What are the most effective antihistamines for treating itchy skin conditions. How do hives and angioedema differ from other skin rashes. What causes acute and chronic urticaria. When should you seek medical attention for hives.

Understanding Hives: Causes, Symptoms, and Types

Hives, medically known as urticaria, are a common skin reaction affecting approximately 20% of people at least once in their lifetime. These itchy, red, raised bumps on the skin can be uncomfortable but are generally harmless. Hives can be classified into two main types:

• Acute hives: Short-term, allergy-related rash lasting from a few hours to six weeks
• Chronic hives: Long-term, often autoimmune-related rash persisting for more than six weeks

While allergic reactions are a common trigger for hives, they can also be caused by various other factors, including:

• Insect stings or bites
• Poisonous plants (e.g., poison ivy, poison oak)
• Certain foods (e.g., milk, peanuts, eggs, fish, shellfish)
• Chemicals
• Medications (e.g., NSAIDs, codeine, blood pressure medicine)
• Infections
• Emotional stress
• Autoimmune disorders
• Physical causes (e.g., cold, sweating, water, sun exposure)

Identifying Hives: Key Characteristics

Hives can appear anywhere on the body and may vary in appearance. The main sign of hives is the presence of red, raised welts. These welts may:

• Have a pale center that turns white when pressed
• Appear in clusters
• Change shape and location within hours
• Range in size from tiny to as large as a dinner plate
• Cause itching, stinging, or burning sensations
• Be accompanied by swelling (angioedema) around the eyes, lips, feet, or throat

Acute vs. Chronic Hives: Key Differences and Triggers

The primary distinctions between acute and chronic hives lie in their duration and triggers. Acute hives typically last less than a day or up to six weeks and are often triggered by specific allergens or non-allergic causes. Identifying and avoiding these triggers can help prevent future outbreaks.

Chronic hives, lasting more than six weeks, are usually idiopathic, meaning the exact cause is unknown. Only a small percentage of chronic hives cases are due to allergic reactions. Despite these differences, antihistamines remain the primary treatment option for both acute and chronic hives.

Hives vs. Other Skin Rashes: Understanding the Distinction

While hives are a specific type of skin rash characterized by raised, itchy red bumps, other skin rashes can take various forms. These may involve changes in skin color or texture, causing roughness, scaliness, or cracking. Unlike hives, not all rashes itch; some may be painful or simply cause discomfort.

Treating Hives: The Role of Antihistamines

Although hives often resolve on their own within a few hours, over-the-counter (OTC) antihistamines are recommended for quick symptom relief. While anti-itch lotions, creams, and topical anesthetics can provide immediate relief from pain and itchiness, they do not address swelling or redness. Antihistamines offer the most comprehensive relief for hives symptoms.

Effective OTC Antihistamines for Hives

For acute cases of hives, several well-known OTC antihistamines have proven effective:

• Curist Allergy Relief (levocetirizine)
• Fexofenadine (brand name Allegra)
• Diphenhydramine (brand name Benadryl)
• Loratadine (brand name Claritin)
• Cetirizine (brand name Zyrtec)

These antihistamines can help reduce itching, swelling, and redness associated with hives. It’s important to note that individual responses to antihistamines may vary, and some people may find certain options more effective than others.

Managing Chronic Hives: Long-term Treatment Strategies

For individuals suffering from chronic hives, a more comprehensive treatment approach may be necessary. This often involves a combination of medications and lifestyle modifications to manage symptoms effectively.

Medication Options for Chronic Hives

In addition to OTC antihistamines, healthcare providers may recommend the following treatments for chronic hives:

• Prescription-strength antihistamines
• Oral corticosteroids (for short-term use in severe cases)
• Anti-inflammatory medications
• Immunosuppressants
• Biologics (e.g., omalizumab)

The choice of treatment depends on the severity of symptoms and individual patient factors. A healthcare provider can help determine the most appropriate treatment plan.

Lifestyle Modifications for Chronic Hives Management

Alongside medication, certain lifestyle changes can help manage chronic hives:

• Identifying and avoiding known triggers
• Maintaining a cool, comfortable environment
• Wearing loose-fitting, breathable clothing
• Managing stress through relaxation techniques
• Following a balanced diet and staying hydrated
• Keeping a symptom diary to track potential triggers and treatment effectiveness

When to Seek Medical Attention for Hives

While most cases of hives can be managed at home with OTC treatments, certain situations warrant immediate medical attention. These include:

• Difficulty breathing or swallowing
• Swelling of the throat or tongue
• Dizziness or fainting
• Severe abdominal pain or vomiting
• Hives that persist for more than six weeks despite treatment
• Hives that significantly impact daily life or sleep

These symptoms may indicate a more serious allergic reaction or underlying condition that requires professional medical evaluation and treatment.

Prevention Strategies: Minimizing Hives Outbreaks

While it’s not always possible to prevent hives, especially in cases of chronic urticaria, there are steps you can take to minimize the risk of outbreaks:

Identifying and Avoiding Triggers

Keep a detailed record of potential triggers, including foods, medications, environmental factors, and stress levels. This can help you identify patterns and avoid known triggers.

Skin Care and Protection

Protect your skin from excessive heat, cold, and sun exposure. Use gentle, fragrance-free skincare products to minimize irritation.

Dietary Considerations

If you suspect certain foods trigger your hives, consider an elimination diet under the guidance of a healthcare professional to identify problematic ingredients.

Stress Management

Since stress can exacerbate hives, incorporate stress-reduction techniques into your daily routine, such as meditation, yoga, or deep breathing exercises.

Emerging Treatments and Research in Hives Management

The field of hives treatment is continually evolving, with researchers exploring new therapies and management strategies. Some promising areas of research include:

Targeted Biologics

Researchers are investigating new biologic medications that target specific pathways in the immune system responsible for hives. These treatments may offer more precise and effective relief for chronic hives sufferers.

Immunotherapy

While primarily used for allergies, some studies are exploring the potential of immunotherapy in managing chronic hives, particularly in cases where specific triggers can be identified.

Gut Microbiome Research

Emerging evidence suggests a potential link between gut health and chronic hives. Studies are investigating how modulating the gut microbiome might impact hives symptoms and frequency.

Personalized Medicine Approaches

Researchers are working on developing more personalized treatment strategies based on individual genetic and immunological profiles, aiming to improve treatment outcomes for chronic hives patients.

Living with Hives: Coping Strategies and Support

Dealing with chronic hives can be challenging, both physically and emotionally. Implementing effective coping strategies and seeking support can significantly improve quality of life for those affected by recurring hives.

Emotional Well-being

Chronic hives can take a toll on mental health, leading to anxiety, depression, and reduced self-esteem. Consider the following strategies:

• Seek counseling or join support groups to connect with others who understand your challenges
• Practice mindfulness and relaxation techniques to manage stress and anxiety
• Educate friends and family about your condition to foster understanding and support

Adapting Daily Routines

Making adjustments to your daily life can help minimize discomfort and manage symptoms:

• Choose clothing made from natural, breathable fabrics
• Use hypoallergenic bedding and laundry detergents
• Maintain a consistent sleep schedule to support overall health
• Plan activities during times when symptoms are typically less severe

Workplace Accommodations

If hives impact your work life, consider discussing potential accommodations with your employer, such as:

• Flexible work hours to accommodate medical appointments or severe symptom days
• Adjustments to work environment temperature or lighting
• Permission to take short breaks for applying treatments or managing symptoms

By implementing these strategies and working closely with healthcare providers, individuals with chronic hives can effectively manage their condition and maintain a good quality of life. Remember that treatment plans may need adjustments over time, so regular follow-ups with your healthcare provider are essential for optimal management of hives.

Best Antihistamines for Hives (Urticaria) – Curist

By Deni Hui, The University of Texas at Austin College of Pharmacy

Curist delivers FDA-approved allergy medicines to your door at half the price of traditional brands. We hope everyone stays safe and healthy during this time.

Have you ever broken out in hives and felt the itchy red bumps on your skin? For most people, hives are usually more than just a temporary nuisance. Read along to learn more about what hives are and what you need to know about them!

Hives (also known as urticaria) are a common skin reaction to an allergen (a substance that causes allergies). About 20% of people will develop hives at least once in their lifetime. Though uncomfortable, It is a harmless skin condition marked by spots on the skin that are itchy, red, and raised. Hives are usually a temporary condition, and there are two different types of hives, acute hives (acute urticaria) and chronic hives (chronic urticaria).

• Acute Hives (Urticaria): Short term, most likely allergy-related rash that fades in 2-3 hours but could hold on for as long as six weeks.
• Chronic Hives (Urticaria): Long term, auto-immune related rash that lasts longer than six weeks.

Hives are the classic sign of an allergic reaction, although hives can erupt for other reasons including:

• Allergens (contact urticaria) like pollen, ragweed, mold spores or pet dander
• Insect stings or bites
• Poisonous plants (e.g. poison ivy, poison oak)
• Foods (e.g. milk, peanuts, eggs, fish or shellfish)
• Chemicals
• Medications (e.g. NSAIDs like ibuprofen, aspirin; codeine, blood pressure medicine)
• Infections (e.g. Strep throat or urinary tract infections)
• Emotional stress
• Autoimmune disorders
• Physical causes (physical urticaria) such as cold (cold urticaria), sweating (cholinergic urticaria), water, or sun exposure.

Hives can appear anywhere on your body and can vary in appearance depending on the person and the situation, but the main sign of hives is the hallmark red raised welts. The welts from hives can:

• have a pale center (turns white when pressed)
• appear in clusters
• change shape and location in a matter of hours
• be tiny or as big as a dinner plate
• itch, sting, or cause a burning sensation
• swelling (or angioedema) around eyes, lips, feet or throat

It is important to note that rarely, a person with hives and angioedema can also get anaphylactic shock which include signs of trouble breathing, a drop in blood pressure, or a loss of consciousness. If this situation ever occurs, make sure to seek medical attention immediately.

The main differences between acute and chronic hives (urticaria) are how long the symptoms last and what their respective triggers are. Acute hives are short-term; they can last for less than a day or up to six weeks. They can be triggered by coming into contact with an allergen such as food, animal dander, insect bite, latex or pollen. Acute hives can also occur from non-allergic causes such as heat, exercise or stress. Being able to identify and avoid these triggers can help prevent this allergic reaction from occurring.

Chronic hives, on the other hand, can stick around for a longer period of time (more than 6 weeks). Most chronic hives are idiopathic, meaning that the exact cause is unknown. Only a small percentage of chronic hives are due to an allergic reaction.

Regardless of whether you have acute or chronic hives (acute or chronic urticaria), antihistamines will be your mainstay of treatment options to help relieve symptoms.

Hives (urticaria) are a particular type of skin rash. They are raised, itchy red bumps that can be large or small in size. Skin rash, on the other hand, can take many other forms often characterized by changes in color or texture of the skin. They can cause your skin to feel rough and look scaly or cracked. Unlike hives, rashes don’t always itch. Sometimes, they hurt or make your skin feel irritated, scratchy or uncomfortable.

Hives are often a temporary skin reaction that can go away in 2 to 3 hours without treatment. However, in some people, hives can persist for weeks or months.

Even though hives typically resolve in a couple of hours, over-the-counter (OTC) antihistamines are recommended as treatment options because they provide the quickest route to symptom relief. Anti-itch lotions, creams as well as topical anesthetics can provide instant relief from the pain and itchiness of hives, but they will not relieve the swelling or redness. Thus, antihistamines are best recommended for quick overall symptom relief.

For acute cases of hives (acute urticaria), some of the best antihistamines are well-known over-the-counter antihistamines such as Curist Allergy Relief (levocetirizine), (fexofenadine (brand Allegra), diphenhydramine (brand Benadryl), loratadine (brand Claritin), and cetirizine (brand Zyrtec) can help reduce swelling, redness, itching, and other problems such as wheezing or difficulty breathing. Chronic hives (chronic urticaria) are usually treated with a three to six month regimen of antihistamines. For chronic hives, it’s recommended to use a newer antihistamine like levocetirizine which does not have the same sedating side effects like Benadryl.

If none of the antihistamines work, consult your doctor or pharmacist as they may also add a different type of antihistamine called an histamine-2-receptor blocker, such as ranitidine or cimetidine. These medications are usually used to treat acid reflux but can also help with reducing hives.

Yes, there are non drowsy antihistamines for treating hives, for instance Curist Allergy Relief (levocetirizine) which is minimally drowsy! Fexofenadine (brand Allegra), loratadine (brand Claritin) and cetirizine) (brand Zyrtec) are all considered newer antihistamines because they were designed to be safer than first generation antihistamines like Benadryl (diphenhydramine) as they do not cause drowsiness, or have very limited drowsiness. These newer antihistamines are non drowsy and can provide ample symptomatic relief for as long as 24 hours.

There is not a single best antihistamine for hives, it depends on which antihistamine works for you. Commonly, people often try Benadryl for hives and while it is effective, it has a significant tradeoff – Benadryl is very sedating. So Benadryl may be effective for acute hives, Benadryl is not appropriate for chronic hives. Instead, a newer antihistamine with less sedating side effects like Curist Allergy Relief (levocetirizine), would be better antihistamine for treating hives.  

The most common side effect of antihistamines is drowsiness, but this is less of a problem with the non-sedating antihistamines used to treat hives. Other possible side effects may include headache, mood changes, nausea or dry mouth. If you are concerned about the drug interactions caused by hives medications with the other medicines you are currently taking, make sure to consult your doctor or pharmacist first.

Hives generally go away in a few hours, but some people may live with chronic hives or regular episodes. Here are a few proven home remedies that can help soothe your itchy skin:

• Use a cold compress: Apply an ice pack or washcloth soaked in cold water to your skin for 10 minutes to provide rapid relief from pain and itchiness. You may repeat it several times throughout the day until symptoms subside.
• Use anti-itch cream: Calamine lotion, menthol, capsaicin or hydrocortisone creams are the most effective in quickly relieving skin discomfort. Other topical anesthetics such as lidocaine cream can provide relief against long term itching or pain.
• Take a cool bath: Heat can make itching worse; while cool water can soothe the skin.
• Avoid triggers: If you are repeatedly experiencing episodes of hives, keep a symptom diary to help you identify foods, allergens (pollen or pet dander), chemicals, activities or medications that might be provoking allergic reactions. Avoid any triggers that you discover in your diary.

Lastly, to learn more about itchy skin and hives, read Curist team member Waverly’s story about her experiences diagnosing chronic hives and treating itchy skin.

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Ships every
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Ships every
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3

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Ships every
4

month

The newest generation of antihistamines! This tiny pill packs a punch – it works faster than Claritin, lasts longer than Benadryl, and causes less drowsiness than Zyrtec.

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Why Levocetirizine Dihydrochloride For Allergies?

Curist Allergy Relief, or levocetirizine dihydrochloride
if you’re scientific, is a new, “third generation” antihistamine, first used in 2007 (Benadryl, a first-generation drug, was first used in 1946). In clinical trials, Allergy Relief worked faster than Claritin and was more effective than Zyrtec!

Usage Tips

1. We recommend taking this at night; it’ll still last until the next day.

2. If you can, consider starting a week or two before you anticipate symptoms will start.

3. Continue daily for smooth and ongoing allergy relief.

Doctor Pro Tip

“Consider trying Curist Allergy Relief if other antihistamines have not worked, or have stopped working to treat allergy symptoms.”

Dr. Marc Goldstein, MD

Curist Allergy Advisor
Chief of Allergy, Pennsylvania Hospital

Everything you need to know about Levocetirizine

Xyzal Generic Levocetirizine 5 mg FAQ

Levocetirizine (the ingredient in Curist Allergy Relief and the ingredient in Xyzal) is an oral antihistamine. It blocks the action of histamine, a natural chemical the body releases during an allergic reaction and helps relieve allergy symptoms.

Curist Allergy Relief levocetirizine treats common allergy symptoms like sneezing, itchy nose, runny nose, itchy eyes, watery eyes, and itchy throat. These allergy symptoms can be caused by an allergic response to allergens like indoor allergens (pet dander like cats or dogs, mold) or outdoor allergens (e.g. pollen, ragweed). Curist Allergy Relief is also used by some doctors to treat hives.

Levocetirizine 5 mg (the active ingredient in Curist Allergy Relief) has an onset of action as quickly as one hour after oral intake. Thus, you can expect to feel symptom relief about an hour after taking a dose of levocetirizine. Levocetirizine can be taken with or without food. Levocetirizine lasts and is therefore indicated for once daily dosing.

Yes, Xyzal can cause drowsiness, but rarely. Research has shown that levocetirizine causes drowsiness in about 6% of the population who take it. If you find levocetirizine drowsy, try taking it in the evening.

Yes, Curist Allergy Relief (levocetirizine 5 mg) is safe and is recommended to use in the evening every day. It is meant to be taken only once every day. Please use only as directed and read the product label for complete dosing instructions and warnings.

No, you do not need to see a doctor before using levocetirizine. Over-the-counter levocetirizine is available to buy online at Curist, and does not need a prescription.

Since there are not a lot of studies done on how levocetirizine can affect unborn babies, it is recommended that pregnant mothers should consult with their doctor or pharmacist first prior to taking an allergy medication. If you are breast-feeding, it is not recommended to take levocetirizine.

Xyzal and Curist Allergy Relief are two brands that both contain the medicine levocetirizine. So in order to take levocetirizine, you can take Xyzal Allergy 24 HR or Curist Allergy Relief levocetirizine which is available at about half the price of Xyzal. Both Xyzal and Curist Allergy Relief levocetirizine have the same strength of levocetirizine (5 mg).

Yes, there is. Levocetirizine is the generic version of Xyzal. It is the name of the medicine in Xyzal. Both Xyzal and Curist Allergy Relief levocetirizine have the same strength of levocetirizine (5 mg), so the relief for allergic symptoms is the same.

Levocetirizine (generic Xyzal) is available over the counter and can be purchased online at Curist. Curist sells generic Xyzal (levocetirizine) at the best price online.

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things to think about uMEDp

The article deals with the pathogenesis of pruritus, possible psycho-emotional problems and somatic triggers of pruritus. The advantages of second-generation antihistamines, in particular cetirizine, are described: in addition to blockade of h2-histamine receptors, the drug inhibits the migration of eosinophils in the focus of inflammation, suppresses the skin response to platelet-activating factor. The results of our own studies showing the effectiveness of cetirizine in dermatological diseases are presented. Namely: the maximum reduction in the intensity of itching already three hours after application during the first five days of therapy.

Fig. 1. Algorithm for diagnosing pruritus

Fig. 2. Distribution of patients by nosology

Fig. 3. The average subjective assessment of the intensity of itching after the use of the drug

Fig. 4. Dynamics of clinical manifestations

The skin makes up about 15% of the total human body weight and is the largest organ. Its most important function is protective.

The condition of the skin has a significant impact on a person’s self-esteem and the formation of interpersonal relationships.

Skin itching is an unpleasant subjective sensation that causes a desire to scratch. This symptom in the vast majority of cases causes discomfort, psycho-emotional stress and exhaustion. In addition, as a result of combing, the integrity of the skin is violated.

It should be noted that, despite the high prevalence of the symptom, it has not been sufficiently studied due to the difficulties of its adequate assessment and the lack of models for research.

Somatic triggers of pruritus

Generalized itching that occurs without concomitant manifestations on the skin can be due to various reasons – from skin xerosis to endocrinological pathologies or carcinoma. That is why in clinical practice one should not neglect the assessment of this important prognostic symptom.

Relatively benign etiological factors include drug allergic reactions, dry skin, scabies, and primary dermatological diseases. Most often, pruritus is observed with dry skin. In older patients, it occurs in 10–50% of cases [1]. Generalized pruritus occurs in 13% of patients with chronic renal failure and in 70–90% on hemodialysis [2]. Liver diseases accompanied by cholestasis (primary biliary cirrhosis of the liver, cholestasis caused by oral contraceptives, intrahepatic cholestasis during pregnancy, etc.) also often cause pruritus [2].

Among the hematological diseases that cause itching are polycythemia, iron deficiency anemia, endocrine diseases – thyrotoxicosis and diabetes mellitus [3].

Pruritus is a common clinical manifestation of AIDS and associated Kaposi’s sarcoma, opportunistic infections. Thus, itching with or without skin rashes is observed in 84% of AIDS patients, in 35.5% of patients with Kaposi’s sarcoma, which developed against the background of AIDS. AIDS-associated opportunistic infections are accompanied by itching in 100% of cases [4].

It has been established that pruritus can appear in malignant diseases. For example, with Hodgkin’s lymphoma, itching occurs in 10-25% of patients, is characterized by high intensity and limited localization, more often in the lower part of the legs. In some cases, this symptom precedes the diagnosis of lymphoma and may serve as an indicator of a less favorable disease prognosis than fever or weight loss [4]. Adenocarcinomas and squamous cell carcinoma of various organs (stomach, pancreas, lungs, colon, brain, breast, prostate) are accompanied by itching on larger areas of the skin: on the legs, upper body and extensor surfaces of the arms. At the same time, there is a direct relationship between the presence of itching and the activity/recurrence of cancer [4].

Secondary skin itching is usually associated with taking drugs such as opium derivatives (cocaine, morphine, butorphanol), phenothiazines, tolbutamide, erythromycin, anabolic hormones, estrogens, progestins, testosterone, aspirin, quinidine and other antimalarial drugs, biologics ( monoclonal antibodies), vitamin B. In addition, it is known that itching can be a subclinical manifestation of hypersensitivity to any drug [5].

Since itching is observed not only in dermatological pathologies, it is advisable to conduct a thorough examination of patients (Fig. 1) and treat them taking into account the identified pathology.

Mechanisms of development and relief of pruritus

Hypotheses of the mechanisms of itch development were formulated on the basis of a study of the pathophysiology of pain, since pain and itch combine common molecular and neurophysiological mechanisms.

The sensation of itching and pain is the result of the activation of a network of free nerve endings in the dermal-epidermal zone. The trigger mechanism is the influence of internal or external thermal, mechanical, chemical stimuli or electrical stimulation. Skin nerve irritation can be mediated by several biological agents, including histamine, vasoactive peptides, enkephalins, substance P, prostaglandins.

It is believed that other, non-anatomical factors, such as psycho-emotional stress, individual subjective perception, the presence and intensity of other sensations and / or distractions, have a significant impact on the degree of itch sensitivity in different areas of the skin.

The nerve impulse that causes the sensation of itching, which has arisen under the influence of any of the listed factors, is transmitted along the same neural connection as pain impulses: from peripheral nerve endings to the dorsal horns of the spinal cord, through the anterior commissure, along the spinothalamic tract to the contralateral laminar nucleus of the thalamus. It is suggested that the thalamocortical tract of tertiary neurons acts as a “relay” for impulse transmission through the integration of the reticular activating system of the thalamus in several areas of the brain. In response, there is a desire to comb the skin, which is formed in the corticothalamic center and is realized in the form of a spinal reflex. After scratching, itching reappears after 15–25 minutes. However, in some cases, especially in patients with chronic dermatoses, the sensation of itching after scratching does not stop, which leads to excoriation.

Despite the fact that many etiological and pathogenetic factors contributing to the occurrence of itching are currently known, their study continues and new mechanisms are being discovered.

The mechanism by which itching is relieved by scratching has not been reliably established. Perhaps, during scratching, sensory impulses are formed that interrupt the neural arc responsible for the occurrence of sensation.

In addition to scratching, vibrations, injections into the itchy area, exposure to heat, cold, and ultraviolet radiation help to reduce itching [3].

Treatment

Therapeutic methods should be aimed primarily at eliminating pathogenetic factors.

Patients are shown sedatives (especially for intense chronic itching), emollients (to reduce skin dryness, which is both a cause and a consequence of itching), topical distractions (cold lotions, menthol-containing products, etc.), antihistamines, which in the vast majority of cases are first-line drugs.

There are two generations of antihistamines: sedatives (Suprastin, Tavegil, Diazolin, Diphenhydramine, Phencarol, Fenistil) and non-sedative/mildly sedatives (cetirizine, levocetirizine, loratadine, desloratadine, fexofenadine, ebastine, rupatadine).

It is important to note that, despite the need to take sedatives, it is better not to use first-generation antihistamines (which have a sedative effect in addition to the antihistamine). Firstly, sleep during their use is non-physiological (drugs inhibit the phase of REM sleep). Secondly, the multiple side effects characteristic of this group of drugs limit the possibility of their use in patients with comorbidities.

Therefore, it is better to use tranquilizers as sedatives, and when choosing antihistamines, preference should be given to second-generation blockers.

Cetirizine occupies a special place among them.

Cetirizine

Cetirizine inhibits the histamine-mediated early phase of the allergic reaction, prevents various physiological and pathophysiological effects of histamine, such as dilation and increased capillary permeability (development of edema, urticaria, redness), stimulation of sensitive nerve endings (itching, pain) and contraction of the smooth muscles of the respiratory and gastrointestinal tract.

In the late stage of an allergic reaction, cetirizine not only inhibits the release of histamine, but also the migration of eosinophils and other cells, thus attenuating the late allergic reaction. Reduces expression of adhesion molecules such as Intercellular Adhesion Molecule 1 (ICAM-1) and Vascular Cellular Adhesion Molecule 1 (VCAM-1), which are markers of allergic inflammation .

In addition, unlike other drugs used for skin manifestations of allergies, cetirizine not only blocks H ₁ -histamine receptors, but also suppresses the skin response to platelet-activating factor [6, 7]. This is confirmed by the results of numerous clinical comparative studies: due to the ability to accumulate in the skin, the drug relieves itching and hyperemia more effectively than such drugs as ebastine, epinastine, terfenadine, fexofenadine and loratadine [8–10].

Compared to other antihistamines, cetirizine has a low volume of distribution of 0.5 l/kg. This provides higher concentrations of the substance in the extracellular space, where the H ₁ histamine receptors are located. Thus, their full employment and the highest antihistamine effect are ensured [11]. Another feature of the drug is its high ability to penetrate the skin. 24 hours after taking a single dose of cetirizine, the concentration in the skin is equal to or even slightly higher than the concentration in the blood. The advantage of cetirizine is the steroid-sparing effect: with the simultaneous administration of cetirizine and inhaled glucocorticosteroids in patients with bronchial asthma, the dose of the latter may be reduced or not increased, despite contact with the allergen.

Among cetirizines, Cetrin occupies a special place. In the study by E.E. Nekrasov et al. in patients with chronic urticaria, Cetrin showed the highest efficacy among other cetirizine generics and the best results in terms of pharmacoeconomics [12].

Application experience

We observed 75 patients aged 18 to 76 years (34 men and 41 women) with diagnoses of “atopic dermatitis”, “allergic dermatitis”, “chronic eczema in the acute stage”, “lichen planus”, “toxidermia” ( Fig. 2).

All patients received topical and systemic therapy, which included the antihistamine drug Cetrin (cetirizine) at a dose of 10 mg once a day at night. The duration of therapy is from 14 to 21 days, depending on the diagnosis.

Patients assessed the effectiveness of itching relief according to a point system: 0 points – no itching, 1 point – mild itching (present, but does not bother), 2 points – moderate (it bothers, but does not interfere with daily activity and / or sleep), 3 points – severe / intense itching (disturbs and interferes with daily activity and / or sleep).

The maximum decrease in the intensity of itching was observed already three hours after taking the drug in the first five days (Fig. 3).

Subsequently, a decrease in itching or its absence was noted by the tenth day of therapy with a simultaneous decrease in the clinical manifestations of diseases (Fig. 4).

The results obtained demonstrate the high efficiency of Cetrin (cetirizine) in the treatment of chronic and acute dermatoses. Cetrin (cetirizine) has a pronounced antipruritic effect, and also reduces other clinical manifestations of allergic dermatosis (infiltration, erythema). In addition, as a symptomatic therapy, the drug can also be used for somatic diseases.

The best remedies for itchy skin for 2023

This material is not an advertisement, it is informational in nature and reflects the estimated opinion of the author. All ranking positions are selected based on the developed selection criteria. Before making a purchase, you need to consult a specialist.

One of the most common reasons for seeking medical advice is itchy skin. It is very irritating, reduces the ability to work, creates discomfort, sleep disturbances. Itching occurs most often due to fungal infections or an allergic reaction. The TOP of the most effective remedies for skin itching will help solve this unpleasant problem.

Contents

• 1 Skin itching: what it is, causes
• 2 Symptoms
• 3 Drug therapy
• 4 The best remedies for itching
  9 0120 4. 1 Second generation antihistamines
  • 4.1.1
    Fenistil

  • 4.1.2
    Loratadine

  • 4.1.3
    Erius

  • 4.1.4
    Allegra

  • 4.1.5
    Zodak-Express

  • 4.2 Topical preparations
    • 4.2.1
      Losterin, zinc-naphthalan paste

    • 4.2.2
      Ichthyol ointment, paste, cream (ichthammol)

    • 4.2.3
      Lorinden-A-Elfa

    • 4.2.4
      Menovazin

Skin itching: what is it, causes of occurrence

Skin itching can simultaneously act on the nerves and irritate, but if you manage to satisfy this annoying need even for a minute, a feeling of pleasure appears. Let’s see what characteristics medicine and physiology will give to skin itching.

A strong desire to scratch the skin is due to the fact that the blood rushes to the receptors in the upper layer of the skin. Irritation of receptors can be facilitated by acids, toxins or hormones contained in the blood. Excess release of any compounds is usually a response to a disease or an event. Depending on this, groups of factors that can cause itching are distinguished.

Signs of itching can occur in anyone, regardless of gender or age. Its occurrence can be a wide range of different factors that are associated or not associated with the course of the disease.

Itching of the skin is a symptom that can be accompanied by a huge number of external signs indicating various types of pathologies. To determine the etiological factor from which such a sign follows, and to give an accurate diagnosis, it is necessary to conduct an instrumental laboratory examination.

The cause of pruritus determines the tactics of therapy, but for most cases conservative methods are sufficient.

Symptoms

Itching of the skin is mainly caused by the course of various diseases, therefore, in addition to the main symptoms, other signs of skin lesions can be observed. These specific clinical manifestations include:

1. The appearance of red spots on the skin, often with a clear border. They are often blistered and protrude above the surface of the skin. In certain diseases, several zones of redness can merge into one.
2. The skin is flaky and the flaking scales cause severe discomfort.
3. Burning sensation.
4. Due to constant scratching, wounds and scratches appear in problem areas, as well as characteristic rashes.
5. Crusts form at the sites of burst vesicles or ulcers.

These clinical manifestations are often symptoms of liver disease. But there are other signs that indicate problems with the liver:

1. Strong gas formation.
2. Disorders of defecation, expressed in diarrhea or constipation. There may be an alternation of both.
3. Urine becomes dark in color, and feces, on the contrary, become discolored.
4. Skin and mucous membranes stain yellow.

Often itching occurs without any rash. In such cases, you can pay attention to the bitterness in the mouth, as well as general malaise.

If physiological causes, such as pregnancy, have contributed to the problem, the list of additional symptoms can be supplemented with the following:

1. Sleep disturbance or lack thereof.
2. A state of irritability.
3. Depression.
4. Feeling of emotional and physical discomfort.

It should be noted that all the above factors are only the main signs that accompany the appearance of itching of the skin. All symptoms are strictly individual. There are exceptions when, in addition to the main symptom, no signs are noted. This happens with diseases of the hematopoietic system or mental disorders.

Drug therapy

If drugs are needed, antihistamines become the basis of treatment, as the main means of regulating the irritability of nerve endings by reducing the amount of free histamine. Antihistamines are considered type 1 histamine receptor blockers, and there are several classes of them.

Everyone knows the first one very well. This class includes drugs such as Tavegil, Diazolin, Suprastin, Diphenhydramine. Their action in modern conditions is considered rough, and the drugs themselves are outdated, because they have side effects: sedation, drowsiness. But, oddly enough, these side effects for those suffering from chronic pruritus can even be useful, since the drugs have an effect on muscarinic cholinergic receptors.

For patients with pronounced neurosis, insomnia and severe irritability, who are exhausted from itching, such side effects can be a salvation, as they will bring relief by helping to calm down and make it easier to fall asleep.

I would like to remind you that each drug is first given an international non-proprietary name or INN. The following lists the most popular commercial names, the first of which is the name of the original medicinal product under which it was marketed.

The best remedies for itching

The inclusion or non-inclusion of individual drugs in the rating, as well as the sequence of presentation of information, is not intended to create advertising or anti-advertising, due to current clinical recommendations. The sequence in which drugs are listed on popular pharmaceutical sites is also taken into account.

Second generation antihistamines

Second generation antihistamines, which do not have a sedative effect, are the basis for the treatment of severe chronic itching, since they do not have the ability to penetrate the structures of the nervous system.

Fenistil

A highly popular drug. It can be prescribed in various dosage forms and for internal use – in the form of tablets and drops, and for external use – in the form of a gel. The use of this drug is allowed even for infants.

Recommended for use in eczema, pruritic dermatoses, urticaria, insect bites and mild burns. It has antipruritic and antiallergic effects. Since the gel does not contain hormones, its use does not cause side effects at all.

The drug is applied to problem areas 2-4 times a day. Its effect is felt within a few minutes, the maximum efficiency is reached after 1-4 hours.

Important! With severe itching, the drug is recommended to be used only as directed by a doctor.

Fenistil

Advantages:

• adults need to use the drug for no longer than 30 days;
• is highly efficient;
• pleasant neutral smell, fragrance-free;
• is easy to apply;
• quick relief;
• is allowed to prescribe to infants from the second month of life.

Disadvantages:

• causes dry mouth;
• pupils dilate;
• increases the heart rate.
• other anticholinergic side effects.

Loratadine

A popular antihistamine for allergy control. It is included in the Russian list of drugs necessary for life, approved by the Government of the Russian Federation. Loratadine relieves the course of seasonal exacerbations and reduces the symptoms of allergic reactions.

The drug is available in two forms – syrup and tablets, the main active ingredient of which is loratadine.

In addition to loratadine, the tablets contain sodium croscarmellose, calcium stearate, lactose, polyvinylpyrrolidone and potato starch. Tablets of different pharmaceutical companies differ in composition, shape and color, as well as in the type of packaging. Both regular tablets and effervescent tablets are available, which dissolve in water.

The syrup contains, in addition to loratadine, citric acid, purified water, sorbitol and flavors. Its packaging and composition also varies from manufacturer to manufacturer.

The drug is produced by several domestic pharmaceutical companies, so the rules for its storage may vary. You can buy it at any pharmacy without a prescription. After purchasing Loratadine, you must carefully read the instructions for use to learn how to properly store the drug.

Loratadin

Advantages:

• low price;
• is of high European quality, as it is included in the list of essential medicines.

Faults:

• headaches.

Erius

Erius can rightly be considered a safe modern drug, which is approved for use in children from the age of six months. It belongs to the group of drugs that block receptors, so it does not have a hypnotic or sedative effect. Erius significantly alleviates the condition not only with skin itching, but also with all kinds of allergic edema, and the effect after its use has a long duration. The drug has proven itself in the treatment of classic allergic diseases – Quincke’s edema, conjunctivitis, urticaria or allergic rhinitis.

Erius is produced in two forms – syrup and tablets.
Taking this drug at strict adherence to the indicated dosage does not affect the decrease in attention while driving a car or working with moving mechanisms. The maximum allowable daily dose is one tablet.

Erius

Advantages:

• good efficiency;
• high quality;
• causes very few side effects.

Weaknesses:

• if the dosage is exceeded, dry mouth, feeling very tired and headaches;
• is contraindicated for pregnant and lactating women.

Allegra

A French-made medicinal product from the well-known company Sanofi-Aventis. Allegra is a new generation antihistamine drug with a complete absence of side effects observed during the use of earlier drugs and alpha-blockers. A positive effect is noticeable after an hour, and its duration after a single dose lasts 24 hours. The drug is not addictive and does not require an increase in dosage, no matter how long it takes. Allegra is prescribed for chronic itching of various forms, chronic urticaria, allergic rhinitis.

When prescribing the drug, care must be taken in people with hepatic or renal insufficiency or pathologies of the cardiovascular system. Allegra is considered to be effective in relieving both symptomatic prurigo and prurigo.

Allegra

Advantages:

• few contraindications;
• fast acting;
• convenient regimen – one tablet per day;
• long acting.

Disadvantages:

• has side effects: nausea, diarrhea, headaches, dizziness, drowsiness, muscle pain, cough;
• is contraindicated in children under 12 years of age, pregnant and lactating mothers, people with high sensitivity to the main components.

Zodak Express

The drug is produced by the Czech company Zentiva, the package contains 7 tablets of 5 mg. Zodak is used for both acute and chronic pruritus, it can be prescribed for almost any allergic disease – from Quincke’s edema to urticaria. Does not cause side effects – dry mouth, drowsiness, changes in pupil size, urinary retention.

The usual regimen is one tablet once a day. For the treatment of a small child, it is possible to prescribe the drug in the form of drops.

Zodak-Express

Advantages:

• the ability to selectively block histamine receptors without causing undesirable side effects;
• convenient regimen – once a day;
• long-term effect of a single dose;
• is ideal for compliance.

Disadvantages:

• slight increase in appetite;
• headaches;
• increased fatigue.

Topical preparations

The use of topical preparations will give a positive effect only in the presence of pruritic dermatosis with an altered condition of the skin – the formation of papules or tubercles, blisters, vesicles or vesicles filled with transparent contents that cause severe itching. These elements are considered primary.

Secondary morphological elements, different from the primary ones, are traces of scratching, crusts, wounds with suppuration, etc. They occur as a result of scratching on the skin, which remains practically unchanged, thus violating the integrity of the skin and threatening to attach a secondary infection. The main objectives of the use of external agents for severe chronic itching are to reduce the intensity of itching, drying, antibacterial and disinfectant action. We offer to consider the most famous drugs.

Losterin, zinc naphthalan paste

A cream preparation that is perfect for daily care of problematic skin. It is based on a natural oil compound – deresined naftalan, and contains urea, salicylic acid, zinc oxide and additional components. Due to the presence of urea, Losterin is able to penetrate deep into the epidermis and produce a stronger exfoliating effect. Also, the drug has a long-term analgesic, antimicrobial, anti-inflammatory, vasodilating effect.

Salicylic acid does not allow the development of microorganisms, and the panthenol, vitamin E and a complex of fatty acids present in the composition regulate the water and lipid balance, providing a trophic effect. The drug is approved for long-term use, taken 2-3 times a day. No toxicity;

Disadvantages:

• individual reaction to naftalan or fragrance composition. When the skin smells of oil, others are not very comfortable.

Ichthyol ointment, paste, cream (ichthammol)

Ichthyol ointment is very popular in dermatology. The drug is available in the form of an ointment, paste or cream, the most effective concentration is 10% or 20%. Provides effective assistance in the fight against itching – reduces skin sensitivity, gives antimicrobial, antistreptococcal and antistaphylococcal effects. The drug has been successfully used to treat neuralgia and various forms of arthritis, in addition to the problem of itchy skin.

The product is applied, without rubbing, on the surface of the skin in a thin layer 2-3 times a day. At night, it is allowed to close the treated area of ​​​​skin with a bandage.

Ichthyol ointment, paste, cream (ichthammol)

Benefits:

• allowed for pregnant and lactating mothers;
• Ichthyol is generally well tolerated;
• the drug is highly effective;
• cheap.

Faults:

• peculiar smell;
• is contraindicated in case of personal intolerance.

Lorinden-A-Elfa

An ointment successfully used to combat itchy skin. Lorinden is very effective for dandruff, dermatitis and seborrhea. The drug is hormonal, in connection with which there are a lot of contraindications, and is released strictly according to the prescription, so a consultation with a dermatologist is necessary. The volume of the tube is 15 mg, the ointment is very economically consumed, practically odorless.

The ointment is applied in a thin layer to the affected areas of the skin 1-2 times a day. The drug does not affect the condition of the hair. After the disappearance of itching, it is recommended to continue using the ointment for 3-4 days. The course of treatment should not exceed 21 days.

Lorinden-A-Elfa

Advantages:

• rapid disappearance of itching;
• combined compound;
• the ability to regulate the work of the sebaceous glands.

Weaknesses:

• dry skin, burning sensation may occur.

Menovazin

Liquid alcoholic topical product with a pleasant minty aroma due to the cooling properties of peppermint oil. The composition of Menovazin, in addition to mint oil, includes two components – procaine and benzocaine, which act as a local anesthetic. When applied to the skin, such a composition acts in a complex way. Menthol pleasantly cools, has an effect on the nerve endings, has a distracting effect, reduces the sensation of itching.

Anesthetics act as pain relievers, penetrate the skin shallowly and affect the transmission of nerve impulses. But at the same time, Menovazin is not absorbed into the blood.

Menovazin

Advantages:

• low price;
• pleasant smell;
• good pain relief;
• absorbs quickly;
• helps with itching, bites, scratches, neuralgia, arthritis.

Disadvantages:

• there are contraindications: hypersensitivity, violation of the integrity of the skin, inflammatory skin diseases at the site of the proposed application;
• not a very convenient bottle;
• with frequent use, side effects such as slight dizziness and lowering blood pressure may occur;
• pregnant and lactating mothers to use with caution.