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.
- Topical corticosteroids, such as hydrocortisone, may not be effective in improving local symptoms, as demonstrated by a randomized, blinded trial involving 92 cases of Toxicodendron dermatitis 1.
- For severe cases with widespread rash or facial/genital involvement, see a doctor who may prescribe oral steroids like prednisone, as these cases may require more aggressive treatment.
- 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 reaction.
- If signs of infection develop (increased pain, swelling, warmth, pus) or if breathing difficulties occur, seek immediate medical attention.
From the FDA Drug Label
Uses For temporary relief of itching associated with minor skin irritations, inflammation and rashes due to: ● eczema ● seborrheic dermatitis ● psoriasis ● insect bites ● poison ivy, oak, sumac ● soaps ● detergents ● cosmetics ● jewelry ● external feminine genital and anal itching The treatment for poison ivy includes hydrocortisone (TOP) for temporary relief of itching associated with minor skin irritations, inflammation, and rashes due to poison ivy 2.
- Key points:
- Hydrocortisone (TOP) can be used for temporary relief of itching associated with poison ivy
- It is used for minor skin irritations, inflammation, and rashes due to poison ivy
- Other uses of this product should be only under the advice and supervision of a doctor
From the Research
Treatment Options
- Local treatment is sufficient for mild to moderate cases of poison ivy dermatitis 3
- Systemic corticosteroids can be added in more severe cases 3
- Treatment depends on the severity of the reaction, with the majority of cases manageable by a nurse practitioner, but physician consultation necessary for systemic involvement 4
- Prophylactic measures include avoidance, protective clothing, barrier creams, and hyposensitization 5
- Washing the area immediately with a solvent suitable for lipids and the use of anti-inflammatory agents, especially corticosteroids, are also effective treatments 5
Prevention and Identification
- Avoiding contact with the plant is the best practice to prevent urushiol-induced allergic reactions 6
- A hand-held Raman spectrometer can be used for confirmatory, non-invasive, and non-destructive identification of poison ivy 6
- Post-exposure prevention using a surfactant, an oil-removing compound, or chemical inactivation can provide significant protection against poison ivy dermatitis 7
- Different treatments, such as Tecnu, Goop, and Dial, have been shown to provide 70%, 61.8%, and 56.4% protection, respectively, when compared to the positive control 7
Management
- Assessing the severity of the dermatitis, prescribing an appropriate supportive therapy, and teaching preventive measures can assist patients with poison ivy dermatitis 4
- Extensive washing with soap and cold water can help reduce the severity of the rash, but there is no direct way to treat urushiol-induced allergic reactions 6