Antihistamines as a Treatment for Eczema
“Eczema is not really a histamine problem, but antihistamines do seem to have some effect. The sedating effect is helpful because scratching always makes eczema worse. So if the medications keep people from scratching [by helping them sleep], indirectly they can help eczema,” says Suephy Chen, MD, a dermatologist and the chair of the department of dermatology at Duke University School of Medicine in Durham, North Carolina. She notes that antihistamines themselves are not fully effective in treating the itch of eczema.
In general, there are two types of oral antihistamines on the market that work to block histamine from attaching to the specific receptor that causes itching and other typical allergy symptoms: first-generation and second-generation antihistamines.
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(Derivatives of some second-generation drugs are referred to as either second- or third-generation, which can be confusing).
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First-generation drugs, such as diphenhydramine (Benadryl) and chlorpheniramine (Chlor-Trimeton), affect the brain and can cause side effects like drowsiness.
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These sedating antihistamines are most beneficial as a treatment for eczema, especially if itchy skin is keeping you from sleeping, says Debra Wattenberg, MD, a dermatologist in private practice in New York City. And getting a good night’s sleep promotes healing and is beneficial for the immune system.
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When taken as directed, first-generation antihistamines are still recommended for severe itching in atopic dermatitis, though they’re generally not recommended for most other purposes.
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One note about first-generation antihistamines: Long-term use, particularly among senior citizens, is linked to an increased risk of dementia, according to research.
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However, further studies are needed to confirm these results. If you are concerned about dementia, second-generation antihistamines (those that do not cross into the brain, or do so minimally) are generally considered to be safer.
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Because most second-generation antihistamines don’t have an effect on the brain, they’re also unlikely to make you sleepy.
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So, as a treatment for eczema, second-generation drugs are “even less likely to work because of the nonsedating properties,” Dr. Chen says. Second-generation antihistamines include loratadine (Claritin) and cetirizine (Zyrtec).
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Whether you’re taking a first- or second-generation variety, just don’t get your hopes up too high. When it comes to using antihistamines to help with eczema, they aren’t a cure. “Antihistamines won’t prevent flare-ups because they don’t target the actual root of the disease, but they do help with the itch, which could allow your flare-up to heal faster,” says Dr. Wattenberg.
