Got a rash that just won’t stop itching? Rashes from lupus are extremely common. In fact, up to 80 percent of MyLupusTeam members report that they’ve had a rash at some point. You may have heard of diphenhydramine (sold in products like Benadryl) to treat allergies, but can it help relieve a lupus rash?

For people with hives, the answer may be yes. Itchy rashes with hives can be extremely uncomfortable, distracting, and frustrating. “When hives start, it makes me feel terrible — the fact that hives appear and due to the intensity of it all. My joints ache with it after, so horrible,” one MyLupusTeam member wrote.

Although antihistamines like diphenhydramine are typically used to treat allergies, they can also help people with lupus who develop hives.

Keep reading to learn more about diphenhydramine and lupus, including when over-the-counter products like Benadryl may be helpful.

Hives and Lupus

Hives (urticaria) are bumps or raised patches of skin that are usually itchy and sometimes look swollen. Hives are commonly due to allergic reactions, but hives that linger for more than 24 hours in people with lupus are usually caused by lupus.

Itching from hives is a common skin sensation with lupus — approximately 10 percent of people with lupus get hives, per Johns Hopkins Lupus Center. One MyLupusTeam member wrote, “My 15-year-old is experiencing chronic hives. … She is miserable and has scratch marks all over her arms and legs.”

Hives may be a symptom of cutaneous lupus erythematosus (CLE), a type of lupus in which the immune system attacks skin cells, causing inflammation that leads to skin rashes that burn or itch. Rashes from CLE usually appear discolored, scaly, and disc-shaped, especially on parts of the body exposed to the sun (discoid lupus) or as a rash on the bridge of the nose (called malar rash or butterfly rash). Other lupus-related conditions like vasculitis or a reaction to a medication can also cause rashes in people with lupus.

Talk to your doctor if you notice hives or hive-like lesions on your skin, as treatment will differ depending on the underlying cause.

Benadryl May Help With Hives

Antihistamines like diphenhydramine are not a treatment for lupus itself, but they can treat hives from lupus. Diphenhydramine works by blocking histamines, chemicals produced by the immune system that can cause allergy symptoms like hives. Diphenhydramine, the main ingredient in Benadryl, is also found in many over-the-counter drugs, including Sudafed, Siladryl, and ZzzQuil.

Some MyLupusTeam members have reported that taking Benadryl helps reduce itchiness and hives from lupus. “When Benadryl is taken, the buzzing and itchiness stop,” one member wrote. Another shared, “Benadryl definitely helps with aches, hives, etc.”

Note that Benadryl is only useful for treating hives from lupus and not general lupus inflammation. The properties of diphenhydramine are designed to block part of the allergic response, which may bring relief to people with lupus who have hives.

Side Effects From Benadryl

Diphenhydramine may provide relief from itchy rashes with hives, but it’s also known to have drowsiness as a side effect. As one MyLupusTeam member wrote, “Doesn’t Benadryl make you sleepy or sluggish during the day?” Daytime drowsiness from Benadryl may affect your daily functioning. For example, it’s best not to drive when you’ve taken diphenhydramine because it might make you drowsy.

Other potential side effects of diphenhydramine are:

• Dizziness
• Dry mouth, throat, or nose
• Nausea or vomiting
• Headache
• Loss of appetite
• Constipation
• Chest congestion
• Muscle weakness
• Trouble with memory
• Lack of concentration
• A sense of nervousness or overexcitement (especially in children)

Other Tips To Reduce Itchiness

In addition to taking an antihistamine, at-home remedies may help reduce itchiness and swelling from hives. Here are some to try:

• Use fragrance-free, gentle soap.
• Avoid hot baths or showers, or try a colloidal oatmeal bath.
• Apply a cold compress to the itchy skin.
• Wear loose-fitting 100 percent cotton clothing to reduce contact with the affected area.
• Keep a journal or notes on when hives occur to see if you notice any patterns or triggers.
• Ask a health care provider about over-the-counter anti-itch ointments or lotions.

Ask Your Doctor About Diphenhydramine for Lupus Rash With Hives

If you experience hives or itchy rashes from lupus, ask your doctor whether diphenhydramine might be a good treatment option for you. Tell your doctor how often you get hives or rashes and if you notice any changes in their size or appearance.

Although hives are common in people living with lupus, your doctor may look for other underlying causes of the rash so they can prescribe appropriate treatment. Be sure to follow your doctor’s instructions regarding the dosage and when to take diphenhydramine, and let them know if you notice any side effects or worsening symptoms.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Do you get hives with lupus? Have you taken Benadryl or another antihistamine to help relieve itchiness? Share your experience in the comments below, or start a conversation by posting on your Activities page.