Encyclopedia of Medical Immunology

2014 Edition
| Editors: Ian R. Mackay, Noel R. Rose, Dennis K. Ledford, Richard F. Lockey

Topical Antihistamines

Reference work entry
DOI: https://doi.org/10.1007/978-1-4614-9194-1_246

Synonyms

Topical antihistaminic agents; Topical histamine antagonists; Topical histamine blockers

Definition

Topical antihistamines are applied to skin to provide relief of pruritus. Although antihistamines demonstrate H1 and H2 histamine receptor blockades, the exact mechanism of how they exert antipruritic effects remains unknown (Zonalon® and Benadryl® topical cream prescribing information). Two common uses for topical antihistamines are for temporary relief of pain and itching associated with multiple insults, including insect bites, minor skin irritations, and urushiol-induced contact dermatitis associated with the Toxicodendron genus in North America. There is an overarching question to the safety and efficacy of topical antihistamines.

Mechanism of Action

Histamine is an endogenous autacoid amine that has many important physiologic functions in neurotransmission, inflammation, and gastric acid secretion (Thurman 2008). Most notably, histamine is vital in mediating...
This is a preview of subscription content, log in to check access

References

  1. Baker A, Johnson D, Levisky JA. Fatal diphenhydramine intoxication in infants. J Forensic Sci. 2003;48(2):425–8.PubMedGoogle Scholar
  2. Benadryl® (diphenhydramine). [prescribing information]. Skillman: Johnson & Johnson; 2012.Google Scholar
  3. Drake LA, Millikan LE. The antipruritic effect of 5 % doxepin cream in patients with eczematous dermatitis. Doxepin Study Group. Arch Dermatol. 1995;131(12):1403–8.PubMedCrossRefGoogle Scholar
  4. Drake LA, Fallon JD, Sober A. Relief of pruritus in patients with atopic dermatitis after treatment with topical doxepin cream. The Doxepin Study Group. J Am Acad Dermatol. 1994;31(4):613–6.PubMedCrossRefGoogle Scholar
  5. Drake LA, Cohen L, Gillies R, et al. Pharmacokinetics of doxepin in subjects with pruritic atopic dermatitis. J Am Acad Dermatol. 1999;41(2 Pt 1):209–14.PubMedCrossRefGoogle Scholar
  6. Eschler DC, Klein PA. An evidence-based review of the efficacy of topical antihistamines in the relief of pruritus. J Drugs Dermatol. 2010;9(8):992–7.PubMedGoogle Scholar
  7. Klein PA, Clark RA. An evidence-based review of the efficacy of antihistamines in relieving pruritus in atopic dermatitis. Arch Dermatol. 1999;135(12):1522–5.PubMedCrossRefGoogle Scholar
  8. Leurs R, Church MK, Taglialatela M. H1-antihistamines: inverse agonism, anti-inflammatory actions and cardiac effects. Clin Exp Allergy. 2002;32:489–98.PubMedCrossRefGoogle Scholar
  9. McEvoy G, editor. AHFS drug information. Bethesda: American Society of Health-System Pharmacists; 2006.Google Scholar
  10. Perry DJ. The local use of benadryl ointment. J Invest Dermatol. 1947;9(2):95–7.PubMedCrossRefGoogle Scholar
  11. Shakouri AA, Bahna SL. Hypersensitivity to antihistamines. Allergy Asthma Proc. 2013;34(6):488–96.PubMedCrossRefGoogle Scholar
  12. Shelley WB, Shelley ED, Talanin NY. Self-potentiating allergic contact dermatitis caused by doxepin hydrochloride cream. J Am Acad Dermatol. 1996;34:143–4.PubMedCrossRefGoogle Scholar
  13. Taylor JS, Praditsuwan P, Handel D, Kuffner G. Allergic contact dermatitis from doxepin cream. One-year patch test clinic experience. Arch Dermatol. 1996;132(5):515–8.PubMedCrossRefGoogle Scholar
  14. Thurmond R, Gelfand E, Dunford P. The role of histamine H1 and H4 receptors in allergic inflammation: the search for new antihistamines. Nat Rev Drug Discov. 2008;7(1):41–53.PubMedCrossRefGoogle Scholar
  15. Turner J. Death of a child from topical diphenhydramine. Am J Forensic Med Pathol. 2009;30:380–1.PubMedCrossRefGoogle Scholar
  16. Zonalon® (doxepin). [prescribing information]. Doak Dermatologics. Fairfield; 2007.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of Pharmacotherapeutics and Clinical ResearchUniversity of South Florida, College of PharmacyTampaUSA