Itchy and dry skin are two of the main symptoms of eczema. As a result of persistently scratching the skin, the following effects may occur:
- Broken skin
- A rash
- Swelling of the skin
Antihistamines have been used for many years to treat these symptoms. Histamines behave a bit like bouncers at a nightclub. They help your body get rid of something that's bothering you - an allergy trigger, or allergen. Histamine is released when the body reacts to a foreign substance (known as an allergen). The released histamine binds to its receptors (H-1 receptors) causing a chain reaction that includes an increase in blood flow to the area, and the release of other chemicals that add to the allergic response. Itching is one of the results.
Antihistamines in eczema are used to help to relieve the itching and evidence indicates they work mostly due to their sedative effect, resulting in less irritation and therefore less scratching of the skin. There is, however, limited evidence to show how antihistamines work to specifically treat eczema. It is likely the sedative effect provides temporary relief, as non-sedative antihistamines have not been found to be helpful in the treatment of eczema.
There are a wide range of antihistamines available, both on prescription and available to buy over-the-counter. Some have more of a sedating effect than others - it’s best to avoid the more heavily sedating brands during the day as they can cause drowsiness. Ask your pharmacist about which ones will suit your needs.
Antihistamines come in different formats. Cream-based antihistamines are not generally used for treating eczema, as they can further irritate the condition, but are often prescribed in the treatment of Urticaria (itchy, raised red areas on the skin, also known as hives). Alternatively, they can be taken in tablet form or as a syrup.
One of the side effects of eczema is a lack of sleep due to the constant itchiness. Antihistamines with a sedating effect are best taken about an hour before going to bed and can help sufferers with sleep. Sedating antihistamines can also cause drowsiness into the following day, so it may be useful to consider the level of concentration you will need the day after, before taking them at night.
Antihistamines are not routinely used for children and you should speak to a pharmacist or your GP for advice if you are looking for a medicine for a young child. They can be prescribed in high doses for short periods of time and are generally used to help get through flare-ups. The use of antihistamines, along with other treatments, such as bandages or special body suits, can be used to give the body chance to heal. If more powerful treatments are needed it is best to get a referral to a GP with a special interest in eczema or to a dermatologist (skin specialist) or dermatology nurse. If lack of sleep is not an issue for your child, your GP or healthcare professional may offer a one-month trial of a non-sedating antihistamine, if needed. It is worth discussing these options with your doctor.
Sources used in writing this article are available on request
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Information written by the talkhealth team
Last revised: 21 November 2017
Next review: 21 November 2020