Itching is a common symptom of polycythemia vera (PV). In some cases, PV-related itching can become so severe that it’s debilitating.

Itching often gets worse after bathing, especially after a warm or hot shower. Mild itching may be manageable with basic skin care, such as moisturizing lotion. For others, the itching — known medically as pruritus — may be harder to control.

Several approaches may help reduce itching, including PV treatment, light therapy, over-the-counter products, and prescription medications.

Below, we’ll cover ways to manage itching based on current research and share tips from myMPNteam members who have found what works for them. Everyone is different, so you may need to try more than one approach to find what works best for you.

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Blood clots or bleeding issues

Itching

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Prevent the Post-Shower Itch

Showering with cooler water may help reduce itching. If you take a warm shower, you can finish with cooler water. A cool bath is another option.

You may also find that it helps to add some cornstarch to the tub. Your choice of cleansing products matters, too.

“Avoid showering with deodorant soap,” advised a myMPNteam member. “Use a mild soap like Dove. I also use Aveeno moisturizing bodywash on my lower legs in the shower, and a similar lotion on my legs after drying off.”

“Avoid showering with deodorant soap. Use a mild soap like Dove. I also use Aveeno moisturizing body wash on my lower legs in the shower.”

— A myMPNteam member

To reduce irritation, carefully pat your skin dry rather than rubbing it with a towel.

Some people with PV have itching after any exposure to water, even if it isn’t hot. If you’re struggling with itching after showers, consider switching to sponge baths or other ways to keep clean until your symptoms improve.

Try Skin Lotions and Creams

Lotion can help keep your skin moisturized. Scratching can damage your skin and raise the risk of infection.

“I use over-the-counter moisturizing gel while showering and smooth anti-itch lotion on my lower legs and ankles after toweling off,” shared a myMPNteam member. “Next to the bed, I keep Aveeno anti-itch concentrated lotion.”

“I use skin cream daily. If I get a spot that’s really itchy, I sometimes use Benadryl itch-stopping gel.”

— A myMPNteam member

“I get itchy in the winter when the house is very dry from the wood stove,” wrote another member. “I use skin cream daily. If I get a spot that’s really itchy, I sometimes use Benadryl itch-stopping gel.”

Antihistamines are sometimes used for PV-related itching, but their effects can vary. Ask your doctor whether an antihistamine is appropriate for you.

Consider Vitamin Supplements

There’s no strong evidence that vitamin supplements relieve PV-related itching. A 2024 review of several studies found that vitamin D treatment was associated with less chronic itching, but the studies were in other conditions, not PV.

“Vitamin D therapy seems to be having a remarkable effect on my pruritus. I took an itch-free shower yesterday for the first time in months.”

— A myMPNteam member

Some members of myMPNteam have noticed benefits from vitamin D supplementation.

“Vitamin D therapy seems to be having a remarkable effect on my pruritus,” wrote a myMPNteam member. “I took an itch-free shower yesterday for the first time in months,” he shared. “To be on the safe side, I also took an antihistamine. But that had pretty much stopped working until I added vitamin D.”

Talk with your PV specialist before trying any over-the-counter supplements or medications. What works for one person may not be safe or effective for you.

Discuss Medical Treatment Options

Itching is a common problem with PV. If home measures aren’t enough, tell your cancer care team. Your doctor may be able to prescribe medications or other treatments.

Phlebotomy

Phlebotomy is a common PV treatment that removes blood to reduce excess red blood cells. It may also help relieve symptoms such as itching.

Cytoreductive Therapies

Some cytoreductive therapies used in PV may help with itching. For example, the targeted therapy ruxolitinib (Jakafi) may help reduce itching.

Interferon alpha is another PV treatment option that may help with itching. Ropeginterferon alfa-2b-njft (BESREMi) is approved by the U.S. Food and Drug Administration (FDA) to treat adults with PV.

Rusfertide (Mimrylo)

Rusfertide (sold under the brand name Mimrylo) is a new type of drug recently approved by the FDA to treat people whose PV isn’t well controlled with other therapies. Rusfertide helps reduce levels of red blood cells by limiting the amount of iron available. In a clinical trial, most people with PV who took rusfertide didn’t need phlebotomy.

Light Therapy (Phototherapy)

Treatment with ultraviolet light may help relieve PV-related pruritus for some people. Ask your healthcare provider whether phototherapy may be an option for you and how to access treatment.

Antidepressant Medications

Selective serotonin reuptake inhibitors (SSRIs) are a type of medication used for depression. Some studies found that SSRIs may also help relieve itching in people with PV. Doctors may prescribe them off-label for this purpose.

Making Treatment Work for You

Once you find a treatment plan that works, follow it as directed. If your symptoms change or the treatment stops helping, tell your doctor and ask what other options are available.

Health experts are exploring new approaches to treat itching in PV. For example, in one published case, naltrexone (a prescription typically used for alcohol or drug use disorders) appeared to relieve severe PV-related itching in one person.

Ask your doctor about other new or experimental approaches to managing itching in PV.

If you have a severe case of itching or other skin symptoms, you may benefit from seeing a dermatologist to get their perspective.