Systemic Therapies: Antihistamines

First generation (sedating H1 Blockers) include diphenhydramine and hydroxyzine. They are used for allergic reactions. In patients with severe pruritus hydroxyzine may be prescribed to be taken at night to help with itch and sleep; however, they are not recommended for long-term therapy in children with chronic skin conditions as they may interfere with normal sleep patterns.

Second generation (non-sedating H1 Blockers) include cetirizine, loratadine, desloratadine and fexofenadine. There are several prescription second generation antihistamines now available including rupatadine and bilastine. These are used for allergic reactions and urticaria (hives).

Unfortunately antihistamines are often ineffective at controlling the itch associated with atopic dermatitis.