From the Guidelines
For poison ivy, the usefulness of over-the-counter topical steroids to alleviate local symptoms is uncertain, and therefore, their use is not recommended as a first-line treatment. According to the 2024 American Heart Association and American Red Cross guidelines for first aid 1, the effectiveness of over-the-counter topical steroids in relieving symptoms from poison ivy, oak, or sumac is uncertain. Additionally, a study published in Circulation in 2024 found that topical corticosteroids that have been demonstrated to improve local symptoms are not available over the counter 1.
Instead, washing the affected area with soap and water or a commercially available decontamination product as soon as possible after exposure is recommended to remove the urushiol oil 1. Cool compresses 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 1. If the rash covers large areas, involves the face or genitals, or if you develop fever or pus-filled blisters, seek medical attention as stronger prescription treatments may be necessary.
Some key points to consider when treating poison ivy include:
- Washing the affected area with soap and water immediately after contact to remove the urushiol oil
- Considering cool compresses or oatmeal baths for relief of local symptoms
- Seeking medical attention if the rash is severe or widespread
- Avoiding the use of over-the-counter topical steroids as a first-line treatment due to their uncertain effectiveness.
From the Research
Topical Steroid Dose and Duration for Poison Ivy
- There is limited information available on topical steroid dose and duration for poison ivy in the provided study 2.
- The study primarily focuses on the treatment patterns and utilization of systemic corticosteroids for poison ivy dermatitis, rather than topical steroids.
- However, it is mentioned that most emergency clinicians offered oral corticosteroid treatment for shorter durations, with 86.26% of prescriptions being for a duration of 1-13 days, 10.80% for 14-20 days, and 2.95% for more than 21 days 2.
- The study suggests that treatment with oral steroids for at least 14 days is recommended, but most emergency clinicians offered this treatment for shorter durations, which was associated with return visits 2.
- It is recommended that emergency clinicians consider treatment of two to three weeks when providing systemic steroid coverage, especially for patients who present to the ED with more severe disease 2.
- There are no specific details on topical steroid dose and duration for poison ivy in the provided study, and more research may be needed to determine the optimal treatment approach.