How to Treat Poison Ivy

While poison ivy or poison oak may not lead to life-threatening events, the intense itching brought on by being exposed to said plants is enough to drive one batty!

The urushiol oil contained in the resin released from the poison ivy, oak, or sumac plant creates an allergic contact dermatitis in about 50% of people who are exposed to the oil.  The reaction almost always involves red, inflamed, circular lesions, which will start “weeping” within a few days, along with the out of control itching mentioned above.

So, what can you do about these symptoms? Not much!  I know, that’s a terrible, no good answer, but it’s the truth.

Your first step after exposure is to wash the affected area with soap and water, which should help rid your skin of the urushiol oil.  Actually, not only should you wash the affected area, you should also wash underneath your fingernails, as this area becomes a safe haven for the oil, which can then be spread to other parts of your body. To assist in the washing procedure, you can use an OTC chemical inactivator, like Tecnu or an oil-removing compound, such as Goop, but just plain soap is a fine option too!

According to studies, there seems to be no significant difference in effectiveness when it comes to comparing the aforementioned options, so instead of spending the extra money for Tecnu or Goop, go grab the Dove (or whatever you’re soap of choice happens to be!).  Oh yeah, dishwashing detergent works wonders as well…I’d say find the sale and stick with that!

I guess I should mention a product called Zanfel –an OTC wash that works similar to soap, but for about 5 times the price!  Apparently, Zanfel is thought to work a little better at improving the lesions but doesn’t do anything more for the itch when compared to your everyday soap.  With this info in mind, I do not recommend Zanfel!

           Next step: dry the weeping lesions.  To do this you can use an OTC product called Burow’s solution.  Also, using calamine lotion, soaking in an oatmeal bath, or applying cool compresses may also help dry up the rashes and reduce the itching.

            I wouldn’t waste my money on over-the-counter hydrocortisone cream because it’s probably not strong enough to help out.   However, the prescription steroid creams can do some good if they are started before the lesions breakout and if less than 10% of your body is affected.

            I do not recommend using topical antihistamines like Benadryl cream or antibiotic ointments like Neosporin because they don’t help with the itching and they can worsen the rash.  It is possible that oral antihistamines would help, but probably more for their sedative effect rather than their ability to calm the itch or rashes!

If lesions cover greater than 25% of your body or if you have lesions on your face or genitals, it’s probably best that you see a physician.  At this point, it’s likely that you need an oral corticosteroid (aka oral steroid) to calm the rash down!

If your physician gives the nod on the steroid pill and they prescribe a Medrol Dosepak, have them change it to prednisone because the starting dose on the Medrol Dosepak is too low and the duration of therapy is too short for poison ivy.

Prednisone 60mg/day for 4 days, then decreasing that by 10mg every 2 days would be a decent regimen for most adults (14 days of treatment).

For children, a good suggestion for a prednisone regimen would be 1 to 2mg/kg once daily for 7 to 10 days, then taper down for another 7 to 10 days (14 to 20 days of treatment).

It is important to taper down when it comes to the steroid treatment because otherwise the lesions may flare back up.

There you have it…not much you can do, right?  You pretty much have to wait it out.  The irritating and extremely itchy rash will actually go away on its own within 1 to 4 weeks, but you can certainly use the recommendations above to help control the symptoms.

Let us know if you have other tips on how to control the symptoms of poison ivy, oak or sumac by leaving a comment below!

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5 comments

  1. Not really a comment. Are there any preferred antibiotics for posion ivy that are not a flox derivative? I have heard very nasty things about that antibiotic.

  2. Hi Allan,

    Typically antibiotics are not needed to treat poison ivy. However, if there is a secondary infection -it can be treated with clindamycin, cephalexin and Bactrim. All of these antibiotics are available in generic and are not flox derivatives.

    Primary treatment for poison ivy includes oral antihistamine (Benadryl, Claritin, Zyrtec, etc), cool compresses, oatmeal bath, wet/cold compresses and hydrocortisone cream.

    Thank you for the comment/question. Hope this helps!

    Nova

  3. Hi Nova, I`m Jude, 53. Thanks for listening.
    I was given Ciprofloxacin for a bad case of poison ivy in
    September of 2008. After just one dosage my body fell
    apart physically and mentally. I was very healthy, strong active and happy. I`m in bad pain and deep depression now.
    There are tens of thousands that have been crippled from
    this toxic drug. They have finally black boxed it.
    I`m alone in the country. Can you recommend anything
    that I can do or take for this hell I`m going through?
    I just want to make aware at least one person, pharmacist or doctor of this horrible drug. Question everything your doctor gives you. Just seems the big drug
    companies are winning over healing, sadly. My best to all.

  4. My doctor prescribed prednisone 20mg for poison ivy rash. I was directed to take 60 mg for five days, then 40 mg for five days, then 20 mg for five days, but I’m concerned that doesn’t taper down slowly enough. Am I right? I think your regimen sounds better.

  5. It should be noted that Prednisone can have serious side effects, in my case a near-mania. The Medrol I was next prescribed was better, but I have seen many mentions that 6 days is probably not enough. Last, for OTC Zanfel is the *only* thing that helps me, and many others swear by it—but the price is outrageous at about $30-40/ounce.

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