Fast Facts: Treating Poison Ivy, Poison Oak, and Poison Sumac

If you have come into contact with poison ivy, oak, or sumac and are looking for treatment options you are in the right place. This article is organized to provide you with just the facts in a short, easily digestible format.

Sections

What to do first

Treatment

Products to avoid

When to get your doctor involved

Final thoughts

References

What to do first

• Wash all areas of the skin that have come into contact with the plant thoroughly with soap and water as soon as possible! The oil that causes the rash, urushiol, takes about 30 minutes to be absorbed into the skin.² Washing quickly reduces the chances of getting a rash but also helps reduce rash severity, so do it even if you are past the 30 minute mark.
• Any mild soap will do. Premium products like Tecnu, Cutter Poison Ivy Scrub, and Zanfel are also available, but are pricy and may not be any more effective.
• Consider clipping your nails, especially if you have been scratching. The rash isn’t contagious, but residual oil under the nails can spread the rash.
• Clean all clothing, shoes, etc. that may have come into contact with the plant to remove the urushiol and prevent additional exposure
• Pets are a common source of exposure. If you haven’t come into contact with any plants, but have pets that spend a lot of time outdoors, consider giving them a shampoo as well.

Treatment

There is no best product for itching (pruritus), but there are a number of home remedies and products that will help.

Compresses, showers, and soaks

• you can make a cold compress by wetting a washcloth with cold water and draping it over the affected area. The gentle skin contact and cool sensation provide temporary relief of itching. Refresh the water in the compress as it starts to warm up.
• cold or lukewarm showers are also helpful, especially for larger rashes.
• soaking in a lukewarm bath with powdered (colloidal) oatmeal for 15-20 minutes can be really helpful. If you have a blender you can make your own by grinding 1 cup of plain oats to a fine powder and adding it to your bath. Companies like Aveeno also make convenient pre-made packets.

Pharmacist Favorite

• For excessive weeping and oozing consider trying Domeboro. It comes as a powder that you mix with water and can be used as either a soak or in a compress. I prefer using it in a compress. Mix according to the package instructions (1 - 3 packets in 16oz of cool water). Dunk a washcloth in the solution, wring it out, and apply it loosely to the affected area. Leave it on for 15-30 minutes. Repeat up to 3 times per day.

Pharmacist Favorite

Topical creams, lotions, and sprays

• For mild itching on small areas you can try hydrocortisone cream 1% (Cortizone 10). Apply a thin film to the affected area 3-4 times daily. If you are using Domeboro or doing oatmeal baths consider applying just after a treatment for longer lasting relief.

Pharmacist Favorite

• For larger areas Cutter also makes a hydrocortisone spray

Pharmacist Favorite

• Caladryl and Caladryl Clear are two popular lotions that can help with itching and weeping blisters. They contain a skin protectant (calamine or zinc acetate) and an itch reliever (pramoxine). The original Caladryl contains calamine, which is pink and can stain clothes, so I prefer the clear product. You can apply it by gently dabbing with a cotton ball or using your fingers 3 - 4 times per day.

Pharmacist Favorite

• Ivarest Poison Ivy Itch Spray is another option for quick coverage of large rashes. It has the same active ingredients as Caldryl Clear and can be applied 3 - 4 times per day.

Pharmacist Favorite

Products to avoid

• Ointments of any kind. They can sometimes make the itch worse or trap bacteria if there are broken blisters.
• Topical products with antihistamines like Benadryl Itch Stopping Cream (diphenhydramine). They don’t work.
• non-drowsy oral antihistamines (Claritin, Allegra, etc.). The rash from poison ivy doesn’t involve histamine. These are unlikely to provide benefit. If appropriate, oral diphenhydramine (Benadryl) may help with sleep for nighttime symptoms.
• Antibiotic creams and ointments. They aren’t helpful and can actually make symptoms worse.³
• Products with lidocaine, benzocaine, or other active ingredients that end in -caine. They can make itching worse.^1,3
• Hot showers/compresses should also be avoided as they usually intensify itching.¹
• Skip any barrier products for preventing poison ivy. There isn’t any proof that they work.³ Avoiding the plants is a better plan.

When to get your doctor involved

• If you have a rash on your face, near your eyes, or on your genitals
• If the rash is extensive and covers large portions of your body
• If you have a rash with broken skin that you believe may have become infected (symptoms such as puss, swelling and heat, fever, redness that is quickly spreading beyond the itchy part of the rash)
• the rash hasn’t gotten better after a week with over the counter treatment
• The symptoms are unbearable and affecting work, sleep, etc.

Final thoughts

The cheap and free options on the list (cold compresses, showers, and oatmeal baths) are all things worth trying. For additional symptom relief my personal over the counter favorites are Domeboro and Caladryl Clear. Domeboro is great for itch relief when you are at home relaxing and need to dry out weeping and oozing blisters. Caladryl Clear is my goto for symptom relief when you have activities planned or need to work.

Keep in mind that these products are helpful, but there aren’t any magic bullets here. If you are extremely sensitive to urushiol or your rash is very large you may find these products are not enough. Some cases of poison ivy require prescriptions for topical steroids or oral steroids. Get seen by a health care provider if you need it.

References