From the Guidelines
To treat spreading poison ivy, immediately wash the exposed area with soap and water, and consider using cool compresses for symptomatic relief, as these methods have been recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. The goal of treatment is to reduce itching, inflammation, and prevent further spread of the rash.
- Washing the exposed area with soap and water as soon as possible can remove up to 100% of the poison ivy oil, reducing the severity of the reaction 1.
- Cool compresses may be used to soothe the affected area and provide relief from itching, although the evidence for their effectiveness is limited 1.
- Over-the-counter topical steroids, such as hydrocortisone cream (1%), may be applied 2-3 times daily to reduce itching and inflammation, but their usefulness is uncertain 1.
- Oral antihistamines, such as diphenhydramine (Benadryl) 25-50mg every 6 hours or cetirizine (Zyrtec) 10mg daily, may be taken to control itching, but their efficacy is also uncertain 1.
- For severe cases that continue to spread, consulting a doctor may be necessary, as they may prescribe stronger topical steroids or oral steroids, such as prednisone, to reduce the severity of the reaction 1. It is essential to prevent further spread of the rash by cleaning under fingernails and laundering all contaminated clothing and items.
- The spreading rash is not contagious, but rather a result of varying reaction times to the urushiol oil from the plant, which causes a delayed allergic reaction.
- Avoiding scratching is crucial to prevent secondary infections and potential scarring.
From the FDA Drug Label
Relieves minor skin irritations due to poison Ivi. Poison oak. Poison sumac. Insect bites Athlete's foot. Allergic itches. Irritations INDICATIONS AND USAGE PredniSONE Tablets are indicated in the following conditions: ... 5 Allergic States Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment: ... Contact dermatitis
- Treatment for poison ivy that spreads:
- For minor skin irritations, aluminum acetate (TOP) 2 may be used.
- For severe cases, prednisone (PO) 3 may be considered for control of severe or incapacitating allergic conditions, including contact dermatitis.
- However, it is essential to consult a healthcare professional for proper evaluation and treatment, as the severity of the condition and the best course of treatment may vary.
From the Research
Treatment Options for Poison Ivy that Spreads
- The treatment for poison ivy that spreads can involve the use of oral corticosteroids, such as prednisone, to reduce inflammation and alleviate symptoms 4, 5.
- A study published in the Journal of Clinical Medicine Research found that a longer course of oral prednisone (15 days) was more effective in reducing the need for additional medications compared to a shorter course (5 days) 4.
- Another study published in The Western Journal of Emergency Medicine found that shorter durations of oral corticosteroids (less than 14 days) were associated with an increased risk of return visits to healthcare clinicians 5.
- Topical corticosteroids can be used for localized non-facial eruptions, while systemic corticosteroids are reserved for severe eruptions 6.
- Initial management of poison ivy dermatitis also includes cleansing, cold compresses, and oral antihistamines for symptomatic relief 6.
Duration of Treatment
- The optimal duration of treatment for poison ivy dermatitis is at least 14 days, according to recommendations 5.
- A longer course of treatment (2-3 weeks) may be necessary for patients with severe disease or those who present to the emergency department 5.
- The duration of treatment should be individualized based on the severity of symptoms and the patient's response to treatment 4, 5.