From the Guidelines
For a rash on the neck and chest, in addition to hydroxyzine, I recommend applying a topical corticosteroid such as hydrocortisone 1% cream or ointment. This is based on the most recent guidelines for the management of atopic dermatitis, which suggest the use of topical therapies including corticosteroids for the treatment of skin rashes 1. The guidelines, published in the Journal of the American Academy of Dermatology in 2023, emphasize the importance of topical therapies in managing atopic dermatitis. When applying the topical corticosteroid, it is essential to follow these steps:
- Apply a thin layer to the affected areas 2-3 times daily for up to 7 days
- For more severe rashes, consider using a medium-potency steroid like triamcinolone 0.1%
- Moisturize the area with a fragrance-free moisturizer like CeraVe or Vanicream after the steroid application to help maintain skin barrier function
- Avoid applying the topical corticosteroid to broken or infected skin If the rash appears infected, consider adding an over-the-counter antibacterial ointment like bacitracin or mupirocin. It is also crucial to avoid hot showers, scented products, and tight clothing against the affected area as these can worsen the rash. If the rash doesn't improve within a week or worsens, seek medical attention as you may need prescription-strength treatments or a different diagnosis.
From the FDA Drug Label
Purpose Anti-itch The FDA drug label does not answer the question.
From the Research
Topical Addition to Hydroxyzine for a Rash on Neck and Chest
- The use of hydroxyzine for a rash on the neck and chest may be associated with hypersensitivity reactions, including urticaria, angioedema, contact dermatitis, anaphylaxis, and fixed drug eruption (FDE) 2.
- Hydroxyzine is an antihistamine medication that has been used in the treatment of anxiety and allergic conditions, but its use can be limited by its side effect profile, including drowsiness and dry mouth 3.
- There is limited evidence on the use of topical additions to hydroxyzine for a rash on the neck and chest, but antihistamine-decongestant-analgesic combinations have been shown to have some benefit in reducing symptoms of the common cold, although the evidence is not strong enough to recommend their use as a first-line treatment 4.
- Classic antihistamines, such as hydroxyzine, have been shown to increase daytime sleepiness and decrease sleep quality, while new-generation antihistamines may have a more favorable side effect profile 5.
- The evidence-based use of antihistamines, including hydroxyzine, for the treatment of allergic conditions such as allergic rhinitis and urticaria, supports their safety and efficacy, but patient preference, access, and costs should be considered when selecting a treatment option 6.