WHAT ARE THE TREATMENTS FOR POISON OAK OR POISON IVY?

* Be aware that the recommended treatments of illnesses are always being improved. This website was last update on 11/1/2024. The best treatment option MIGHT have changed since that time.

1. Over the counter sprays
- Tecnu * must be applied within 2 hours after exposure
- Zanfel *

2. Calcineurin Inhibitors - ONLY USE if corticosteroid can not be used.  Associated with cancer.
- tacrolimus topical 0.03% *
- pemecrolimus topical 1.0% * 

3. Steroid Creams
- fluticasone prppionate topic 0.05% *
- betamethasone dipropionate O.05%*
- clobetasol 0.05%*

4. Antihitamine
- cetirizine *
- diphenhydramine *
- hydroxyzine *
- promethazine (Phenergan) 6.25-12.5 mg *

5. Immunosupressive therapy
- azathiiprine *
- cyclosporine *
- mycophenolate mofetil *

6. Oral prednisone is 1 mg/kg/day (maximum initial dose 60 mg/day) tapered over two to three weeks. Example, prednisone is given at a dose of 40 mg for five days, 20 mg for five days, 10 mg for five days, and then discontinued. 15-day courses only rarely result in rebound dermatitis

CAUTION:

1. If someone is exposed to smoke from burning poison ivy, oak, or sumac, it can cause a reaction in the lung. The lung reaction can be severe enough to cause difficulty breathing and death if not treated early.
2. A “6-Day” Methylprednisone Dose Packs should be avoided because there will likely be a rebound dermatitis.
4. A high-strength corticosteroid cream used for more than 7 days might start to thin a person’s skin.
5. Prednisone is best to taken in the morning because it makes some people and anxious, which may cause insomnia especially if taken late in the day.
6. Topical agents such benzocaine, topical antihistamines, and topical antibiotics containing neomycin, or bacitracin are of little value and are not recommended. 7. All medications have a risk of side effects.
8. Mild side effects are nausea, vomiting, diarrhea, itching, and light skin rash.
9. Possible Severe side effects are a severe skin rash, an anaphylactic allergic reaction (leading to the inability to breathe and subsequent death if not treated rapidly), and Clostridioides difficile infection (C. Diff.) of the colon.
10. Medications such as creams, lotions, and gels should be tested in small dosages in areas of the body that are not easily seen.

Consult “Epocrates.com” for each Specific Medication’s possible “Adverse Reactions.” Side effects are also referred to as “Adverse Reactions.” Epocrates.com will tell you both “common reactions” and “serious reactions.” You will have to create an account, but it is simple, fast, and free.

WHAT ARE THE SYMPTOMS OF POISON IVY OR POISON OAK?

The most characteristic sign of Poison Ivy and Poison Oak is a streak of redness and blister from where a plant’s oil resin touches a person’s skin. However, sometimes the plant’s resin will get spread out from scratching or wearing clothing, and this will cause the typical streak to spread out. The rash may also have blisters and swelling, and cause an intense itch.

WHAT CAUSES POISON IVY OR POISON OAK?

The cause of the Poison Oak or Ivy rash is contact with a plant oil resin that contains urushiol. Urushiol is an irritant, which is contained in poison oak, poison ivy, poison sumac, and some other plants. This urushiol chemical causes an allergic reaction, which leads to the characteristic redness, blisters, and itching—and sometimes pain.

HOW IS POISON OAK OR POISON IVY DIAGNOSIS?

The diagnosis of Contact Dermatitis (Poison Oak or Poison Ivy infection) can be made by a careful history, and visual inspection of the skin.