From the Guidelines
For poison ivy, immediate washing with soap and water is the most effective treatment to remove the urushiol oil and prevent the rash, with the potential to remove up to 100% of the oil if done immediately after contact 1.
Treatment Approach
To manage poison ivy, a multi-faceted approach is recommended:
- Washing with soap and water: As soon as possible after exposure to remove the urushiol oil, with the effectiveness decreasing over time, to 50% at 10 minutes, 25% at 15 minutes, and 10% at 30 minutes 1.
- Topical corticosteroids: Although their effectiveness is uncertain, especially for over-the-counter options like hydrocortisone 1% cream, they may be used to reduce inflammation and itching 1.
- Cool compresses and oatmeal baths: May be considered for relief of local symptoms, although their usefulness is based on expert opinion and limited evidence 1.
- Oral antihistamines: Their usefulness for alleviating local symptoms from poison ivy is uncertain, but they may help with sleep at night 1.
Prevention and Further Care
Prevention is key, including learning to identify poison ivy, wearing protective clothing, and washing clothing and equipment after potential exposure. For extensive rashes or those affecting sensitive areas, seeking medical attention may be necessary for further treatment, such as oral steroids. The rash itself is not contagious, but the oil can remain active on surfaces for years, making thorough cleaning essential to prevent continued exposure.
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 The hydrocortisone (TOP) can be used for the treatment of poison ivy, as it temporarily relieves itching associated with minor skin irritations and rashes due to poison ivy.
- Key points:
- Hydrocortisone (TOP) is used for minor skin irritations and rashes.
- It temporarily relieves itching associated with poison ivy.
- This product should only be used under the advice and supervision of a doctor for other uses 2.
From the Research
MDM for Poison Ivy
- Poison ivy dermatitis is an acute self-limiting problem that can cause significant discomfort, and treatment depends on the severity of the reaction 3.
- The majority of poison ivy cases can be managed by a nurse practitioner, but physician consultation is necessary if there is systemic involvement 3.
- Treatment regimens for poison ivy dermatitis vary, and common therapies include topical and systemic treatments, with attention given to complications of therapy 4.
- Approximately 50% to 75% of the US adult population is clinically sensitive to poison ivy, oak, and sumac, and there is a need for a better therapy to definitively prevent allergic contact dermatitis to these plants 5.
Treatment Patterns and Utilization
- A retrospective claims-based analysis found that healthcare utilization outcomes are impacted by prescription practices of systemic corticosteroids, and shorter duration oral corticosteroids are associated with increased risk for return visits 6.
- Emergency clinicians often offer oral corticosteroid prescriptions for shorter durations, which can lead to undertreatment and increased healthcare utilization 6.
- A randomized, controlled trial found that a longer course of oral prednisone (15 days) may be more effective in reducing the need for other medications and saving patients' time and exposure to excess medication 7.
Recommendations
- Treatment of poison ivy dermatitis should be based on the severity of the reaction, and systemic corticosteroids should be prescribed for at least 14 days to reduce the risk of return visits 6, 7.
- Healthcare clinicians should consider treatment of two to three weeks when providing systemic steroid coverage, especially for patients who present to the emergency department with more severe disease 6.