What is the treatment for poison ivy?

Treatment for Poison Ivy

Immediate washing with soap and water or a commercial decontamination product is the most effective first-line treatment for poison ivy exposure, and should be done as soon as possible after contact to remove the urushiol oil and minimize symptoms. 1

Immediate Management

1. Decontamination:

   • Wash the exposed area with soap and water or a commercial decontamination product immediately after exposure 1
   • Effectiveness of washing decreases rapidly with time:
     • 100% removal if done immediately
     • 50% at 10 minutes
     • 25% at 15 minutes
     • 10% at 30 minutes 1
   • Even washing 2 hours after exposure can reduce symptoms by 55-70% 1

2. Remove contaminated clothing:

   • Handle with gloves to prevent spreading the oil
   • Wash clothing separately from other laundry

Symptomatic Relief

For established rash and symptoms:

1. Cool compresses may provide relief of local symptoms 1

2. Oatmeal baths may help relieve itching 1

3. Topical treatments:

   • Over-the-counter hydrocortisone (0.2-2.5%) has uncertain effectiveness for poison ivy 1, 2
   • FDA-approved uses for hydrocortisone include temporary relief of itching from poison ivy, oak, and sumac 2

4. Antihistamines:

   • Evidence for effectiveness is limited 1
   • May help with sleep at night but questionable efficacy for daytime itching 1

When to Seek Medical Care

Medical evaluation is necessary for:

• Severe or widespread rash
• Facial or genital involvement
• Signs of infection
• Rash that doesn't improve with home treatment
• Difficulty breathing or swallowing (emergency)

Prescription Treatment Options

For severe cases requiring medical attention:

• Systemic corticosteroids (prescription required):
  • Most effective when combined with high-potency topical corticosteroids 1
  • For severe cases, a 14-15 day course is preferable to a shorter 5-day course 3, 4
  • Longer courses (15 days) reduce the need for additional medications compared to shorter courses 4

Common Pitfalls to Avoid

1. Delaying washing after exposure - effectiveness decreases dramatically with time 1

2. Using low-potency over-the-counter steroids - these have not been shown to improve symptoms significantly 1

3. Treating for too short a duration - shorter courses of systemic steroids (when prescribed) are associated with return visits and may require additional treatment 3

4. Scratching the rash - can lead to secondary infection

5. Burning the plants - can aerosolize the oils, causing respiratory exposure

Remember that poison ivy dermatitis is self-limiting and typically resolves within 2-3 weeks 5, 6, but proper early intervention can significantly reduce the severity and duration of symptoms.