Is hydrocortisone or Benadryl better for hives

By Isabella Storyclaire

last updated November 20, 2024

Contributions sourced from

How to Treat Hives

If you have only one outbreak of hives and you dont have breathing difficulties, you probably dont need medical attention. Yet if you continue to get multiple bouts of hives that continue after a couple of weeks, you may want to call a doctor, Elmariah suggests. Most often, the hives will resolve during this time or youll figure out whats causing them.

But hives that continue for weeks warrant a trip to a specialist, such as a dermatologist or an allergist. If they continue for six weeks or longer theyre considered chronic hives, which tend to be caused by the same triggers as short-term or acute cases of hives. Because dermatologists and allergists are skilled at working with hives, theyre your best bet for getting appropriate treatment, Dr. Rossi explains.

How Doctors Diagnose Hives

Expect to undergo a thorough physical exam. The dermatologist or allergist will also likely ask you to review your hives experience in detail, including when the hives started, if you suspect anything in particular triggered your hives, what medications youve tried, and what type of response youve gotten. Come prepared with this information.

Doctors will also verify that the bump (or bumps) is hives, often circling the spot on your skin to see if it disappears the next day (if so, its a hive, Elmariah says).

Once theyve confirmed that it is hives, theyll work to determine the trigger. Rossi says: Figuring out the cause can be the most frustrating part of it, especially if the tests arent helpful.

You may require additional testing. If an allergy is suspected, you may need to undergo allergy testing. If you are diagnosed with a severe allergy, the doctor may prescribe an epinephrine auto-injector (such as an EpiPen) in case youre accidentally exposed to your allergen. (1)

And because chronic hives can signal autoimmune disorders, you may need to have a blood draw in which doctors will look for a common antibody found in many autoimmune disorders. In rare cases when a bout of hives doesnt disappear within 24 hours, your doctor may do a skin biopsy to see if theres inflammation of the blood vessels, Rossi adds.

Treatments Doctors Use for Hives

Doctors usually prescribe antihistamines as the first course of treatment for hives. Acute cases can generally be treated with over-the-counter antihistamines like loratadine and pseudoephedrine,cetirizine, fexofenadine, or diphenhydramine.

If your hives are persisting (or youve already tried OTC antihistamines without success), your doctor may move to another class of antihistamines called histamine type 2 receptor antagonists, or H2 blockers, including cimetidine (Tagamet) and famotidine (Pepcid)(both available over the counter); up the dose of antihistamines (some as high as four times); or combine several antihistamines, Friedman says.

In some cases, your doctor may prescribe an oral steroid, such asprednisone (Deltasone), if your hives still arent responding. Oral steroids are stronger but can cause more significant side effects than antihistamines. (3)

If youre still not seeing results, your doctor may recommend even stronger medications, like an injectable prescription medication called omalizumab(Xolair). There is also evidence that off-label use of stronger medications that suppress the immune system under careful monitoring by a specialist may be helpful in patients with difficult-to-manage hives.

Its important to note that you shouldnt try taking high doses of vitamins or any other off-label medication on your own without instruction from your doctor. No one treatment works for everyone, Friedman says. And for some, such therapies may not be safe.

15 Ways to Get Rid of Hives

You may be able to relieve hives with home remedies, including aloe vera or an oatmeal bath, and over-the-counter products. But a doctor may need to treat severe or chronic hives.

Hives (urticaria) are a rash on your body. Identifying what triggered your hives is crucial to preventing them from happening again. If you can identify the trigger, you can avoid contact with it.

Although hives are often associated with allergic reactions, they can also occur due to:

Hives generally fade within 24 hours and dont require treatment.

However, you should seek immediate medical attention if you experience any of the following:

dizziness
swelling in your throat or face
difficulty breathing

These may indicate a severe allergic reaction and require emergency care.

If your hives are milder, continue reading to learn how to ease any discomfort and speed up the healing process.

Some remedies and other products may cause a skin reaction. Its best to do a skin patch test before applying.

In most cases, home remedies can help you find relief. Here are a few ways to soothe itchy skin:

Use a cold compress

Applying something cool to your skin can help relieve irritation and swelling. To do this, grab a bag of frozen veggies or wrap a handful of ice in a towel and apply it to the affected area for up to 10 minutes. Repeat as needed throughout the day.

Take a bath with an anti-itch solution

There are several products you can add to a bath to relieve itching. These include colloidal oatmeal or one or two handfuls of baking soda.

Learn more: How to make an oatmeal bath

Avoid products that may irritate the skin

Certain soaps may dry your skin and cause more itching when you have hives. Make sure to use a mild soap thats marketed for sensitive skin. These typically omit fragrance and irritating chemicals.

You should also avoid using irritating moisturizers or lotions. When in doubt, opt for a formula that targets sensitive skin, such as these options. Applying immediately after bathing may also help soothe the itch.

Keep things cool

Heat can make itchiness worse. Wear lightweight clothing and keep the temperature in your house cool and comfortable. Avoid sitting in direct sunlight.

If home remedies arent relieving your symptoms but you arent ready to head to the pharmacy you may want to give a few natural solutions a try.

Natural remedies arent regulated or approved by the Food and Drug Administration (FDA), so use them with caution.

Witch hazel

The natural tannins found in the herb witch hazel can help relieve irritation. Despite this, it may cause contact dermatitis. Its best to test it on a small patch of skin before applying it all over.

You can apply witch hazel to your skin like a mask a few times each day. Let it sit on the affected areas for about 20 minutes, and then rinse it off.

Aloe vera

Aloe vera is a natural anti-inflammatory. According to the National Center for Complementary and Integrative Health, applying it to the skin can help people with acne, herpes simplex, psoriasis, and other conditions affecting the skin. It is typically well-tolerated.

But, as with any new product, its important to do a skin patch test before application, especially if you have sensitive skin. Some aloe products may also have added fragrance or other chemicals, so be sure to read the label.

You can apply topical aloe vera to your hives as needed, likely a few times a day. Be sure to follow any instructions on the package.

If the above remedies arent enough to help your hives, over-the-counter (OTC) treatments may help relieve your symptoms. Not only can OTC options relieve itching and irritation, but they can also target your bodys histamine response, which is what causes hives.

Calamine lotion

Products containing calamine can help relieve itching by cooling your skin. You can apply calamine lotion directly to your skin:

Make sure you mix the lotion before using it by shaking the container.
Put some calamine lotion on a cotton pad or cloth.
Apply the pad or cloth directly to the hives and let dry.

You can treat the hives with calamine lotion as necessary.

Diphenhydramine (Benadryl)

This oral antihistamine can reduce rash and other allergy symptoms like itching by working from the inside out.

Be sure to follow the dosage instructions on the package. Benadryl usually kicks in within an hour and should start to relieve your symptoms the same day.

Benadryl may cause drowsiness.

Fexofenadine (Allegra), loratadine (Claritin), and cetirizine (Zyrtec)

These antihistamines typically come in 12- or 24-hour formulas to provide extended relief. Theyre also less likely to cause drowsiness than diphenhydramine.

You may need to adjust the dosage to effectively treat hives, so talk with a doctor or pharmacist. They can advise you on how much to take and how often.

If youre experiencing severe or chronic hives, you may need prescription medication. Talk with a doctor about your symptoms and how you can best find relief.

Common prescription options include:

Prednisone (Deltasone)

This corticosteroid is taken orally. You should only use it for a short period of time as directed by a doctor. Corticosteroids can have side effects, especially if taken for extended periods of time. Side effects can include:

elevated blood pressure
elevated eye pressure (glaucoma)
swelling
weight gain
immunosuppression, which means you may get infections more easily

To reduce side effects, take oral corticosteroids at a lower dose and transition to corticosteroid creams with your doctors supervision.

Omalizumab (Xolair)

This medication must be injected under the skin. This option is only available if your hives are chronic and dont respond to antihistamines. Common side effects include:

headache
dizziness
inner ear pain
cold symptoms

Dapsone (Aczone)

This antibiotic is available topically and as an oral medication. This medication can treat inflammation due to hives or other skin conditions that are caused by bacterial infection. Its important to take all antibiotics as prescribed.

Antibiotics only help relieve symptoms caused by a bacterial infection.

Leukotriene-receptor antagonists

This nonsteroidal treatment option is taken orally. These drugs should be used only after steroid treatment and antihistamines have been unsuccessful. There is not a lot of quality research to support their use for hives. Common side effects include:

headache
nausea
cough
low fever

If your symptoms worsen or last longer than a couple of days, you may want to talk with a doctor. They can identify the cause and provide medication to help relieve your symptoms. Understanding your triggers may help prevent future outbreaks.

Hydrocortisone vs Antihistamines

Different medications can be used to treat the same condition. For individuals who are not medical professionals, finding the right medication, can often be confusing and challenging.Hydrocortisone and antihistamines are great examples of common medications with a variety of uses for different conditions. Lets break down these two medications and help you get a better understanding of their uses.

Hydrocortisone

Hydrocortisone is a corticosteroid or steroid, which belongs to a group of drugs called glucocorticoids. It has strong anti-inflammatory effects and can be used for conditions affecting the immune system. This can include conditions such as arthritis, inflammatory bowel disease (ulcerative colitis and Crohn's), asthma, bronchitis, and some skin rashes like eczema and hives. Most corticosteroidswill need a prescriptionfrom a doctor, but some topical formulations, like hydrocortisone, can be purchased over-the-counter.

Antihistamines

Antihistamines are medications that work by blocking the effects of histamines, chemicals responsible for allergic symptoms. These symptoms include congestion, runny nose, sneezing, itchy throat, hives, skin rashes anditchy or watery eyes. Antihistamines can also be used to provide relief forother conditions such as motion sickness, insomnia and anxiety. It is important to note some antihistamines can cause drowsiness and should not be taken before driving or operating heavy machinery. If you need to stayalert aftertakingmedication, make sure to let the doctor know as they can prescribe you a non-drowsy antihistamine.

Medications

Corticosteroids and antihistamines encompass a wide range of medications. Examples include the following:

Corticosteroids

Hydrocortisone
Prednisolone
Triamcinolone
Desonide
Dexamethasone

Antihistamines

Loratadine
Fexofenadine
Cetirizine
Chlorpheniramine

What are the differences between the two?

Corticosteroids have more anti-inflammatory effects than antihistamines, and antihistamines and corticosteroids have different side effects.
Antihistamines can cause dry mouth, drowsiness, decreased production of tears, problems with urination, changes in vision, constipation and agitation.
Corticosteroids can cause fluid retention, hypertension, headaches, muscle weakness, growth of facial hair, thinning of the skin, suppresion of the immune system,and much more.

Ezcema

Eczema is a common condition in which corticosteroids and antihistamines are used. Eczema, medically known as atopic dermatitis, usually causes dry, itchy and cracked/sore skin. Eczema is a chronic long-term conditionwhich can affectdevelop both in adulthood andchildhood, sometimes before the age of 1. There is no known cause, but it can run in families, and can often developalongside asthma and hay fever.

Eczema has a common presentation pattern. Eczema can present on any part of the body, but is most common on the hands, insides of the elbows, back of the knees,and the face and scalp in children. Eczema can be manageable at most times, but people can suffer flare-up periods where their symptoms become more exaggerated. Some individuals might have triggers that can cause eczema flare-ups such as soaps, detergents, stress and weather.

Hydrocortisone and eczema

Hydrocortisone is used to reduce inflammation which occurseczema. It reduces redness by constrictingblood vessels at the surface of the skin.

Antihistamines and eczema

Some people maystruggle with severe itchiness duting aneczema flare. Antihistamines can be prescribed to help control itching. They will not help get an eczema flare-up under control but will help soothe symptoms.

Medzino offers a wide range of eczema and allergy relief medications. To get a prescription, simply fill out an online consultation form and one of ourdoctors will review it and make sure the medication is suitable for your symptoms. Our pharmacy will then dispatch the medication once they get approval, and send it straight to your door in plain discrete packaging.

References

NHS Choices. Antihistamines. [Online] NHS. Available from: https://www.nhs.uk/conditions/antihistamines/
NHS Choices. Steroids. [Online] NHS. Available from: https://www.nhs.uk/conditions/steroids/
NHS Choices. Overview - Atopic eczema. [Online] NHS. Available from: https://www.nhs.uk/conditions/atopic-eczema/
Mayo Clinic. Atopic dermatitis (eczema) - Symptoms and causes. [Online] Mayo Clinic. Available from:https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/symptoms-causes/syc-20353273