If you have come this far, it is probably because you want to find out whether antihistamines are useful for your atopic dermatitis or that of your child. You may be wondering about the risks associated with ebastel®, loratadine, cetirizine, polaramine®, or atarax®, as well as how you should or can take them.
The reality is that antihistamines are safe medications with very few adverse effects and can be used with confidence if necessary. The question is whether they should be used in people with atopic dermatitis.
Surely your pediatrician or doctor has prescribed them to you “for the itching” at some point, and yes, they may have provided some relief… but have you seen any improvement in the areas of dermatitis? Have you seen the redness and flaking disappear? Is the relief really that great? If it is the inflammation of the skin that causes the itching and antihistamines do not seem to improve it, do you think there is any point in taking them?
Let’s see what the scientific evidence says about this.
How do antihistamine pills work?
As their name suggests, these compounds block histamine receptors, which cause allergies, hives, and some types of itching in our bodies. Specifically, type 1 antihistamines are used for these conditions, as type 2 antihistamines are usually used for digestive conditions that have nothing to do with what we are talking about.
There are two types of type 1 antihistamines:
- Sedatives: these are drugs that are able to cross the blood-brain barrier, reach the brain, and have a mild sedative effect. They make us sleepy. Examples of this type include Polaramine® and Atarax®.
- Non-sedatives: these are the most commonly used, especially for seasonal allergies, as they do not cross the blood-brain barrier and therefore do not cause drowsiness. Other antihistamines you may be familiar with belong to this type: loratadine, desloratadine, cetirizine, ebastine, bilastine, etc.
Are antihistamines commonly used?
A recent publication by the JAAD revealed that 22% of patients with atopic dermatitis who visited a dermatologist in the US were prescribed an antihistamine, usually of the sedative type. Pediatricians also prescribe this type of antihistamine in 16% of cases. However, non-dermatologist specialists prescribe non-sedating antihistamines in approximately one in three patients.
I believe that these data may reflect what is happening in our country as well.
Are antihistamines effective for the itching associated with atopic dermatitis?
The reality is that numerous scientific studies, reviewed by the Cochrane Library, show that antihistamines do not actually reduce itching in atopic dermatitis. Of course, they are not useful for improving eczema.
It is known that in many cases, people with atopic dermatitis take them because they relieve other symptoms also related to atopy, such as allergic rhinitis, conjunctivitis, or food allergies.
Just because they are prescribed does not mean they are effective. In many cases, we give them with the idea that, as sedatives, they can help you fall asleep and have a better night’s sleep by “masking” the itching. However, it has been found that these medications can worsen sleep quality by shortening REM sleep. Not only that, but if their effect persists in the morning (which it often does), they can interfere with learning ability and memory.
So what are the recommendations?
You know that the star treatment for atopic dermatitis is topical corticosteroids. In some cases, we also resort to calcineurin inhibitors. And it is on these two pillars that we must focus the treatment of atopic dermatitis in children and adults to control outbreaks. Obviously, all this must be accompanied by appropriate care and moisturizing measures, which I already mentioned in another article.
I’m not the only one saying this; the American Academy of Dermatology advises against the use of antihistamines exclusively to control the itching of atopic dermatitis. They can, of course, be used in people who, in addition to their dermatitis, suffer from another condition that clearly improves with these medications (rhinitis, conjunctivitis, etc.).
I hope this article has answered your questions about antihistamines.
Do you usually use them for your dermatitis or your child’s? Do you find them useful?
If you have any further personal questions, I can help you through the online consultation.
