When Do Dermatologists Recommend An Antihistamine For A Child With Eczema
Your childs dermatologist may recommend that you give your child an antihistamine when: An intense itch keeps your child awake on most nights.
When your childs dermatologist recommends an antihistamine, it will be one labeled sedating. This will help your child sleep through the night.
A sedating antihistamine will help your child sleep. It will not treat the eczema or stop the itch.
Youll still need to treat your childs eczema. Once the eczema is under control, it wont itch so much and keep the child awake at night.
Q : What Is The Scratch And Itch Cycle Of Eczema
The scratch and itch cycle of eczema can cause discomfort, disrupt sleep and affect quality of life:
- In people with eczema the skin does not retain moisture very well, which causes it to dry out easily.
- This makes the skin more open to allergens and irritants, which can trigger the skin to release chemicals that make the skin itchy.
- Scratching itchy skin causes more chemicals to be released, making the skin feel itchier.
- If eczema is well managed this can avoid the scratch and itch cycle. It is therefore important to keep skin that is prone to eczema well moisturised, by using moisturising creams on the skin every day.
Taking Care Of Your Eczema
Stopping itchy eczema symptoms as soon as possible is essential to managing the condition. Sticking to your medications is very important.
I recommend taking antihistamines in conjunction with topical steroids to improve the skin health, says Wattenberg she also advises against topical antihistamines, which she says may actually irritate your eczema. Your doctor might suggest a corticosteroid cream, which is a topical steroid thats often a go-to treatment for eczema, according to the Eczema Foundation, and helps fight inflammation.
Also, youll want to steer clear of irritants or allergens. A study published in January 2021 in the journal Cell found that for some people with eczema, acute itching may be caused by environmental allergens like animals, dust, and mold. Also, researchers found that for those with eczema, taking antihistamines may not always help with these hyper-acute flare-ups because the itch-signals are carried along different brain pathways.
And of course, don’t forget to keep your skin hydrated by using plenty of moisturizer. According to the American Academy of Allergy, Asthma & Immunology, moisturizers help improve the skin barrier.
Additional reporting by Regina Boyle Wheeler.
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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, indirectly they can help the eczema,” Dr. Chen says, adding that antihistamines are still not as effective as we would like in treating the itch of eczema.
In general, there are two types of oral antihistamines on the market: first-generation antihistamines and second-generation antihistamines. First-generation drugs, such as Benadryl and Chlor-Trimeton , affect the brain and can cause side effects like drowsiness, according to the Cleveland Clinic. These sedating antihistamines are most beneficial as a treatment for eczema, especially if the eczema symptom of itchy skin is keeping you from sleeping, says Dr. Wattenberg. And getting a good night’s sleep promotes healing and is beneficial for the immune system, according to the nonprofit Allergy & Asthma Network. When taken as directed, first-generation antihistamines are safe, even for children, according to the American Academy of Dermatology Association, though its important to talk to your childs doctor first.
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What Is An Antihistamine
When the immune system is alerted to intrusive substances it reacts to protect the body by releasing histamines into the blood. Histamines react further and cause allergy symptoms like runny nose, sneezing, or skin irritations. Antihistamines fight back and give relief for many of the allergy symptoms.
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Progression Of A Pollen Allergy: Asthma And Hay Fever
Children with atopic eczema are at higher risk of developing an allergy to pollen, but it does not always get to that point. When an allergy does develop, however, it manifests in the nose, eyes or respiratory system, with the appearance of:
- allergic asthma
- allergic rhinoconjunctivitis
Asthma, atopic eczema and hay fever are all different manifestations of the same condition: atopy. Some people with atopy experience all three, either alternately or simultaneously. Others will have just one or two over the course of their life. When eczema appears first, it is often followed by asthma and then rhinitis. This phenomenon is known as the Atopic March.
The term Atopic March refers to the fact that, in the majority of cases, atopy starts off a rather predictable progression: the first manifestation is eczema beginning in the first 6 months of life, followed by asthma by the age of 2 to 4 years, and finally rhinoconjunctivitis.
20% of French people have a respiratory allergy
A child who has one parent with an allergy has a 30% chance of developing an allergy as well
Q : How Can Skin Be Maintained And Protected Every Day
It is important to keep skin that is prone to eczema well moisturised every day:
- Moisturisers add moisture and form a barrier that protects the skin, so that it retains moisture. If the protective barrier of skin is damaged eczema frequently develops.
- Apply non-perfumed moisturiser to the face and body twice every day.
- Avoid moisturisers containing food proteins such as goat milk, wheatgerm and nut oils.
- After a bath or shower in lukewarm water, pat the skin dry and apply moisturiser.
- Use non-soap based wash or oil and avoid soap and bubbly products which dry out the skin.
- After swimming , rinse and apply moisturiser.
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Try To Reduce The Damage From Scratching
Eczema is often itchy, and it can be very tempting to scratch the affected areas of skin.
But scratching usually damages the skin, which can itself cause more eczema to occur.
The skin eventually thickens into leathery areas as a result of chronic scratching.
Deep scratching also causes bleeding and increases the risk of your skin becoming infected or scarred.
Try to reduce scratching whenever possible. You could try gently rubbing your skin with your fingers instead.
If your baby has atopic eczema, anti-scratch mittens may stop them scratching their skin.
Keep your nails short and clean to minimise damage to the skin from unintentional scratching.
Keep your skin covered with light clothing to reduce damage from habitual scratching.
Inside The Tricky World Of Eczema Triggers
People with eczema tend to have an over-reactive immune system. When triggered by a substance inside or outside the body, the immune system responds by producing inflammation. It is this inflammatory response that causes the itchy, painful, rash-like symptoms common to several types of eczema.
Types of eczema include: contact dermatitis, atopic dermatitis, dyshidrotic eczema, nummular eczema, seborrheic dermatitis and stasis dermatitis. Its common for people to have more than one type of eczema simultaneously throughout their lives, especially those living with AD.Eczema affects people uniquely. Each type of eczema has different triggers, symptoms and treatments. A substance that triggers eczema in a parent may not do the same to their child. Thats why its important to know what type of eczema you have and what substances triggered the flare-up so you can manage symptoms appropriately.
Keith Heeley, who works at a commercial real estate firm in Los Angeles, developed atopic dermatitis in his mid-20s. I have really dry skin, he described. Sometimes I will get weeping on some of the open wounds where water will start pouring out. But by far the most frustrating part is the itch. Its like having a bottomless itch that you cant get to. You want to scratch to the very bottom of your being.
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Beyond The Eczema Rash
When we hear the word eczema, visions of red or dark, dry, itchy, inflamed patches of skin come to mind. After all, the eczema rash is a tell-tale sign of the inflammatory skin disease that affects more than 30 million Americans. But there is more to eczema than what meets the eye. Have you ever thought about what goes on beneath the surface of your skin to bring forth this annoying rash?
Why does exposure to certain things like household cleaners, pet dander or cigarette smoke trigger flares in some people with eczema, but not in others? And why is it common for people with atopic dermatitis to also have asthma, hay fever, food allergies, or a combination of all three? How are they connected?
While scientists dont have all the answers yet, they are making strides in understanding the mechanisms of this disease. This has allowed them to develop advanced treatments like the first biologic for moderate to severe AD, which tackles inflammation at the cellular level.Ready for some movie trivia? There was a 1966 science fiction film called Fantastic Voyage, starring Raquel Welch, about a submarine crew who shrunk themselves to microscopic size to venture inside an injured scientist to repair the damage to his brain.
Join us as we take our own fantastic voyage and go beyond the rash and underneath the surface of the skin to better understand how eczema impacts our day-to-day lives.
What If Antihistamines Stop Working Or Dont Work For Chronic Hives
My chronic hives can be pretty stubborn, and, while antihistamines are a huge help, some flare-ups require a stronger approach. If antihistamines arent giving you enough relief, its best to see an allergist to talk about additional treatment options. They may recommend a combination of antihistamines or even prescribe other medications to manage your symptoms.
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Side Effects Of Antihistamines As Treatment For Eczema
Because first-generation drugs are sedating, here are some side effects you need to watch out for, according to the National Health Service in the United Kingdom, especially if you’re taking them at times besides before bed:
- Your ability to drive or operate machinery may be impaired.
- You might not be able to think clearly, so work or school may be difficult.
- Mixing antihistamines with other sedatives, muscle relaxers, or sleeping pills can increase the sedation.
Common side effects also include dry mouth, dizziness, and decreased appetite, according to MedlinePlus. First-generation antihistamines may not be right for you. Talk to your doctor if you have any of these medical conditions:
- Epilepsy
- Diabetes
Many first-generation antihistamines are available without a prescription at your local drugstore, says Wattenberg. Prices vary, but at one nationwide drugstore chain, a box of 24 Benadryl Allergy Liqui-Gels cost less than $9. Store brands with the same active ingredients are generally less expensive. Ask your doctor about what would be best for you, suggests Wattenberg.
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Topical And Oral Antihistamines For Atopic Dermatitis
Antihistamines come in topical formulations, which can be applied directly to the skin, and oral formulations are ingested by mouth and affect the release of histamines throughout the body. In clinical trials, topical antihistamines have demonstrated little use in treating AD and are not recommended by the American Academy of Dermatology for people with AD. In addition, there are concerns with side effects with the use of topical antihistamines in people with AD.2
Oral antihistamines may be used to treat itching in people with AD, but research has not shown a significant benefit of using antihistamines in AD. Short-term, occasional use of antihistamines that are sedating may be beneficial in people who are experiencing sleep loss due to itching at night, however, the American Academy of Dermatology recommends that other treatments should be used to properly manage AD.1
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Homeopathic And Natural Remedies
Non-prescription remedies can also be an excellent treatment to have on hand. These include:
- Vitamin E oil – used topically on your eczema patches it helps calm inflammation and contains antioxidants to protect and build skins cells.
- Vinca Minor extract – helps soothe red, inflamed skin.
- Graphite Supplement – helps improve a variety of skin conditions, including eczema
- Cool baths – soothe the skin
- Oatmeal soap or lotion – oatmeal calms angry, inflamed skin and also moisturizes
The Trick To Identifying Eczema Triggers
Patch testing is a tool many doctors use to diagnose potential eczema triggers. In this test, allergists like Wein apply adhesive strips or patches to an eczema-free area of the back. The patches contain substances that are believed to cause irritation in people with eczema.
After 48 hours, the doctor removes the patches and inspects the skin for reactions. After two more days, the doctor looks at the patch sites for signs of inflammation. If there is inflammation, the allergy to a particular substance is confirmed.
Most scientific evidence regarding trigger factors in AD relates to dietary exclusions or house dust mite avoidance strategies, Wein said. There is little consistency across studies in the type of diet evaluated, and indications for special diets were not always made clear. It is also unclear what role factors such as stress, humidity or extremes of temperature have in causing flaresjust that these factors should be avoided where possible.
Heeley knows firsthand the frustration that comes when elimination diets fail to identify triggers. He wonders if the stress of trying to identify triggers might contribute to his flare-ups.
Maybe I need to tone down my stress level and think more calmly about tackling the problem, he admitted. I just knew that it had something to do with food and my digestive tract. I thought I tried all of the elimination diets, but I couldnt find anything that correlated.
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How Do Antihistamines Help Relieve Itching In Eczema
If you have eczema, your doctor may prescribe you medications that are classified as antihistamines. These are medicines that can help control itching due to eczema. Severe itch caused by eczema often interferes with the quality of life. But why does this itch occur? Medical research shows that itch occurs as a result of increased levels of histamine in the dermis of the skin. Itch is usually associated with redness and dryness of the skin.
Antihistamines block the release of histamine in the dermis of the skin. This controls histamine levels in the body, and subsequently the itching in eczema. Some examples of antihistamines include hydroxyzine and cetirizine.
Do Antihistamines Help Eczema
In the case of eczema, the symptoms manifest on the skin with itching being the most unbearable symptom of all. Some persons experience a high degree of itch relief after taking antihistamines, and some people do not find any benefit and do experience side effects such as drowsiness.
Much research has been conducted to determine the effectiveness of antihistamines on eczema symptoms but there is no conclusive evidence that says that antihistamines affect the eczema itself. The most exciting research in the area of antihistamines revolves around a few different histamine receptors in the body.
There are a few histamine receptors, but type 1, called H1, and type 4, called H4 receptor blockers have recently found to be very effective with both receptor types are blocked at the same time.
There are no available H4 receptor blockers on the market as of yet, though many studies and trials are ongoing and are showing great promise in stopping the itch in eczema.
The mechanism appears to be due to inhibiting certain nerve growth factors and other inflammatory chemicals that drive the itchthis is a very exciting field and should yield some nice treatments for eczema sufferers in the future!
In the mean time, there are many H1 and H2 receptor blocking anti-histamines on the market. In general, the only ones that are used for those who have eczema are intentionally used to sedate and to help one to sleep..solely for the purpose of making you too drowsy to scratch yourself.
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Do Not Recommend That Patients Take Systemic Non
Non-sedating antihistamines are only of value if treating pruritus in a setting of urticaria . There is strong evidence to support the impact of non-sedating antihistamines on the quality of life of patients with urticaria and their productivity in daily activities. Furthermore, non-sedating antihistamines exhibit favourable efficacy and safety profiles.
The Australasian Society of Clinical Immunology and Allergy treatment guidelines for urticaria state that increasing second-generation H1 antihistamines up to four times the standard packaging dose may be required to obtain a clinical improvement. These non-sedating antihistamines include cetirizine, levocetirizine, loratadine, desloratadine and fexofenadine.
All other itchy rashes such as eczema and psoriasis are not mediated by histamine. Therefore, these agents are of no clinical value and should not be recommended. Rather, these itchy rashes should be managed with topical anti-inflammatory therapies and/or systemic immunomodulation.
The use of a sedating antihistamine which causes central sedation and helps induction of sleep/drowsiness may be helpful in breaking the itch/scratch cycle with all itchy rashes.
Supporting evidence
Independent, not-for-profit and evidence-based, NPS MedicineWise enables better decisions about medicines, medical tests and other health technologies. Our programs are funded by the Australian Government Department of Health. ABN 61 082 034 393
Lifestyle Changes For Treating Eczema
For some people, certain foods trigger eczema. Monitor what you eat and pay special attention to which foods seem to trigger flare-ups. For example, fish, peanuts, eggs, and soy are common culprits.
One thing that contributes to the severity of eczema is stress. Reducing stress, anxiety, nervousness, or depression in your life can play a huge role in helping with eczema relief and reducing flares.
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