The effectiveness of virtual reality-assisted hypnosis against itch: the creation and evaluation of a new therapeutic concept

Abstract

Chronic itch is a disabling condition with currently limited treatment options. Virtual reality (VR) is an approach that takes people to another place and has demonstrated to temporarily reduce itch. Hypnosis, which is a state of relaxation, has been applied with more long-term relief of itch in the specific case of severe eczema. However, hypnosis tends to depend on an individual’s susceptibility, or ease to come into hypnosis. A combination of VR and hypnosis (VRH) has been proposed, since it may combine the longer-lasting effects of hypnosis with VR, making the hypnosis more accessible by facilitating imagination. Even though VRH is promising, it has never been investigated in itch. This study focusses on the patient-guided development and evaluation of a novel VRH-based treatment scheme - including the design and programming of a VR-environment, and the creation of the accompanying hypnosis scripts - directed at chronic itch. On top of that, we here propose an interventional study to assess the effectiveness of the VRH and VR in reducing itch and its psychological burden in individuals with chronic itch. In this randomized controlled trial, a VRH and a VR treatment will be studied for their potential to reduce clinical itch from baseline till after 8 sessions and at follow-up (6 weeks after the end of treatment). Secondarily, the VRH and the VR treatment groups are compared. The medical treatment need, itch sensitivity and overall wellbeing of the participants are also assessed. Patient inclusion is expected around late summer/autumn 2023. If effective, this technique may be further optimized to provide an on-demand treatment option to alleviate itch (independent of its origin) and its associated burden of disease.