What is the treatment for pediatric contact dermatitis caused by Toxicodendron radicans (poison ivy)?

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Last updated: May 16, 2025View editorial policy

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From the Guidelines

For pediatric poison ivy treatment, washing the affected area with soap and water as soon as possible is the most effective initial step to remove the plant oil (urushiol) that causes the reaction. This is supported by the 2024 American Heart Association and American Red Cross guidelines for first aid, which state that washing with soap and water can remove up to 100% of poison ivy oils if done immediately after contact 1.

Key Recommendations

  • Wash the affected area with soap and water as soon as possible to remove the plant oil (urushiol) that causes the reaction
  • Consider using cool compresses or oatmeal baths for relief of local symptoms, as suggested by the guidelines 1
  • The usefulness of over-the-counter topical steroids, such as hydrocortisone cream, to alleviate local symptoms from poison ivy is uncertain, and their effectiveness has not been consistently demonstrated in studies 1
  • Oral antihistamines, such as diphenhydramine, may be considered for help with sleep at night, but their efficacy for itching is questionable, and they should be used with caution in children 1

Additional Considerations

  • Keep fingernails short to prevent scratching and infection
  • The rash typically resolves within 1-3 weeks
  • For severe cases with widespread rash, facial involvement, or signs of infection (increasing redness, warmth, swelling, or pus), consult a doctor as oral steroids or antibiotics may be needed
  • Poison ivy causes an allergic contact dermatitis when urushiol binds to skin proteins, triggering an immune response that creates the characteristic itchy, blistering rash, and treatment focuses on symptom management while the body naturally resolves the reaction 1

From the FDA Drug Label

Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: ... poison ivy, oak, sumac ...

  • Hydrocortisone (TOP) can be used to temporarily relieve itching associated with poison ivy.
  • However, the label does not provide specific guidance on pediatric use, so caution should be exercised when considering this treatment for children.
  • It is recommended to consult a doctor for pediatric poison ivy treatment under their advice and supervision 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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