Poison ivy is the body’s response to allergen contact with urushiol oil, the resin of the plant. Most people will come into contact with the resin by touching it. However, inhalation and touching objects that have been in contact with the resin are also possible. As the old saying goes, “Leaves of 3, let it be.”
How do I know if I have it?
Signs and symptoms can vary from person to person. Some people are able to come in contact with the resin without response, while others will have an immune-mediated reaction. Typically the skin will appear red, swollen, and extremely itchy. Over the course of several days blisters will develop, break open, and weep. It is important to know that the fluid from the blisters will not transmit poison ivy, as they contain no resin.
I think I may have come into contact with the plant resin. What should I do?
Poison ivy will generally appear on areas that were not protected by clothing. Transmission is possible by touching clothing that has come into contact with the resin. Therefore, any clothing or tools that may have been in contact with the resin need to be thoroughly washed. It may be advisable to shower within 5 to 10 minutes after contact, but may only lessen your chance of having a skin reaction. Pets can also transmit the resin. If resin is present on their body or fur, it can be passed to humans through direct contact.
Most cases of poison ivy are able to be treated with over-the-counter (OTC) medications and/or topical products. However, if any of the following apply to you please seek treatment from your physician:
Exclusion for Self-Treatment
• Less than 2 years of age
• Reaction that involves a large proportion of the body (arms, legs, abdomen)
• Reaction and/or swelling of eyes, mouth, or nose
• Impairment of daily activities due to itching, pain, or other symptomatic discomfort
• Reaction lasting more than 2 weeks
What OTC products are available?
If you do not have any of the exclusion criteria then it is appropriate to treat with OTC products. There are several different options. Depending on your particular reaction and severity of symptoms, it may be advisable to start with non-drug therapies. Poison ivy is usually self-limiting, meaning the body can recover without any treatment in 2 to 3 weeks. However, there are options to treat your symptoms
Non-drug options include using a gentle soap free of perfumes, warm (not hot) shower, and cool compresses. The recommendations made in Figure 1 (above) can be tried for 2 days. If itching has not subsided within 2 days, try using a topical antihistamine, such as Benadryl® cream. If symptoms improve, follow your course of action until your conditions resolves or seek medical treatment if you experience no relief after a week of treatment.
Hydrocortisone cream is the most effective form treating symptoms associated with poison ivy. It is safe to apply to all parts of the body except the eyes and eyelids. It should be applied three to four times daily and is available OTC in strengths ranging from 0.25% to 1%. Hydrocortisone cream is not appropriate for children under the age of 2 or if the rash persists beyond 7 days.
Astringents may be used for weepy lesions to promote drying. Products are often used as soaks or in wet compresses that can be applied to the affected area several times a day up to 7 days. After using such products, you may notice that there will be drying and tightening of the skin.
Sodium bicarbonate paste or cold compresses can provide itch relief. To make a sodium bicarbonate paste, mix a small amount of sodium bicarbonate (Arm & Hammer Baking Soda®) and water and apply directly to the rash. Compresses should consist of clean cloths soaked in cool water applied to the skin for 20 to 30 minutes or as often as desired. Use a fresh cloth and solution with each application.
Oatmeal baths provide skin hydration, cleanse and remove skin debris, and protect against the drying and tightening of the skin. To make your own, place a packet of oatmeal into fast running water. Occasionally mix the oatmeal into the water as the tub fills to avoid excess clumping. Soak in it for 15 to 20 minutes at least twice daily followed by a pat dry.
With such a vast variety of products from which to choose, it may be hard to determine which one is right for you. Creams are appropriate for both weeping and non-weeping blisters, whereas ointments are only appropriate for non-weeping blisters. Gels may offer any easy method of application, with sprays being the easiest. Combination products may be useful for some, containing several of the above ingredients.