What is the treatment for poison ivy?

From the Guidelines

The most effective treatment for poison ivy is immediate washing with soap and water to remove the urushiol oil, followed by the use of cool compresses for symptom relief, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. The treatment for poison ivy involves several steps to relieve symptoms and promote healing.

• First, wash the affected area with soap and lukewarm water as soon as possible to remove the plant oil (urushiol) that causes the reaction, as this can remove up to 100% of the oil if done immediately after contact 1.
• Apply cool compresses to reduce itching and inflammation, as this may be considered for relief of local symptoms from exposure to poison ivy, oak, or sumac 1.
• Oatmeal baths may also be considered for relief of local symptoms from exposure to poison ivy, oak, or sumac 1.
• The usefulness of over-the-counter topical steroids, such as hydrocortisone cream, and antihistamines to alleviate local symptoms from poison ivy is uncertain, and therefore, their use is not recommended as a first-line treatment 1.
• For severe cases with widespread rash or facial/genital involvement, see a doctor who may prescribe oral steroids like prednisone, typically 40-60mg daily for 1-2 weeks with a gradual taper.
• Avoid scratching to prevent infection and wear clean cotton clothing to reduce irritation.
• The rash typically resolves within 1-3 weeks as your body processes the urushiol oil that triggered the allergic contact dermatitis.
• If the rash worsens, shows signs of infection (increased pain, swelling, warmth, or pus), or doesn't improve after a week of home treatment, seek medical attention.

From the FDA Drug Label

Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: eczema psoriasis poison ivy, oak, sumac insect bites detergents jewelry cosmetics soaps seborrheic dermatitis temporarily relieves external anal and genital itching The treatment for poison ivy includes hydrocortisone (TOP) to temporarily relieve itching associated with minor skin irritations, inflammation, and rashes due to poison ivy 2.

From the Research

Treatment Options for Poison Ivy

• Washing the area immediately with a solvent suitable for lipids is a recommended treatment for poison ivy, as it helps to remove the oil soluble oleoresin that causes the reaction 3.
• Anti-inflammatory agents, especially corticosteroids, are also used to treat poison ivy, and can be prescribed orally or topically 3, 4, 5.
• The duration of oral corticosteroid treatment can vary, but studies suggest that a longer course of treatment (at least 14 days) may be more effective in reducing the risk of return visits to healthcare clinicians 4, 5.
• A randomized, controlled trial found that a 15-day regimen of oral prednisone was more effective in reducing the use of other medications and improving patient outcomes, compared to a 5-day regimen 5.

Considerations for Treatment

• The severity of the poison ivy reaction can impact the treatment approach, with more severe cases requiring longer courses of treatment 4, 5.
• Patients who present to the emergency department may require more aggressive treatment, including longer courses of oral corticosteroids 4.
• Education on appropriate treatment pathways for poison ivy may be needed to reduce healthcare utilization associated with undertreatment 4.