Taking antihistamines with Vitamin A helps relieve the acne itch
All types of acne, especially severe or hormonal acne, can be hard to deal with. It affects people’s emotions, daily activities, work, studies, and relationships.
Effective treatment of acne is key to improving the quality of life of people with acne.
But what is Vitamin A, how do you take it and how does it work?
Isotretinoin, a derivative of Vitamin A, is one of the most effective treatments for severe acne. Known by brand names like Oratane, Roaccutane and Accutane, it has the potential to induce long-term remission.
However, its powerful effects come with a range of side effects, the most common being dry and itchy skin.
Recent research indicates that combining isotretinoin with antihistamines may significantly alleviate these uncomfortable side effects, improving patient adherence and outcomes.
The Challenges of Isotretinoin
Isotretinoin works by targeting all major causes of severe acne, including excessive sebum production, clogged pores, and inflammation.
It is a very effective treatment for severe acne. These capsules target all the known causes of cystic acne.
Isotretinoin capsules are a type of retinoid. They come from Vitamin A. These capsules help unblock pores. They also prevent new blockages. This reduces oil production and calms the redness and swelling of acne.
Isotretinoin makes the oil glands less welcoming to the bacteria that cause acne. It can lead to long-term remission in up to 85% of people with severe cystic acne.
Some people can have long-lasting acne clearance from just one course of oral isotretinoin. This treatment usually lasts 5-6 months at a normal dose. At a low dose, it can last 10-12 months.
A small number of people may, however, have their acne come back. This return is usually less severe than before. It can happen after a long time without any signs of acne including pimple outbreaks.
Depending on the severity of the recurrence, another course of isotretinoin may help.
If you have chest acne, back acne or hormonal acne, talk to your doctor about oral isotretinoin.
While it is highly effective, its potency comes with a price- side effects. Common complaints include dry skin, cracked lips, and persistent itching.
For some patients, these side effects are severe enough to disrupt their daily lives and lead to stopping treatment.
The Challenges of Isotretinoin
Isotretinoin works by targeting all major causes of severe acne, including excessive sebum production, clogged pores, and inflammation.
It is a very effective treatment for severe acne. These capsules target all the known causes of cystic acne.
Isotretinoin capsules are a type of retinoid. They come from Vitamin A. These capsules help unblock pores. They also prevent new blockages. This reduces oil production and calms the redness and swelling of acne.
Isotretinoin makes the oil glands less welcoming to the bacteria that cause acne. It can lead to long-term remission in up to 85% of people with severe cystic acne.
Some people can have long-lasting acne clearance from just one course of oral isotretinoin. This treatment usually lasts 5-6 months at a normal dose. At a low dose, it can last 10-12 months.
A small number of people may, however, have their acne come back. This return is usually less severe than before. It can happen after a long time without any signs of acne including pimple outbreaks.
Depending on the severity of the recurrence, another course of isotretinoin may help.
If you have chest acne, back acne or hormonal acne, talk to your doctor about oral isotretinoin.
While it is highly effective, its potency comes with a price- side effects. Common complaints include dry skin, cracked lips, and persistent itching.
For some patients, these side effects are severe enough to disrupt their daily lives and lead to stopping treatment.
How Does Isotretinoin Work?
Isotretinoin works by reducing sebum production — shrinking the sebaceous glands, leading to less oil on the skin. It also stops pores from getting blocked by normalising the shedding of skin cells and reduces bacteria by making the skin less appealing to acne-causing germs.
Why it causes dryness and itching:
- Decreased oil production: Leads to dryness of the skin, lips, and mucous membranes.
- Skin barrier disruption: Reduced sebum can impair the skin’s protective barrier, increasing sensitivity and itching.
- Inflammation: Dry skin can inflame and worsen itchiness.
Isotretinoin often has a psychological impact on those with acne. Discomfort due to persistent itching can lead to scratching causing skin damage.
Unmanaged side effects may cause patients to discontinue treatment prematurely.
Why Itching Occurs During Treatment
Itching during isotretinoin treatment is primarily due to extreme skin dryness.
Isotretinoin significantly reduces the skin’s ability to retain moisture by shrinking the sebaceous glands.
This dryness weakens the skin barrier, making it more susceptible to irritation and inflammation.
The right skin care products can also help reduce the itching.
Enter Antihistamines: A Surprising Ally
Antihistamines are commonly used to treat allergies, but their benefits extend beyond relieving sneezing and watery eyes.
These medications block histamine, a compound that triggers itching and inflammation.
In the context of isotretinoin treatment, antihistamines can soothe dry, itchy skin and improve overall patient comfort.
How Antihistamines Work in Acne Treatment
Antihistamines alleviate itching and dryness through several mechanisms:
- Blocking histamine receptors: This reduces the sensation of itching.
- Reducing inflammation: Antihistamines have anti-inflammatory properties that calm irritated skin.
- Regulating sebum production: Research suggests that some antihistamines may also reduce oil production, indirectly benefiting acne-prone skin.
Research Findings
A study in the International Journal of Dermatology looked at the effects of using antihistamines with isotretinoin. This study lasted three months and included 75 patients.
Only 10% of participants who took the antihistamine with isotretinoin reported itching. In contrast, 33% of those who did not take antihistamine with isotretinoin experienced itching.
Participants taking both antihistamine and isotretinoin also recorded higher levels of satisfaction, with 54% of participants taking both noting their satisfaction levels at ‘excellent’.
The study showed that patients using the combination had a similar number of acne spots. Researchers compared this to those using only isotretinoin.
The Benefits of Combining Treatments
The combination of antihistamine and isotretinoin may not have lowered the number of breakouts. However, it was very effective in reducing itchy skin.
Easing side effects like dryness and itching from isotretinoin can help people stay on their treatment plans.
When side effects are more manageable, patients are more likely to continue their medication. This support can lead to better health outcomes. This is especially important for those with moderate to severe acne.
When patients can manage these side effects, they are more likely to finish the full treatment course.
Adding antihistamines to the treatment plan for people taking isotretinoin may help them feel more comfortable with their acne.
This suggests that combining these medications can improve their experience.
In addition to antihistamines, patients can adopt simple skincare routines to minimise dryness and itching:
- Gentle cleansers: Wash your face with mild, fragrance-free cleansers to avoid further irritation.
- Moisturisers with ceramides: Ceramides help restore the skin barrier and retain moisture in the skin.
- Lip balms: Prevent and treat chapped lips.
- Avoid harsh products: Steer clear of exfoliants or alcohol-based products that can exacerbate dryness.
Practical Tips for Patients
If you’re considering adding antihistamines to your acne treatment plan, keep these tips in mind:
- Consult your dermatologist: Always discuss new medications with your healthcare provider.
- Choose non-sedating antihistamines: Second-generation options won’t make you drowsy.
- Incorporate hydrating skincare: Use gentle cleansers and moisturisers with ceramides to support your skin barrier.
- Stay hydrated: Drinking plenty of water helps combat dryness from the inside out.
Expert Recommendations
Consider a young university student struggling with severe acne. After starting isotretinoin, they experienced unbearable itching that made it hard to focus on their studies.
Their dermatologist recommended adding non-sedating antihistamine, and within weeks, they noticed a significant improvement.
With their itching under control, they completed their treatment and now enjoys clear, glowing skin.
Dr Lisa Byrom advocates for the inclusion of antihistamines in treatment plans for patients experiencing itching due to isotretinoin.
“It’s a safe and simple addition,” she notes. “Managing side effects is crucial for ensuring patients stay on track with their treatment.”
Future Applications
The success of combining isotretinoin with antihistamines highlights the importance of patient-centred care.
Dermatologists are increasingly exploring complementary therapies to minimise side effects and improve patient outcomes.
However, researchers need to conduct future studies on the following:
- Optimal dosages: Determining the most effective antihistamine dosages for itch relief.
- Long-term safety: Monitoring any potential interactions over extended periods.
- Alternative remedies: Investigating other agents that may alleviate isotretinoin-induced side effects.
Conclusion
Using antihistamines with isotretinoin can help with a common side effect of acne treatment: itchy, dry skin.
By improving patient comfort, this approach not only enhances adherence to therapy but also contributes to better clinical outcomes.
Patients should consult their dermatologist to tailor a treatment plan that addresses both acne severity and side effect management.
Reference: Hazarika N, Yadav P, Bagri M, et al. Oral isotretinoin with desloratadine compared with oral isotretinoin alone in the treatment of moderate to severe acne: a randomized, assessor-blinded study. Int J Dermatol 2024;63(7):929-35. doi: 10.1111/ ijd.17129 [published Online First: 2024/03/28]
