enough fluids to keep your skin hydrated
Pay attention to products or environmental factors that seem to worsen your symptoms. Keeping track of possible triggers may help you identify patterns and discuss them with your care team.
Other medical and lifestyle interventions
For some people with PV, post-bath itching continues even after they make changes to their bathing and skin care routines. Treating PV may help ease aquagenic pruritus, but itching can continue even when other PV symptoms are well managed.
If itching continues to affect your daily life, your doctor may recommend additional treatments.
Options for aquagenic pruritus management may include:
- selective serotonin reuptake inhibitors, a type of antidepressant
- phototherapy, which uses controlled exposure to ultraviolet light
- antihistamines, although their effectiveness can vary
Some PV treatments may also help ease aquagenic pruritus. Jakavi (ruxolitinib), a treatment that blocks proteins involved in the JAK signaling pathway, has been shown to ease itching in some people with PV.
Not being able to bathe or shower without itching, stinging, or burning can affect your daily routine and quality of life. If post-bath itching continues to interfere with your daily activities, talk with your doctor. Your care team can help you identify possible triggers and discuss treatment options that may be appropriate for you.
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