TREATMENT — Poison ivy dermatitis usually resolves within one to three weeks without treatment. The most common complication is bacterial skin infection; the risk of infection can be reduced by keeping the area clean and dry and avoiding scratching and rupturing the blisters. Signs of infection may include increasing redness, tenderness and pus. Some people develop skin color changes after poison ivy dermatitis resolves. These changes tend to occur in people with darker skin and usually resolve without treatment.
Treatments that may help alleviate the itching, soreness, and discomfort caused by poison ivy dermatitis include:
Topical therapies — For some people, adding oatmeal to the bath, applying cool wet compresses, and applying calamine lotion may help to relieve itching. Once the blisters begin weeping fluid, astringents containing aluminum acetate (Burrow's solution) and Domeboro may help to relieve the rash. A soap mixture called Zanfel may also relieve the symptoms.
Antihistamines — Antihistamines are medicines that help stop an allergic reaction, and they may be used to relieve itching in people with poison ivy dermatitis. Oral antihistamines are available in formulas that are sedating and nonsedating:
* Sedating formulas (eg, diphenhydramine [Benadryl®]) may be helpful for patients with difficulty sleeping as a result of poison ivy dermatitis.
* Nonsedating formulas (eg, loratadine (Claritin®), cetirizine (Zyrtec®) may be preferred for daytime.
Topical steroids — Topical steroids (applied to the skin) may be helpful if they are used during the first few days after symptoms develop. Low potency topical steroids (available in the United States without prescription) are of little benefit; most patients require a high potency prescription formula. High potency formulas should not be used on the face, genitals, or in skin folds due to the risk of adverse effects.
Steroids — Patients with severe or widespread poison ivy dermatitis (especially on the face or genitals) may need steroid pills or injections (eg, prednisone) to help relieve itching and swelling. Pills are usually given for 14 to 21 days, with the dosage slowly decreased over time.
Antibiotics — Patients who develop a skin infection because of poison ivy dermatitis may need antibiotics to treat the infection. Antibiotics are not helpful for people with poison ivy who do not have a bacterial infection.
Other treatments — An herbal therapy called jewelweed extract has been used to treat poison ivy dermatitis, although it has not been proven effective. Patients should avoid applying topical antihistamines (creams or lotions), anesthetics containing benzocaine, and antibiotics containing neomycin or bacitracin to the skin. These creams or ointments could make the rash worse.
