Struggle with dry, itchy, and bumpy skin since you were a child? As these are telltale signs of eczema, you’re not alone. This skin condition is so common that it affects infants, children, and adults alike around the globe. One common treatment people reach for during flare-ups is an antihistamine. Unfortunately, oral antihistamines sold over the counter may only provide little relief.
The largest study to date examining the connection between first- and second-generation antihistamines and eczema, conducted at McMaster University and published in BMJ, not only questions the drugs' effects but also points to the risk of cognitive impairment from these readily available medications.
“The findings support moving away from routine antihistamine use in atopic dermatitis care and toward treatments that are more effective, less likely to cause harm, and are more certain to control eczema inflammation,” said study senior author Derek Chu, associate professor with McMasters Department of Medicine, Canadian Institutes of Health Research Chair in Allergy, and Lead of Canada’s Allergy Clinical Trials Network, in a statement.
Although Commonly Used, the Efficacy of Antihistamines for Eczema Is Unclear
Eczema is a skin condition that can present in several types. Since it’s one of the most common chronic inflammatory skin diseases, affecting more than 31 million Americans, predominantly children, according to Cleveland Clinic, many people reach for oral antihistamines they already have at home to combat flare-ups.
The theory goes that antihistamines help relieve itching and support sleep during an eczema outbreak; however, some health practitioners haven’t been very clear on what to recommend as clinical evidence is lacking.
To help formulate future guidelines, the McMaster team reviewed 47 randomized trials containing data from over 6,000 children and adults with varying degrees of eczema. More specifically, the study compared the effects of first- and the more modern, second-generation antihistamines commonly sold without the need for a prescription in drug stores and pharmacies.
Read More: Could a Common Allergy Pill and Heartburn Medication Combination Really Ease PMS Symptoms?
Antihistamines Showed Very Low or No Effects With Some Cognitive Side Effects
Interestingly, the study found differences in efficacy and side-effect profiles when comparing these two different kinds of over-the-counter antihistamines. First, second-generation drugs that carry the active ingredients cetirizine hydrochloride, loratadine, and rupatadine, respectively, provided only minor itch relief, which both patients and clinicians didn’t consider significant.
The older, first-generation antihistamines, with the active ingredients diphenhydramine HCl, chlorpheniramine maleate, and dexchlorpheniramine maleate, respectively, showed little to no evidence of relief. They also come with side effects.
Due to their chemical characteristics, first-generation antihistamines can enter the brain and are notorious for causing drowsiness and general cognitive impairment. Those effects aren’t typically observed in second-generation antihistamines.
What Does Help With Eczema?
Oral antihistamines can be an important staple in the household medicine cabinet to treat allergies. The sedative side effects of first-generation antihistamines have also come in handy, being used to help with sleep or motion sickness. But evidence suggests eczema isn’t one of their many targets.
“Eczema care increasingly focuses on controlling skin and immune inflammation with moisturizers, topical anti-inflammatory treatments, and whole-body treatments like phototherapy, biologics, and oral JAK inhibitors,” said Chu, listing the treatment forms that do work for this skin condition.
“[The findings may] help keep eczema control as simple and straightforward as possible, with patients focusing on high-value treatments,” added Chu.
This
article is not offering medical advice and should be used for informational
purposes only.
Read More: Sun Allergies Can Cause More Than a Sunburn, From Itchy Rashes to Severe Reactions
Article Sources
Our writers at Discovermagazine.com use peer-reviewed studies and high-quality sources for our articles, and our editors review for scientific accuracy and editorial standards. Review the sources used below for this article:
- This article references information from a study published in BMJ:Antihistamines for atopic dermatitis (eczema): systematic review and network meta-analysis of randomised trials
- This article references information from the Cleveland Clinic: Eczema