From the Guidelines
To manage urushiol-induced contact dermatitis, immediately wash the affected area with soap and water to remove the plant's oil, as this can remove up to 100% of the oil if done immediately after contact. This is supported by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. The effectiveness of washing with soap and water decreases over time, with a 50% reduction at 10 minutes, 25% at 15 minutes, and 10% at 30 minutes.
Key Management Strategies
- Washing with soap and water as soon as possible after exposure
- Using commercial decontamination products, commercial hand cleaners, or dishwashing soap and water can produce 55% to 70% reductions in local symptoms, even when used 2 hours after urushiol application 1
- Topical corticosteroids may be recommended for symptomatic treatment, but over-the-counter options may not be effective, as evidenced by a randomized, blinded trial involving 92 cases of Toxicodendron dermatitis, which found no significant improvement with 0.2% hydrocortisone lotion, 1.0% hydrocortisone ointment, 2.5% hydrocortisone ointment, or 2.5% hydrocortisone cream 1
Additional Considerations
- For severe reactions, consulting a doctor for prescription-strength corticosteroids may be necessary
- Preventative measures, such as learning to identify the plant, wearing protective clothing, and using barrier creams, can also be effective in reducing the risk of exposure.
From the FDA Drug Label
Uses temporarily relieves itching associated with minor skin irritations, inflammation, and rashes due to: ... poison ivy, oak, sumac The management of urushiol-induced contact dermatitis may include the use of hydrocortisone (TOP) to temporarily relieve itching associated with the condition, as it is used for minor skin irritations and rashes due to poison ivy, oak, sumac 2.
From the Research
Management of Urushiol-Induced Contact Dermatitis
The management of urushiol-induced contact dermatitis involves several approaches, including:
- Prophylactic measures such as avoidance, protective clothing, barrier creams, and hyposensitization 3
- Washing the affected area immediately with a solvent suitable for lipids 3
- Use of anti-inflammatory agents, especially corticosteroids 3
- Topical application of quaternium-18 bentonite lotion, which has been shown to prevent or diminish experimentally produced poison ivy and poison oak allergic contact dermatitis 4
Treatment Regimens
Treatment regimens for urushiol-induced contact dermatitis may vary, but common approaches include:
- Topical therapies, such as corticosteroids and barrier creams 5, 3
- Systemic therapies, which may be used in more severe cases 5
- Measures to avoid allergic contact dermatitis, such as education on how to identify and avoid contact with poison ivy and related plants 6
Current Research and Developments
Current research is focused on developing more effective therapies to prevent and treat contact dermatitis caused by poison ivy, oak, and sumac, including the development of a vaccine (immunotherapy) 7. However, despite these efforts, there is still a need for a better therapy to definitively prevent allergic contact dermatitis to these plants 7.