There it is again:
You hives are breaking out, and it is a complete torture that you are desperate for a fast solution.
You may be wondering, among the prescription drugs and over the counter medicine —
What is the best Antihistamine for hives treatment, when comparing brands like Zyrtec vs Allegra, Benadryl, Claritin etc?
And if you are allergic to Antihistamines or these allergy medications simply do not work, what are your alternatives for itchy skin hives relief?
Skin Hives In A Glance
Hives, or Urticaria, is a common condition that affects most people at some time in their lives.
Hives are reddish, itchy rashes that can appear on any part of the body for vary triggering factors, such as allergic reactions, insect stings, and physical stimulus like heat and pressure.
These skin rashes can cause some a lot of distress which is highly attributed to itching. The most common types of hives include acute hives which form and can disappear within a day, and chronic hives which can persist and last for more than 6 weeks.
Antihistamines remain the mainstay of hives treatment, says Medscape.
3 Antihistamine Generations: How Do They Work?
Antihistamines can be defined as a collection of drugs used in the treatment of allergic disorders. When the body comes into contact with the particulate in the outside environment it reacts by releasing a chemical known as Histamine.
As indicated by the American Osteopathic College of Dermatology, Histamine binds with h1 receptors on cells and this provides defense mechanism to the body. When histamine is released in large amounts, it can lead to swelling and itching of the affected area.
Antihistamines work by blocking the H1 receptors thus it becomes impossible for the released histamine to bind with the receptors in the cells. Antihistamines technically inhibit the reaction of the histamines. This makes them effective in treating hives.
The video below gives excellent illustration on Antihistamine pharmacology, from Histamine to Anti-Histamine, and what does an Antihistamine do.
Antihistamines can be classified as First generation which are the oldest drugs, and the Second-Third generation which is the newest form of antihistamines.
First generation antihistamines are sedating and they are associated with certain side effects such as drowsiness. The second generation antihistamines are non-sedating and they don’t have side effects.
The first generation antihistamines are the older form of antihistamines and they are widely available at relatively cheaper prices. These form of antihistamines are the more effective in the treatment of hives by blocking the reaction of the histamine. However, due to their side effects they are mostly taken before bedtime and they may also affect your ability to handle machinery.
According to Queen’s University and Kingston General Hospital of Canada, the second and third generation of antihistamines possess many of the desirable clinical effects of the first-generation agents – but with a much more tolerable side effect profile.
The second and third generation antihistamines are the newest form of antihistamines. These form of antihistamines are not associated with any side effect, therefore, they can be taken even during the day according to the doctor’s prescription.
Professor Fink gave a comprehensive overview of Antihistamines in video below.
Antihistamine for Hives Treatment and Itchy Skin Relief
Patients, before the use of these antihistamines should identify how frequent their hives appear. In order for the medicines to be effective the doctor should be able to do some tests on the patient so that he can identify the root cause of the hives and recommend the right drugs.
There are those antihistamines that are very popular in the treatment of hives. For the purpose of this post we will refer to them as the key antihistamines, which include:
- Diphenhydramine (Benadryl)
- Cetirizine (Zytrec)
- Loratadine (Claritin)
- Fexofenadine (Allegra)
These popular antihistamines are made up of the first generation antihistamine and second generation antihistamines:
- Diphenhydramine (Benadryl): Benadryl is a first generation antihistamine which is readily available over the counter and also can prescribed by the doctor. This is a short lasting type of antihistamine since it temporarily relieves the symptoms of hives. Although it is a short lasting antihistamine, it is effective in relieving hives symptoms. Being a first generation antihistamine, Benadryl causes drowsiness in patients and the doctor would recommend you to take it before bedtime. >> Learn more
- Cetirizine (Zytrec): This is one of the most popular second generation antihistamine. It is able to treat all allergies as well as relieving hives. This antihistamine is readily available without prescription, additionally, due to its fewer side effects it can be taken anytime of the day without affecting your normal activities. These drugs can treat both the acute and chronic hives effectively and thus it can be a long lasting antihistamine. >> Learn more
- Loratadine (Claritin): This a second generation antihistamine that relieves the symptoms of all the types of hives. This drug can effectively relieve itching in both acute and chronic hives. Loratadine is can be available in form of syrup or tablets thus it’s an oral antihistamine. Although it is a second generation antihistamine which are known for being non-sedative, loratadine can cause some side effects including headache, dry mouth, blurred vision, and urinary retention. This drug is available as without prescription but it is advisable that you read the manufacturer’s instructions carefully to avoid wrong dosage.
- Fexofenadine (Allegra): This is a second generation antihistamine that has the ability to treat hives as well as relieve nasal congestion troubles. Fexofenadine is available only as a prescription by the doctor. This antihistamine should never be used on children who are very young, specifically younger than 4 years old. This drug is available in form of tablet, capsule or syrup. Fexofenadine being non-sedative antihistamine cause less drowsiness compared to the first generation antihistamines.
Doctors may prescribe these antihistamine for hives treatment and itchy skin relief, while they are also available over the counter as shown below. >> Learn more
Zyrtec vs Allegra Benadryl Claritin: Best Antihistamine?
There are no studies done that can conclude a single best Antihistamine for hives treatment, while different people may have different responses to the same drugs.
However, antihistamines can be weighed or compared according to their side effects and efficacy. More often than not these side effects are more common with the first generation antihistamines than with second generation antihistamines.
Diphenhydramine whose brand name is Benadryl and being a first generation is more sedative than all the other second generation antihistamines. Diphenhydramine is the commonly used antihistamine for treatment of acute hives. It is effective since immediately it is administered in the body it starts its action. Although diphenhydramine is effective in the treatment of the acute hives, it is very short lasting.
Cetirizine (Zyrtec) which is a second generation antihistamine can be compared to diphenhydramine. Cetirizine and diphenhydramine have something in common, that is, they start their action immediately they are administered in the body. Cetirizine, unlike the diphenhydramine is long lasting and thus have a longer duration of action in the body.
|Antihistamine||Key Characteristics||Generic Name||Brands|
|First Generation||Sedative in nature|
Cause drowsiness / sleepiness
Short duration of action hence more intake of tablets (every 4 to 6 hours)
Central Nervous System side effects
|Second (and Third) Generation||Non-Sedative in nature|
Result in no or little drowsiness
Long duration of action so can be given once daily
Potential cardiac toxicity
Cetirizine and Diphenhydramine have similar efficacy and thus, this makes cetirizine a good option for treatment of hives. Cetirizine has more added advantages over diphenhydramine since it has very minimal sedative effects to the central system.
Studies have shown patients who receive cetirizine have a lower sedation compared to patients receiving diphenhydramine. Diphenhydramine can also cause dry mouth, headache and nausea.
Although, both being second generation antihistamines, cetirizine and loratadine can be compared. These two antihistamines are effective in treating acute hives. But when it comes to the sedative effects, cetirizine seems to be causing higher sedative effects than loratadine.
Studies have shown that cetirizine is more likely to cause drowsiness and affect the central nervous regions than loratadine. Cetirizine, however, acts earlier or faster than loratadine, this makes it more effective in alleviating the symptoms of hives than loratadine.
Clinical research published in PubMed Health summarize some differences and effects of oral Antihistamine as below:
- For Chronic Idiopathic Urticaria (CIU) or chronic hives symptoms improvement:
- Among newer antihistamines, Cetirizine (Zyrtec) and Levocetirizine (Xyzal) are more sedating than Loratadine (Claritin) and Fexofenadine (Allegra).
- Newer antihistamines are well tolerated in children.
In video below, medical experts outline the factors to consider when you choose best antihistamine for your allergies, including hives rashes triggered by allergic reactions that cause histamine release. When you pick the right the drugs, they are likely to relieve you from the terrible hives.
>> Learn more about Loratadine (eg. Claritin and Alavert) for Allergy Relief
OTC Antihistamine Products for Allergic Reactions
Some of the other over the counter antihistamines include:
- Alavert: This is one of the best over the counter antihistamines that can treat hives. It is known to relieve symptoms including itching, running nose, hay fever and other allergies. This drug is associated with very few side effects, however, just like any other drug that involves self-treating, patient should always read the manufacturer’s instructions carefully. Alavert is normally an oral drug that dissolves quickly. >> Learn more
- Tylenol Allergy: This is available as a tablet and most of the times it is used to relieve symptoms like itchy eyes and running nose. The Tylenol allergy exists as multipurpose tablet and thus it may not be very effective as the other antihistamines. However, this drug is useful in people with various allergic reactions including hives due to its ability to relieve multiple symptoms. It is associated with causing various side effects including drowsiness, blurred vision, nausea, dry mouth, throat or nose. It is always advisable to read the manufactures instructions before using the drug. >> Learn more
- Desloratadine: This is an oral antihistamine that is usually available in form of a tablet, syrup or disintegrating tablet. Desloratadine is effective in treating several allergic symptoms as well as chronic hives. It relives chronic hives symptoms including itching and the reddish rash. This drug can cause several side effects including drowsiness and dizziness. Patients receiving this drug are always advised to avoid alcohol simply because it can worsen the side effects. Most manufacturers and doctors recommend high level of safety caution when it comes to using the drug.
Patients with various reactions with drugs and those who have other conditions such pregnant women should always seek doctor’s advice before using any of the antihistamines. This is the best way to avoid nasty reactions with antihistamines.
What If You Are Allergic to Antihistamine Drugs — Any Alternatives for Hives Rashes Relief?
Hives and other allergic disorders have become very common to people. Hives can be very nasty when they affect anyone and when people are affected by this condition they are always on the look out to seek the best medication that can relieve the symptoms so that they can live their normal lives. This has led to the increased demand for over the counter antihistamine drugs which are also effective relieving the symptoms of hives.
However, some users experience allergic reactions to Antihistamine, with the reported adverse effects / reactions included chest tightness, shortness of breath, stomach upset, and more.
If you are allergic to Antihistamine, what are the alternatives to relieve your hives symptoms?
Alternative #1: Homeopathic Remedies for Hives
One hives treatment approach that has gained popularity over the years to get rid of hives fast is homeopathic remedy – a complementary or alternative medicine (CAM).
Homeopathy is a medical practice based on the philosophy that the body has the ability to heal itself, in which homeopathy as a system of alternative medicine founded in 1796 by Samuel Hahnemann in Germany and has been widely practiced nowadays.
A leading over the counter homeopathic product for hives treatment is Oxyhives, which contains all-natural active ingredients like Apis Mellifera (honey bee) and Arnica Montana flower that have been used for decades as natural medication to cure itchy hives.
Oxyhives is a topical homeopathic solution that once applied to skin, the natural ingredients will provide instant relief on intolerably hives symptoms by fighting against itchiness, redness, irritation, pain, and swelling.
Alternative #2: Anti-Itching Cream for Hives Rashes
Itching is one of the most distressing symptoms of hives. Over the counter products that can relieve this symptom are quite several including anti-itching cream. This can be applied on the affected area and within a very short time the itchy effect will relieved. >> Learn more
Alternative #3: Diets and Food as Natural Antihistamines for Skin Hives
These are actually diet and foods to eat as natural antihistamine to heal chronic hives.
Some of the best diets to heal chronic urticaria include foods that contain Omega-3 Fatty Acids, Vitamin C, Flavonoids, and Bromelain.