Localized Neuropathic Pruritus: Life-changing OTC topical called Dermeleve. Key ingredient is strontium, which interferes with the calcium-dependent receptors and calcium channels that are necessary for itch signaling. Works in about 5 minutes, lasts for about 5 hours. STUNNING EFFICACY. It burns l...

Minor, localized neuropathic itch (postherpetic neuralgia, notalgia paresthetica, etc.) can be treated with local, skin-directed treatments such as topical menthol-based creams or lotions and topical capsaicin. I generally avoid topicals containing tricyclic antidepressants such as topical doxepin o...

For compounded topicals, I really like topical gabapentin, amitriptylline, lidocaine (GAL) for broader areas, or ketamine, amitriptylline, and lidocaine (KAL) for smaller areas given the potential toxicity of ketamine. I get my GAL from Skinmedicinals and my KAL from the Art of Medicine. Both are re...