Antihistamines, mostly H1
antihistamines, administered both topically and systemically, are among the most widely used drugs. While systemically applicable
antihistamines are usually taken orally or administered intravenously, while local
therapy is used on the eye, nose or skin. Systemic
antihistamines are most frequently used during the pollen season (
hay fever,
asthma) or are used all year round, e.g., for
house dust and animal hair
allergies. Furthermore,
urticaria is a major indication for the use of H1
antihistamines, also as long-term treatment. Although H1
antihistamines are not licensed for
pruritus and
prurigo, they are frequently used in these diseases. However, since in many diseases with
pruritus and
prurigo the
histamine receptor does not play a decisive role in the pathogenesis of
pruritus, they show limited efficacy. Two Cochrane reviews have not shown any significant
antipruritic effects of H1
antihistamine treatment in
atopic eczema as single
therapy or in combination, e.g., with topical glucocorticosteroid
therapy. A retrospective case series with a so-called high-dose
antihistamine therapy with non-
sedating antihistamines was effective in treating chronic
pruritus. This article summarizes the possibilities of systemic
antihistamines in
pruritus, especially with regard to limitations and future prospects.