Antihistamines may not offer meaningful relief from eczema symptoms
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- Reviewed by Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
Nearly half of people living with atopic dermatitis (eczema) in the United States turn to oral antihistamines to relieve the symptoms of a flare-up. But a new analysis suggests that this treatment offers little benefit — and in some cases, may increase risk of cognitive and other side effects.
The analysis, published online July 29, 2026, by The BMJ, involved a review of 47 clinical trials involving over 6,200 children and adults (ages 1 to 43, 52% female), most of whom had moderate to severe atopic dermatitis. The researchers evaluated the effectiveness of oral antihistamines and other medications in easing symptoms like itching and difficulty sleeping.
Although antihistamines produced some improvements, most were far too minor to be noticeable — and the drugs didn’t appear to reduce the frequency of eczema flare-ups. Specifically, older “first generation” antihistamines like diphenhydramine (Benadryl) and newer “second generation” nonsedating antihistamines like loratadine (Claritin) reduced doctor-scored skin signs of eczema severity by only 1.87 points on an 83-point scale — far short of the 8.2-point change needed before patients would notice symptom relief. Itch scores (reported by patients or caregivers) improved by less than 1 point on a 10-point scale, versus the 3-point threshold considered meaningful.
Safety was a bigger concern. First-generation antihistamines caused roughly 66 additional cases of cognitive impairment per 1,000 patients — including confusion and memory problems — and higher rates of stopping treatment due to side effects. Among the second-generation options, effects varied: loratadine wasn’t linked to cognitive impairment, while cetirizine and levocetirizine (Xyzal) carried slightly increased risk.
The authors recommended against routine use of antihistamines for eczema, as they’re unlikely to help much and may carry unnecessary risks. Moisturizers and topical anti-inflammatories remain better initial choices for treating eczema, but antihistamines may still be a reasonable option for patients with other allergic conditions like hives or hay fever.
Image: © Viktoriya Skorikova/Getty Images
About the Author
Joyce Hendley, Staff Writer
About the Reviewer
Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
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