Best Poison Ivy Treatments

Exposure to poison ivy is problematic for many people, causing a condition known as contact dermatitis that is characterized by a rash and itching sensation.

Poison ivy can cause debilitating skin rashes especially when it affects the eye area. Poison ivy contains an oil called urushiol which is found in all parts of the poison ivy plant. My brother in law is very sensitive but some of his kids are not at all affected by the poison.  Studies estimate that between 80-85% of people are allergic to urushiol.

I recently got a consult from a patient in Wisconsin who had tried all the home remedies below and could not sleep at night due to the terrible poison ivy rash. She ended up needing the "big guns" below. 

First, though I would try the natural treatments listed below. 

First: Try to Avoid Poison Ivy at All Costs: "Leaves of 3 Let it Be!"

• each leaf has three leaflets
• leaf edges may be smooth or notched
• in the Northern and Western United States and Canada, poison ivy is a shrub. In the East, Midwest, and South, it's a vine

The leaves change also color with the seasons:

• spring - reddish with yellow-green flowers
• summer - green
• fall - orange, red, or yellow with off-white berries
• winter - leaves fall off, and the vine appears "hairy"

Second: if you are exposed, do this fast:

1. Remove all exposed clothes

2. Wash all exposed areas without rubbing with cold water

Third: Try these home remedies

Usually poison ivy rash clears up on its own. But  the itching associated with the rash can be difficult to bear, can even impact on sleep, and/or drive you crazy. 

The following poison ivy remedies may provide relief from symptoms:

1. Use Rubbing Alcohol

Rubbing alcohol can remove the urushiol oil from the skin, helping to minimize discomfort.

People should do this ASAP after contact with poison ivy, particularly within the first 10 minutes of exposure. If going camping or hiking, it is a good idea to carry alcohol wipes always.

The U. S. Food and Drug Administration (FDA) notes that urushiol can remain on the surface of most items that come into contact with poison ivy, sometimes for years, unless treated with rubbing alcohol or water.

2. Shower or Bathe Your Body

Thoroughly wash the skin, and under even the fingernails, with plain soap and lukewarm water to remove plant oils. Regular tap water can be used instead of rubbing alcohol, although it is best to use alcohol first and then shower or bathe.

Some reports note that showering within 60 minutes of exposure may help limit the spread and severity of the rash.

Wash all items that come into contact with the plant: always wear rubber gloves to do this.

3. Cold Compress or Ice Packs

Cool, wet compresses or ice packs (ie frozen peas) can help to reduce itching and inflammation.

To make a cold compress, run a clean washcloth under cold water; wring off excess water or wrap around ice pack or bag of ice. Apply to the skin for 15 to 30 minutes. Repeat this several times a day as needed.

Some people find relief by soaking the compress in an astringent liquid to further reduce swelling and itching, for example, aluminum acetate, apple cider vinegar, and chilled black tea.

4. Avoid Scratching Your Skin

Scratching the skin can lead to a cycle of inflammation and can even lead to an infection. It may also cause blisters to burst, which may become infected from the usual bacteria on your body's surface.

Leave all blisters alone: do not pop them. The blister's skin covering is protecting your body from a source of infection. 

Fingernails may also contain traces of urushiol, which can be transmitted to the skin through scratching. So wash under all fingernails to avoid further itching and a more severe poison ivy rash.

5. Use Over the Counter Topical Lotions and Creams

Over-the-counter creams and lotions may help to relieve the symptoms of a poison ivy rash.

Over the counter lotions that can help relieve the itching and swelling of a mild poison ivy rash are available without a prescription, such as:
1. Over-the-counter hydrocortisone creams
2. Calamine lotion
3. Aloe vera gel, taken from the aloe vera plant
4. Products containing zinc: The FDA advises:

• Applying topical OTC skin protectants, such as zinc acetate, zinc carbonate, zinc oxide, and calamine dry the oozing and weeping of poison ivy, poison oak, and poison sumac. Protectants such as baking soda or colloidal oatmeal relieve minor irritation and itching. Aluminum acetate is an astringent that relieves rash.

https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm049342.htm

6. Oral Antihistamines

Oral antihistamines help decrease the severity of allergic reactions, thereby reducing itching and rash, but avoid if you have glaucoma or narrow angles. Diphenhydramine (Benadryl) is one example that may also help some people sleep better through their symptoms.

Do not apply antihistamine cream to the rash, as it may make itching worse.

7. Oatmeal Bath

Some studies have shown that oatmeal has antioxidant and anti-inflammatory properties that benefit a variety of inflammatory skin conditions.

Adding oatmeal or an oatmeal-based product to a lukewarm bath can help: soaking in the tub for up to 30 minutes may provide symptom relief.

8. Bentonite Clay

Bentonite clay may help poison ivy rash after applying a paste of bentonite clay and water to the affected area.

Some sites and studies show that using a modified version of bentonite clay (quaternium-18 bentonite) effectively prevents or reduces the allergic contact dermatitis caused by poison ivy and poison oak.

9. Baking soda

Baking soda (aka, sodium bicarbonate) is a natural cleaning agent and may help. 

Add a cup of baking soda to the tub is recommended by the American Academy of Dermatology for relief from poison ivy rash.

10. "The Big Guns" Medication

In addition to natural and home-based poison ivy remedies, steroid medications such as topical and even oral prednisone may be needed to ease itching and inflammation.

These steroid medications come in a variety of forms including:

• creams
• gels
• injections
• lotions
• tablets

My favorite: 

1. Clobestol gel 1/4 inch to affected area 3-4x/ day often works well. 

2. Elocon 0.1% cream works also. 

Antibiotics may sometimes be necessary if an infection develops due to scratching the skin or picking at blisters.

When to see a doctor

Most cases of poison ivy dermatitis clear up without medical intervention. However, it is important to see a doctor if the rash:

• is near the eyes, mouth, or genitals
• covers a large portion of the body (over 25 percent of the skin)
• does not improve after 7 to 10 days
• contains pus or soft yellow scabs

Severe reactions with the following symptoms require emergency medical treatment:

• difficulty breathing
• difficulty swallowing
• fever
• rash near or in the mouth
• swelling of the eyes

Avoiding poison ivy rash

Poison ivy dermatitis is easier to prevent than it is to treat.

Recognizing and avoiding the plant is the best way to prevent poison ivy rash. However, the following tips can also help:

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• Wear protective clothing. Cover up when outdoors, or in areas where poison ivy is likely to grow. PVC gloves or thick gardening gloves can be useful, but thin latex gloves may allow the oil to penetrate through to the skin.
• Wear barrier substances. Certain products, usually containing bentoquatam, are available to reduce the symptoms of poison ivy contact if applied before exposure. These substances must be washed off within a few hours of exposure to the plant.
• Wash anything that comes into contact with the plant. The oil from poison ivy can linger for years. Anything that touches it must be thoroughly washed with soap and water to avoid contact with the skin.
• Remove poison ivy from the garden. It can be a challenging and dangerous job as all parts of the plant - even the roots - contain urushiol. Professional removal may be the best option. Never burn poison ivy as the smoke can cause severe reactions. Even the dead plant can cause contact dermatitis.
• Prepare a poison ivy kit. Keeping several poison ivy treatments on hand -including rubbing alcohol, water bottles, and soap - can allow for a speedy response to exposure, thus reducing the severity of symptoms.