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Antihistamines eczema: Eczema treatment: Antihistamines

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Eczema treatment: Antihistamines

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Antihistamines for Eczema

Written by Stephanie Watson

  • When are antihistamines used for eczema?
  • Which eczema symptoms do they help?
  • How do antihistamines work for eczema?
  • Which types of antihistamines work for eczema?
  • Can antihistamines help babies with eczema sleep?
  • Who shouldn’t take antihistamines for eczema?
  • What are the possible side effects?
  • Is there an antihistamine diet for eczema?
  • More

Eczema is a skin condition that makes skin inflamed, scaly, and itchy. The itch can be intense enough to keep you or your child up at night. And if you scratch too much, you might irritate your skin and start a cycle that makes you itch even more.

Antihistamines are medicines that can treat eczema. Some antihistamines also help you sleep. These medicines won’t stop eczema flares, but they can break the cycle of itching and scratching that makes flares worse.

Antihistamines aren’t the main treatment for eczema, but they work together with steroids, moisturizers, and other medicines to control symptoms like itching and sleeplessness.

You may take antihistamines for eczema caused by allergies. Eczema, allergies, and asthma often go together. Doctors call these three conditions the “atopic triad.” If you have eczema you’re likely to have allergies, too.

Some antihistamines help you sleep if the eczema itch keeps you awake. Your doctor might prescribe what’s called a sedating antihistamine for eczema relief at night.

Antihistamines aren’t a cure for eczema, but they can help relieve the itchiness it causes. The itch can be the most annoying symptom of eczema. Sedating antihistamines can help with sleeplessness caused by itching at night.

Histamine is a chemical that your immune system releases when you’re allergic to things like pet hair, pollen, or shellfish. When histamine is released, fluid leaks from your blood vessels into your skin, which leads to swelling, a rash, itching, and other symptoms of an allergic reaction.

Antihistamines block histamine to relieve the itch and bring down swelling in your skin.

The sedative in some antihistamines relaxes you and makes you sleepy. By helping you sleep, these medications keep you from scratching your skin during the night and irritating it even more.

Dyshidrotic eczema is a type of eczema that causes small, fluid-filled blisters on the palms of the hands, sides of the fingers, soles of the feet, and sides of the toes. The itch from these blisters can be intense. Taking an antihistamine for dyshidrotic eczema may help relieve the itch.

Antihistamines come in two main groups: sedating and nonsedating. The best antihistamine for eczema is the one that relieves your symptoms.

Sedating antihistamines are also called first-generation antihistamines because they were the first antihistamines released. These medicines contain a sedative to help you sleep.

Examples of sedating antihistamines are:

  • Chlorpheniramine (Chlor-Trimeton)
  • Diphenhydramine (Benadryl, PediaCare Children’s Allergy, ZzzQuil)
  • Doxylamine (Unisom)

Sedating antihistamines are good at promoting sleep, but they don’t work as well as other eczema medicines at stopping the itch.

Second-generation antihistamines are newer medicines. These nondrowsy antihistamines for eczema don’t make you feel as tired, so you can take them during the day. Examples are:

  • Cetirizine (Zyrtec)
  • Fexofenadine (Allegra)
  • Loratadine (Alavert, Claritin)

You can buy both types of antihistamines over the counter without a doctor’s prescription. They come in tablets and capsules.

While antihistamines do make babies sleepy, these medicines aren’t recommended for children younger than 4 because young children are more sensitive to the effects of antihistamines. Kids under age 4 are at higher risk for seizures and other serious side effects from these medicines.

Check with your pediatrician before giving your baby any eczema treatment. Your doctor can suggest safer ways to relieve the itch and help your baby sleep.

Antihistamines are safe for most healthy adults, but they can cause side effects in people with health problems including:

  • Heart disease
  • High blood pressure
  • Abnormal heart rhythm
  • Kidney or liver disease
  • Glaucoma
  • Urinary retention

Antihistamines may not be safe for women who are pregnant or breastfeeding.

Sedating antihistamines make you sleepy, which could be a problem if you have to drive or operate heavy equipment.

Antihistamines for eczema may cause side effects like:

  • Drowsiness — even the nonsedating ones
  • Dry mouth and eyes
  • Blurry vision
  • Constipation
  • Belly pain
  • Headache

To make sure you take these medicines safely, follow the dosing instructions on the package. If you have any questions about how much to take or to give your child, ask a doctor.

Antihistamines are also an ingredient in some over-the-counter cough and cold remedies. Check the ingredients list on any of the medicines you buy. Taking more than one medicine with antihistamines at a time could lead to more side effects.

These medicines can also interact with other drugs that make you sleepy. Before you take an antihistamine, let your doctor know if you also take sleeping pills, sedatives, or muscle relaxers.

Histamine is a type of amine, a chemical that forms when bacteria break down proteins. You might notice that your symptoms flare up after you have foods or drinks naturally high in amines, like:

  • Cheese
  • Smoked meats like salami, ham, and sausage
  • Pickled or canned food like sauerkraut
  • Shellfish such as shrimp and lobster
  • Chocolate
  • Snacks and sweets that contain preservatives or artificial colors
  • Red wine

You may want to limit or avoid these foods.

A few natural antihistamine foods for eczema are less likely to flare up symptoms:

  • Fresh meat, fish, chicken, and eggs
  • Fresh fruits and vegetables
  • Grains like oats, rye, and millet
  • Fresh pasteurized cow, goat, and sheep milk
  • Cream cheese and butter

A food diary can help you pinpoint which foods set off your eczema symptoms and which ones ward off flares. You might also ask a dietitian for help fine-tuning your diet.

Top Picks

Do h2 antihistamine tablets or liquids help with eczema symptoms in people already using eczema creams or ointments?

Review question

Are h2 antihistamines (which suppress the effects of chemicals released during an allergic reaction known as “histamines”) in tablet or liquid form safe and effective in people of any age diagnosed with eczema when used in addition to creams and ointments compared to an inactive substance (placebo) or no addition to creams and ointments?

Relevance

Eczema (also known as atopic eczema or dermatitis) is a skin disease that often affects children and adults. In developed countries, 10 to 20% of all people are affected by eczema during their lifetime. The main symptom is itching, which leads to scratching and, together with inflammation of the skin, often causes redness. The symptoms of eczema can lead to insomnia and fatigue, reducing quality of life. Antihistamines are often used for pruritus (particularly oral h2 antihistamines) and may improve symptoms of eczema when taken in addition to standard skin treatments (eg, emollients, moisturizers, steroid creams), although it is believed not to treat her. Many antihistamines are available without a prescription, such as cetirizine or loratadine. Although h2 antihistamines are often prescribed to treat eczema, we don’t know how effective or safe they are.

Study profile

We searched for suitable studies up to May 2018. We included 25 randomized controlled trials involving 3285 people of all ages diagnosed with eczema. 8 studies included children or adolescents and 17 included adults. The gender of the participants and the severity of symptoms were often not reported. All studies were carried out in secondary care institutions – hospitals, research clinics, dermatological and surgical centers. This means that the participants likely had more severe eczema than when recruited at the first point of contact (i.e. primary). All but one study compared h2 antihistamines with placebo. The researchers studied 13 different h2 antihistamines, most of which were less sedatives (known as “second-generation antihistamines”). The studies lasted from 3 days to 18 months. 7 trials were funded by pharmaceutical companies; these were the largest trials included in this review.

Main results

We did not find convincing evidence that h2 antihistamines help patients with eczema.

One study compared cetirizine 0.5 mg/kg/day with placebo (in children over 18 months). No data were provided on pruritus in eczema as assessed by patients. Cetirizine is likely associated with fewer (mostly mild) adverse events and slightly less need for additional h2 antihistamines to prevent exacerbations. Despite improvement in clinical signs as assessed by clinicians in both groups, the results suggest no difference between groups (all moderate-quality evidence).

When compared with placebo, we found no evidence that an increased dose of cetirizine, 10 mg/day, for 4 weeks affects patient-reported pruritus, number of side effects, physician-reported symptoms, or number of eczema flare-ups as measured by treatment used (all evidence is of low quality). Side effects reported in both groups included drowsiness, skin problems, breathing problems, and headaches.

Compared to placebo, fexofenadine 120 mg/day given to adults for 1 week appears to provide some relief from patients’ pruritus, and also more for physicians’ pruritus, and little or no effect on enrollment experiencing side effects (predominantly drowsiness and headaches), or treatment volume indicating the number of flare-ups of eczema (all moderate-quality evidence).

In adults for 4 weeks, we found no evidence of a difference between placebo and loratadine 10 mg/day for patient-reported pruritus, physician-reported side effects, or symptoms of eczema (all low-quality evidence). The number of exacerbations of eczema was not assessed in this study. The study authors reported only one side effect (folliculitis) that occurred in the placebo group.

Only one study assessed quality of life, but the results could not be analyzed.

Quality of evidence

For all key comparison outcomes, certainty (certainty) in the evidence was low to moderate. Among the reasons for the decline in the quality of the evidence are concerns about how the studies were conducted and the inclusion of too few participants, leading to less accurate results.

Translation notes:

Translation: Enokyan Sarina Manvelovna. Editing: Kukushkin Mikhail Evgenievich. Project coordination for translation into Russian: Cochrane Russia – Cochrane Russia on the basis of Kazan Federal University. For questions related to this translation, please contact us at: [email protected]; [email protected]

Treatment of eczema: topical and systemic therapy

  • Eczema
  • On hand
  • On feet
  • Dry
  • Wet
  • Dyshidrotic
  • Microbial
  • Symptoms
  • Treatment

Treatment of eczema should be carried out only after consultation with a dermatologist,
independent fight against the disease, the use of folk remedies can only worsen the condition of the skin,
enhance the inflammatory response. The pathological process can be complicated by the reproduction of a fungal infection,
pathogenic bacteria, the formation of purulent acne.

The therapeutic effect depends on the suspected cause of the inflammation.
With nervous disorders, psychological trauma, sedatives are recommended.
drugs, antidepressants, tranquilizers. For hormonal disorders
background, it is important to cooperate with a narrow specialist – an endocrinologist, who
will help restore the balance of hormones. If, during the diagnosis, the patient
foci of chronic infection have been identified, treatment begins with the elimination of the infectious process.

Antihistamine therapy

Antihistamines block the action of histamine receptors (diphenhydramine, suprastin, tavegil, duovel, etc.).
They have anti-allergic and sedative effects, as well as anti-inflammatory effects.
Many drugs are addictive, so they are not recommended to be taken for more than 10 days.
Modern drugs are distinguished by the absence of tachyphylaxis and a rapid therapeutic effect,
however, some may have side effects, so consultation with an allergist or dermatologist is required.

Corticosteroids

Corticosteroid drugs are used for almost all types of eczema (weeping,
dry). They reduce inflammatory reactions, have an immunosuppressive effect,
relieve itching and other symptoms. They are prescribed in the form of ointments, creams,
tablets or injections. This type of drug is often recommended in combination with potassium and calcium preparations in order to avoid side effects.
When taking CS, addiction may develop, they are also characterized by a withdrawal syndrome, therefore, after reaching a therapeutic
effect, the dosage should be gradually reduced.

For the treatment of microbial eczema are prescribed
antibiotics, antifungals, immunomodulators. Multivitamins can help speed up healing
complexes in which the content of vitamins of groups A, E, B is mandatory.