Antihistamine Withdrawal: Can It Affect Your Eczema? | MyEczemaTeam

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Antihistamine Withdrawal: Can It Affect Your Eczema?

Medically reviewed by Jazmin N. McSwain, PharmD, BCPS — Written by Amanda Jacot, PharmD
Posted on September 12, 2023
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If you have eczema, there’s a good chance you also have allergies. Up to 60 percent of people with atopic dermatitis — the most common type of eczema — develop allergic rhinitis (hay fever) or asthma later in life.

You may take antihistamines to treat allergies or help with pruritus (itching) associated with eczema. But what happens if you stop taking them? Can it make your eczema worse?

Continue reading to learn more about antihistamines, how they can be used to treat eczema, and what might happen if you stop taking them.

What Are Antihistamines?

Antihistamines are drugs commonly used to treat the symptoms of hay fever and other types of allergies, including:

  • Skin rash due to an allergic reaction
  • Nasal congestion
  • Urticaria (hives)
  • Itchy, watery eyes
  • Itchy throat
  • Sneezing

The U.S. Food and Drug Administration (FDA) also has approved antihistamines for treating atopic dermatitis.

Some antihistamines, such as diphenhydramine (Benadryl), can also be used to treat stomach problems such as nausea, vomiting, and motion sickness.

Types of Antihistamines

Antihistamines can be grouped based on whether or not they are sedating — that is, whether they make you feel drowsy.

Those that are sedating are also known as first-generation antihistamines. You can buy some first-generation antihistamines over the counter including:

  • Diphenhydramine
  • Chlorpheniramine (Chlor-Trimeton)
  • Doxylamine (ZzzQuil and Unisom)

Nondrowsy antihistamines are also known as second-generation antihistamines. Over-the-counter second-generation antihistamines include:

  • Cetirizine (Zyrtec)
  • Loratadine (Claritin)
  • Fexofenadine (Allegra)
  • Desloratadine (Clarinex)
  • Levocetirizine (Xyzal)

How Do Antihistamines Work?

Histamine is one of the chemicals your immune system releases to protect you from a threat, like a germ. Antihistamines work by blocking the effect of histamine. Sometimes, your immune system can overreact and release histamine in response to something harmless, like pollen, dust, or animal dander. This can cause an allergic reaction.

Antihistamines can bind to the receptors that histamine normally activates to cause an allergic reaction. When antihistamines bind to the histamine receptors, they block histamine from starting the reaction.

Antihistamines for Eczema

If you have eczema and allergies, you may take an antihistamine to prevent an allergic response to allergens. Eczema commonly occurs alongside allergies. Exposure to allergens can trigger a release of histamine. Too much histamine can cause itchy skin or trigger an eczema flare-up.

Some MyEczemaTeam members have used antihistamines to help with itching. One member shared, “I tried a nondrowsy antihistamine (the type used for hay fever) to help with the itching. It helped me.”

Histamine likely plays a role in eczema inflammation. However, research has found that OTC antihistamines aren’t very good at relieving itching caused by eczema. A 2019 review found that while fexofenadine probably slightly reduced itching due to eczema, cetirizine and loratadine didn’t help to improve eczema symptoms. Antihistamines that are applied to the skin (such as some formulations of diphenhydramine) are also not effective for eczema.

Although antihistamines may not work well to control eczema, they may be able to help you sleep if itching is keeping you awake. The American Academy of Dermatology Association recommends using a sedating antihistamine for a short time to help with itching that prevents sleep. You still need extra treatment to manage eczema, even if you can sleep better by taking an antihistamine at night.

“I have found giving him an antihistamine helps with the itching, especially at night,” shared a parent of a child with eczema.

Talk to your dermatologist or pediatrician about the right type of antihistamine and the right dose to use to help with sleep.

Antihistamine Side Effects

Like all medications, antihistamines can cause side effects. Common side effects include:

  • Drowsiness
  • Dizziness
  • Dry mouth
  • Dry eyes
  • Blurry vision
  • Headache
  • Thicker mucus in your airways
  • Difficulty urinating
  • Increased heart rate
  • Low blood pressure

Side effects are more common in sedating antihistamines as compared to nondrowsy antihistamines. However, side effects can occur with nondrowsy antihistamines, too. Talk to your doctor if you experience any side effects that worry you or don’t go away.

What Is Antihistamine Withdrawal?

People who stop taking an antihistamine sometimes develop symptoms of antihistamine withdrawal. The most common symptom is pruritus. In a 2019 study of who experienced itching after stopping cetirizine, researchers described the symptom as ”intense or unbearable.”

Antihistamine withdrawal may happen with any antihistamine after any amount of time. People from the previously mentioned 2019 study experienced antihistamine withdrawal symptoms after taking antihistamines for just over a week to several years.

Antihistamine withdrawal may happen in the first few days after you stop taking it. People from the study started to experience withdrawal symptoms between 12 hours and five days after stopping cetirizine.

It’s not clear how antihistamines cause withdrawal symptoms. Researchers have discovered that antihistamine withdrawal symptoms are more common with cetirizine, but they aren’t sure why. More research is needed to learn more about how antihistamines cause withdrawal symptoms and how it may affect people with medical conditions like eczema.

How Can Antihistamine Withdrawal Affect Eczema?

There isn’t any research on how stopping antihistamines can affect eczema, but there are some things you should watch for if you discontinue taking your antihistamine.

The Itch-Scratch Cycle

If you experience intense itching after you stop an antihistamine, it might trigger the itch-scratch cycle. Eczema can be triggered by itching. When itching leads to scratching, it can cause more inflammation that worsens eczema and dry skin. Worsening eczema symptoms and dry skin can cause even more itching, which leads to a vicious cycle called the itch-scratch cycle.

A MyEczemaTeam member experienced painful symptoms after forgetting their antihistamines: “I forgot to take my antihistamine last night, so my hand and arms are painful today.”

Exposure to Allergens

Eczema is associated with developing allergies. Although allergies and eczema are different conditions, exposure to certain allergens or irritants may trigger eczema. They include:

  • Pollen
  • Certain foods (e.g., eggs, milk, tree nuts)
  • Dust mites
  • Pet dander
  • Air pollution
  • Cigarette and tobacco smoke

If you’re taking an antihistamine to help with allergy symptoms, try to avoid allergy triggers. Talk to your dermatologist about the best way to control your allergy and eczema symptoms.

Managing Itch

If you experience itching after stopping an antihistamine, talk to your dermatologist about eczema treatment options. There may also be some things you can do at home to help you manage the itching.

A MyEczemaTeam member asked, “I itch so bad. What do you all do to ease the itching other than antihistamines?” One member answered, “An ice pack helps some.” Another member suggested, “Epsom bath salts are great for the skin. Stay in for 20 minutes to let it work.”

Other tips to help cope with itching include:

  • Wear loose-fitting clothes.
  • Cover your itchy skin.
  • Apply ice packs or cool compresses to the affected area.
  • Apply a moisturizer after bathing.
  • Keep fingernails short.
  • Take a bath with colloidal oatmeal.

You may be able to help your eczema symptoms by preventing eczema flares. You can take action to prevent flares, even if you’re not sure exactly what triggers your eczema, by doing the following:

  • Develop a skin care routine with help from your dermatologist.
  • Explore an eczema diet that includes anti-inflammatory foods.
  • Reduce stress as best you can.

Talk With Others Who Understand

MyEczemaTeam is the social network for people with eczema and their loved ones. On MyEczemaTeam, more than 49,000 members come together to ask questions, give advice, and share their stories with others who understand life with eczema.

Have you experienced antihistamine withdrawal? How did you manage your symptoms? Share your experience in the comments below, or start a conversation by posting on your Activities page.

    Posted on September 12, 2023
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    Jazmin N. McSwain, PharmD, BCPS completed pharmacy school at the University of South Florida College of Pharmacy and residency training at Bay Pines Veterans Affairs. Learn more about her here.
    Amanda Jacot, PharmD earned a Bachelor of Science in biology from the University of Texas at Austin in 2009 and a Doctor of Pharmacy from the University of Texas College of Pharmacy in 2014. Learn more about her here.

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