Which antihistamine is best for skin rash
Antihistamines
Typesof antihistamine
There aremany types of antihistamine.
They're usually divided into2 main groups:
They also come in several different forms includingtablets, capsules, liquids, syrups, creams, lotions, gels, eyedrops and nasal sprays.
Which type is best?
There'snot muchevidence to suggest any particularantihistamine is better than any other at relieving allergy symptoms.
Some people findcertain types work well for them and others do not. You may need to try several types to find one that works for you.
Non-drowsy antihistamines are generally the best option, as they're less likely to make you feel sleepy. But types that make you feel sleepy may be better if your symptoms stop you sleeping.
Ask a pharmacist for advice if you're unsure which medicine to try as not all antihistamines are suitable for everyone.
Howto take antihistamines
Take your medicine as advised by the pharmacist or doctor, or as described in the leaflet that comes with it.
Before taking an antihistamine, you should know:
- how to take it including whether it needs to be taken with water or food, or how to use it correctly(ifeyedrops or a nasal spray)
- how much to take (the dose) this can vary depending on things such as your age and weight
- when to take it including how many times a day you can take it andwhen to take it (some types shouldbe taken before bedtime)
- how long to take it for some types can be used for a long time, but some are only recommended for a few days
- what to do if you miss a dose or take too much (overdose)
The advice varies depending on the exact medicine you're taking. If you're not sure how to take your medicine, ask a pharmacist.
Sideeffects of antihistamines
Like all medicines, antihistamines can cause side effects.
Side effects of antihistamines that make you drowsy can include:
- sleepiness (drowsiness) and reduced co-ordination, reaction speed and judgement do not drive or use machinery after taking these antihistamines
- dry mouth
- blurred vision
- difficulty peeing
Side effects ofnon-drowsy antihistamines caninclude:
- headache
- dry mouth
- feeling sick
- drowsiness although this is less common than witholder types of antihistamines
Check the leaflet that comes with your medicine for a full list of possible side effects and advice about when to get medicalhelp.
If you think your medicine has caused an unwanted side effect, you can report it through the Yellow Card Scheme.
Takingantihistamines with other medicines, food or alcohol
Speak toa pharmacist or GP before taking antihistamines if you're already taking other medicines.
There may be a risk the medicines do not mix, which could stop either from working properlyor increase the risk of side effects.
Examples of medicines thatcouldcause problems if takenwith antihistamines include some types of:
Try not to drink alcohol while taking an antihistamine, particularly if it's a type that makes you drowsy,as it can increase the chances of it making you feel sleepy.
Food and other drinks do not affect most antihistamines, but check the leaflet that comes with your medicine to make sure.
Whocan take antihistamines
Most people can safely take antihistamines.
But speak to a pharmacist or GPfor adviceif you:
Some antihistamines may not be suitable in these cases. A pharmacist or doctor can recommend one that's bestfor you.
Loratadine is usually recommended if you need to take an antihistamine in pregnancy. Loratadine or cetirizine are usually OK to take while breastfeeding.
Always check the leaflet that comes with yourmedicine to see if it's safe for you before taking it or giving it to your child.
Howantihistamines work
Antihistamines block the effects of a substance called histamine in your body.
Histamine is normally released when your body detects something harmful, such as an infection. It causes blood vessels to expand and the skin to swell, which helpsprotect the body.
But in people with allergies, the body mistakes something harmless such as pollen,animal hair or house dust for a threat and produces histamine. The histamine causes an allergic reaction with unpleasant symptoms including itchy, watering eyes, a running or blocked nose, sneezing and skin rashes.
Antihistamines help stop this happening if you take them beforeyou come into contact with the substance you're allergic to. Or they can reduce the severity ofsymptoms if you take them afterwards.
Find out more about your medicine
The leaflet that comes in the packet with your medicine will have detailed information about it, including how to take it and what side effects you might get.
If you no longerhave the leaflet that came with your medicine, you can search for an online versionof it using our medicines A to Z.
You may also find information on individual antihistamines onthese websites:
Page last reviewed: 16 May 2023 Next review due: 16 May 2026
Zyrtec vs. Claritin for treating allergies
Many people use antihistamines to treat allergy symptoms. Zyrtec (cetirizine) and Claritin (loratadine) are two popular brands. They contain different compounds but appear to be equally effective.
Antihistamines can reduce allergy symptoms, such as watering eyes, itchy skin, hives, and swelling. They may also help with dermatitis or mosquito bites, but manufacturers usually market them for specific allergies.
Zyrtec is a brand name for the drug cetirizine. Claritin is the brand name for loratadine. Zyretc and Claritin are in the same class of medications. Both are second-generation antihistamines and generally work the same way in the body. Neither is clearly better than the other.
In this article, we provide details about the differences between Zyrtec and Claritin. We also compare them to two other popular brands of antihistamines: Benadryl and Allegra.
Zyrtec and Claritin are brand-name medications that people can buy over the counter (OTC). They are available in various forms, including pills, chewable tablets, and syrups.
Regardless of marketing claims, little scientific evidence shows that either is more effective.
Active ingredients
Zyrtec and Claritin have different active compounds.
Zyrtec contains cetirizine hydrochloride, also called cetirizine HCL, while Claritin contains loratadine.
Drowsiness
Zyrtec and Claritin are second-generation antihistamines. They are less likely to make a person feel drowsy or otherwise affect alertness than older, first-generation antihistamines.
The labeling of Zyrtec says that a person should not take it when driving a vehicle or using machinery. People should avoid taking Zyrtec with alcohol or other medicines that could cause drowsiness.
Timescales
Zyrtec and Claritin are effective for about 24 hours. A person should only take one dose per day. The body absorbs both antihistamines quickly, but Zyrtec seems to work faster for some people.
A 2019 article states that antihistamines reach their peak concentration between 30 minutes and 3 hours after swallowing them.
Researchers are often studying, comparing, and improving antihistamines. Other popular brands on the market today are Allegra and Benadryl.
- Allegra: This contains the active ingredient fexofenadine. Allegra is non-sedating, so drowsiness is not a common side effect, although it is possible. Allegra is also a second-generation antihistamine.
- Benadryl: This contains the active ingredient diphenhydramine. This can last
up to 24 hours , which is longer than the other three. It aims to treat minor skin reactions and seasonal allergies. Benadryl is a first-generation antihistamine, which makes it sedating, so people tend to feel drowsy after taking it.
When people come into contact with an allergen, their immune system reacts and produces a chemical called histamine.
Histamine causes many allergy symptoms, including inflammation of the skin or sinuses, pain, redness, and wheezing.
Immune responses also encourage extra mucus to develop, which helps to clear allergens from the nose and throat.
Allergy medications block histamine responses. This dulls the bodys response to minor or harmless allergens, such as pollen, dust, and pet dander.
Claritin and Zyrtec are effective and safe for most people with minor allergies. However, as with all medications, there may be some side effects.
Side effects
Everyone reacts to medications differently, but Claritin and Zyrtec may have the following side effects:
Allergic reactions
Some people experience a severe allergic response called anaphylaxis after taking antihistamines. A person should seek emergency medical attention if any of the following symptoms are present:
- hives
- a swollen throat
- swollen lips or face
- trouble breathing or other respiratory symptoms
- a racing heartbeat
Children
Some antihistamines are safe for children, but it is a good idea to talk with a doctor or pharmacist and check the label carefully before giving antihistamines to a child.
Pregnancy
A 2020 article examined the association between antihistamine use during early pregnancy and birth defects. Contrary to findings from older studies, the authors stated there was a lack of evidence to support an association.
The American College of Obstetricians and Gynecologists states that Zyrtec (citirizine) and Claritin (loratadine) may be safe during pregnancy.
The labeling for Zyrtec states that it is unsuitable during breastfeeding.
Pregnant people should check with a doctor before using an antihistamine or any other drug.
Claritin and Zyrtec are popular OTC antihistamines. Doctors consider them safe and effective treatments for minor allergies.
Both are second-generation antihistamines. These cause less drowsiness than first-generation antihistamines.
No research has concluded that Zyrtec or Claritin is more effective, but some people report better responses with one or the other. The slight differences between the two may make one drug more appropriate for some people.
People can purchase Zyrtec, Claritin, and other popular brands without a prescription from supermarkets, pharmacies, and online stores.
Contact dermatitis
Matthew Hall, M.D.: Patients can get allergic to various things that they are using, such as soaps, lotions, makeups, anything that contacts the skin.
DeeDee Stiepan: Nickel, which is often used in costume jewelry, is the most common allergen. So how can someone know if they're having an allergic reaction to something they're putting on their skin?
Dr. Hall: Patch testing is the crucial test that we perform to assess for allergic contact dermatitis. It's a weeklong test. We have to see patients on Monday, Wednesday and Friday of the same week.
DeeDee Stiepan: During the initial visit, the dermatologist determines possible risk factors that may be causing the contact dermatitis.
Dr. Hall: Then, based on that, we customize a panel of allergens for each patient that are placed on these aluminum discs that are taped onto the back.
DeeDee Stiepan: After two days, the patient comes back to get the patches removed.
Dr. Hall: But we also have to see the patient back on Friday because it can take 4 to 5 days before we see reactions. So it's a weeklong commitment.
DeeDee Stiepan: At the end of the week, patients are provided with a list of what they're allergic to.
Dr. Hall: We also give them access to a customized database of products that are safe for them to use that do not contain the substances that they are allergic to.
DeeDee Stiepan: For the Mayo Clinic Newsnetwork, I'm DeeDee Stiepan.
What Is The Best Anthistamine For Itching?
Oct 05, 2017
Mildra asked
What is the best anti-histamine to take for bodily itchiness. I don't believe I have allergies but I believe histamine is released in areas on my body that I itch. I need something to calm those nerves down. Steroid ointments don't seem to work.
Answer
To answer this question, we must first note that if histamine is being released, it would be considered some sort of immune reaction to a foreign pathogen. In may not be what we consider "typical allergy symptoms" such as watery eyes and a runny nose, but it would nonetheless still be considered an allergy. As such, it is important to try and discern the cause of the allergy and eliminate the allergen if possible.
For your symptoms, looking towards an antihistamine medication is a good idea. There are many different histamine receptors in the body but Histamine-1 (H1) receptors typically cause allergy symptoms including body itchiness. As such, we will look at a few different anti-histamine-1 (H1 antagonist) medications.
Most antihistamine medications can be purchased over the counter (OTC), although one that we are going to recommend is by prescription only. To start, let's look at the OTC histamines we recommend.
Diphenhydramine, which is the active ingredient in Benadryl, is sold over the counter and helps to provide fast-acting itch relief. Diphenhydramine is a first generation antihistamine and works by stopping and reversing the action of histamine on a persons blood vessels, and can therefore help the symptoms of an allergic reaction, like a persistent itch.
While diphenhydramine is generally a safe medication for those under the age of 65, it does cause drowsiness because it crosses the blood brain barrier and affects the central nervous system. Therefore, it is difficult for some people to take this medication orally throughout the day; In fact, many people use diphenhydramine to help them sleep at night and it is marketed under different names as a sleep aid. So although we typically see the best results with diphenhydramine, many people can't tolerate it during the day.
The good news is Diphenhydramine comes in a topical cream which a person can use to help relieve their itchiness without the drowsiness but it may not be as effective as taking it by mouth.
Although diphenhydramine is considered the first line agent with proven effectiveness, there are some other OTC options that shouldn't sedate you as much. The other OTC options are Claritin (loratadine), Allegra (fexofenadine), Zyrtec (cetirizine), Xyzal (levocetirizine), Chlor-Trimeton (Chlorpheniramine) and Tavist (clemastine).
While any of the above options could work for you, studies indicate that Xyzal (levocetirizine) is the most effective over the counter antihistamine for itching and uticaria (hives). It is the newest antihistamine that has been made available OTC and is the one I would recommend for you based on its evidence.
In terms of prescription medication, I would recommend you ask your doctor about hydroxyzine. It is a histamine-1 antagonist medication that can be used to both stop itchiness due to histamine release as well as the anxiety that may come along with all of the itching. As hydroxyzine is also a first generation antihistamine, it too can make a person sleepy and is typically dosed 3 times daily. It's just another option if everything you have tried thus far has been ineffective.
Finally, we mentioned at the beginning of the article that H1 receptors are mainly responsible for allergy symptoms. There is however, much evidence that suggests taking the combination of a histamine-1 and histamine-2 blocker works better than taking a histamine-1 medication alone for bodily itching. We often see patients prescribed both together and it seems to be more effective in some cases. Some examples of H2 blockers are Pepcid and Zantac. This could be an option to bring up with your doctor as well!
