Causes and Treatment of Hodgkin Lymphoma Itching

Itching (pruritus) can be a symptom of Hodgkin lymphoma. It’s not known exactly why, but about 10% to 25% of people with Hodgkin lymphoma have intense itching. It’s possible that cells in the body release chemicals near nerves that make a person feel itchy.

The itching can feel like a burning sensation on a certain area of skin, especially on the lower legs. It can also feel like persistent itching all over your body.

Itching is more common in Hodgkin than in non-Hodgkin lymphoma. In some people, the itching starts before they get diagnosed with cancer. There can also be a rash with itching, which may look similar to common skin conditions like eczema.

This article covers why itching can be a sign of Hodgkin lymphoma and how to cope with it.

Woman scratching her legs
IAN HOOTON/SCIENCE PHOTO LIBRARY / Getty Images

What Causes Hodgkin Lymphoma Itching?

The exact cause of itching in Hodgkin lymphoma is not known, but it is believed that some blood cells release chemicals near the nerves of the skin and irritate these nerves. People feel irritation in the form of itching.

However, an itch does not necessarily mean that the cancer is in your skin. Non-specific skin symptoms or other skin involvement in Hodgkin lymphoma are reported in 15% to 50% of people with the disease. Of these, only a minority actually have Hodgkin lymphoma of the skin or cutaneous Hodgkin lymphoma.

It's possible that there is more than one reason for the itching in people with Hodgkin lymphoma pruritus. Several theories are being explored by researchers who are trying to figure out why itching happens in Hodgkin lymphoma.

When Does Lymphoma Itching Occur?

Hodgkin itch is medically known as paraneoplastic pruritus. While this itch occurs with other blood cancers, it’s more common in patients with Hodgkin lymphoma and is recognized as a sign of the disease.

The Hodgkin's itch can develop weeks (or even months) before the other clinical signs of lymphoma show up. The itching can be severe and may have a negative impact on a person’s quality of life.

Itching in Hodgkin lymphoma can be an indicator of a less favorable prognosis when a patient also has a significant fever or weight loss (also known as the "B-symptoms" of lymphoma).

Other Hodgkin Lymphoma Symptoms

Hodgkin lymphoma can also cause other symptoms, such as:

  • Fever without a clear cause (such as an infection)
  • Swollen lymph nodes that do not hurt (however, some people notice lymph node pain after they drink alcohol)
  • Night sweats (which can be severe enough that people have to get up to change their clothes)
  • Loss of appetite, abdominal pain/fullness 
  • Losing weight without trying (usually more than 10% of a person’s body weight and happens within 6 months)
  • Fatigue

How Is Hodgkin Lymphoma Itching Treated?

There have not been many large studies to investigate which treatments might be effective for itching in Hodgkin lymphoma. 

According to a 2014 study, one drug that appears to be effective for Hodgkin lymphoma itching is Emend (aprepitant) a neurokinin-1 receptor antagonist. Emend is most often used to help prevent nausea and vomiting from chemotherapy. More research is needed to see if it could also help with itching.

Other treatments have also been explored for Hodgkin disease itching. Antidepressants, sedating antihistamines, oral steroids, light therapy for cutaneous T-cell lymphoma, thalidomide, and others can be tried. Some treatments have been found to be effective for itchiness in certain types of lymphoma, but not others.

Home Remedies for Itching

There are also some strategies and simple home remedies that can help you cope with Hodgkin itching, such as:

  • Keeping your skin moisturized 
  • Avoiding very hot or very cold temperatures (e.g., not staying outside in freezing or sweltering weather, not taking long hot showers or baths)
  • Using soothing bath, shower, and skincare products
  • Staying hydrated and nourished 
  • Using a humidifier in your home if the air tends to be dry
  • Wearing clothes that let your skin “breathe” and are made of soft, non-irritating materials (e.g., cotton, bamboo)
  • Making sure any cosmetics you use are for sensitive skin or hypoallergenic 
  • Applying a cool compress to your skin if it’s irritated
  • Staying out of swimming pools that have chlorine in them 
  • Managing your stress levels, getting regular physical activity, making quality sleep a priority, and taking other steps that support your overall health
  • Asking your provider about treatments like phototherapy

Support

While there have not been any controlled studies, mind/body therapies that are used in an integrative way to help people cope with the symptoms of cancer treatment (such as massage therapy, meditation, or acupuncture) may be of some benefit. 

Ask your oncologist about what they've learned working with other people with Hodgkin lymphoma. It might be helpful to join an online support community of other people who are also coping with itching from Hodgkin lymphoma to get ideas, as well as to experience the support that can come from knowing you are not alone in your experience.

For Caregivers and Loved Ones

If your loved one is coping with the Hodgkin itch, know that the symptom is real and can be severe. It's important for people in their life to believe them and to understand what they're going through.

Be patient when your loved one is itching, especially if they are in a lot of distress. Try to step back and picture it as the itch talking, and not your loved one, if they are being short with you. Social media can be a good place for caregivers to connect with others who are going through the same experiences. 

When to Talk to Your Healthcare Provider

If you have itching that is making you very uncomfortable or does not seem to be responding to things you’re trying on your own at home, ask your provider about what else you might be able to try.

If you’re not sure what’s causing the itching, talk to your provider about it. There are many common reasons for itching that are not Hodgkin lymphoma, like eczema, psoriasis, and even something as simple as a case of poison ivy or allergies. 

Your provider can do tests and talk to you about your itching to rule out a potentially serious cause like cancer. If you’re having itching along with other symptoms that are concerning you, like a fever, weight loss, and swollen lymph nodes, tell your provider.

Summary

Some people with Hodgkin lymphoma have itching as an early sign of cancer. Itching is more common in Hodgkin than in non-Hodgkin lymphoma. 

The itching from Hodgkin lymphoma can be just on the legs or may spread to other parts of the body. Some people notice a rash as well. 

Itching happens for a lot of reasons that are not cancer. However, if you have other concerning symptoms like a fever that does not have a clear cause and swollen lymph nodes, you should talk to your provider. 

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading

By Indranil Mallick, MD
 Indranil Mallick, MD, DNB, is a radiation oncologist with a special interest in lymphoma.