Antihistamines do not improve atopic dermatitis symptoms
Although many patients with atopic dermatitis (AD) use antihistamines, no high-level evidence exists to prove that nonsedating antihistamines reduce itch in patients with AD or provide benefit in controlling AD symptoms, except perhaps sleep and AD comorbidities such as allergic rhinitis, according to a study.
To evaluate the use of sedating and nonsedating antihistamines for AD in 2003–2012, the authors used data on physician visits in 2013–2012 from the National Ambulatory Medical Care Survey and identified sedating and nonsedating antihistamine use at visits for AD.
A total of 990,000 annual visits for AD were reported. A significant proportion of visits across physician specialties (16–44 percent) reported a prescription of antihistamines for AD. Dermatologists and paediatricians were the main prescribers of sedating antihistamines (58–70 percent), while most family or general practitioners, internists, and other specialties used nonsedating antihistamines for AD (55–100 percent).
Interestingly, a 2003 study has shown that dermatologists warrant further evidence in terms of the efficacy of antihistamines and their mechanism of action in the treatment of AD to enhance patient care. [J Cutan Med Surg 2003;7:467-473]
The present study was limited by the accuracy of AD diagnosis and medication recording, according to the authors.
“Antihistamines are often used to treat pruritus associated with AD despite lack of evidence for their efficacy,” they said. “The American Academy of Dermatology does not recommend the general use of antihistamines in the management of AD, although the value of short-term sedating antihistamine use for insomnia secondary to itch is recognized.”