What is the treatment for poison sumac exposure?

Treatment for Poison Sumac Exposure

Immediate washing with soap and water or a commercially available decontamination product is the most effective first-line treatment for poison sumac exposure. 1

Immediate Management

• Wash the exposed area with soap and water or a commercial decontamination product as soon as possible after exposure - this can remove up to 100% of the urushiol oil if done immediately 1
• Effectiveness of washing decreases with time: 50% at 10 minutes, 25% at 15 minutes, and only 10% at 30 minutes after exposure 1
• Even washing 2 hours after exposure can produce 55-70% reduction in symptoms compared to no washing 1
• Remove all contaminated clothing, jewelry, and other materials from the area of exposure to prevent continued contact with urushiol 1

Symptomatic Treatment

• Apply cool compresses to the affected areas to relieve local symptoms 1
• Oatmeal baths may be considered for symptomatic relief of itching 1
• Over-the-counter topical steroids have uncertain effectiveness for poison sumac dermatitis 1
  • A randomized trial showed that low-potency hydrocortisone products (0.2% lotion, 1.0% ointment, 2.5% ointment, and 2.5% cream) did not significantly improve symptoms 1
• Over-the-counter antihistamines have uncertain effectiveness for relieving local symptoms 1
  • They may help with sleep at night but have questionable efficacy for itching 1
  • One observational study with 89 participants did not find statistically significant symptom reduction with oral antihistamines 1

When to Seek Medical Care

• For severe reactions or large areas of exposure, consult a healthcare professional 2, 3
• Medical attention is needed if the rash:
  • Involves the face, eyes, or genital areas
  • Covers a large portion of the body
  • Is accompanied by severe swelling, difficulty breathing, or fever 4, 5
• Prescription-strength treatments may be necessary for severe cases:
  • High-potency topical corticosteroids
  • Systemic corticosteroids for extensive involvement 1, 4

Effectiveness of Treatment Options

• Commercial decontamination products (like Tecnu), automotive hand cleaners (like Goop), and dishwashing soap all showed significant protection compared to no treatment 6
• Comparative effectiveness: Tecnu (70% protection), Goop (61.8% protection), and dishwashing soap (56.4% protection) - differences between these products were not statistically significant 6
• Cost considerations: Tecnu ($1.25/oz) versus Goop or dishwashing soap ($0.07/oz) 6

Important Considerations

• Poison sumac contains urushiol, the same allergenic compound found in poison ivy and poison oak 2, 3
• Approximately 50-75% of adults are clinically sensitive to these plants 3
• Symptoms typically appear 24-48 hours after exposure 2
• The rash can last up to 3 weeks, with severity proportional to the area and duration of exposure 1
• The rash itself is not contagious, but urushiol oil can be transferred from unwashed clothing or other items 4

Prevention

• Learn to identify poison sumac plants to avoid exposure 2, 3
• Wear protective clothing when in areas where these plants may be present 4
• Wash all potentially exposed clothing and equipment after outdoor activities 4
• Consider barrier creams or products designed to protect against urushiol if frequent exposure is anticipated 3