The Best Treatments for Poison Ivy

Q. My kids get poison ivy a few times each year and, even with treatments, they still have an itchy rash for a few weeks. What are the best treatments for poison ivy? -- Tim, Heath, TX

A. You would think that a poison ivy rash would be as easy to treat as it is to recognize. Unfortunately, it isn't that easy. Choosing the type of steroid to use, as well as the dose to give, carefully is very important to ensuring that your child's poison ivy goes away as quickly as possible.

Mistakes that are often made in treating poison ivy include:

• mistaking poison ivy for some other rash, such as impetigo, chickenpox, or chiggers
• using an over-the-counter-strength topical steroid, which usually isn't strong enough for anything but the most mild cases of poison ivy
• using a prescription-strength topical steroid cream or ointment when a child has moderate or severe poison ivy and really needs an oral steroid for symptom relief
• taking an oral steroid at too small a dose or for too short a time (such as a prepackaged steroid dose pack); this may help relieve symptoms at first, but they may flare up again after a few days.
• only relying on OTC poison ivy "cures" and not visiting your pediatrician
• using topical antihistamines or topical anesthetic creams or ointments, which can lead to further irritation and reactions

Poison Ivy Treatment

The best treatments for poison ivy usually include:

• cold, wet compresses that can be applied to itchy areas of your child's skin for 15 to 30 minutes a few times each day
• cool or lukewarm colloidal oatmeal baths
• anti-itch creams, such as Calamine Lotion, Caladryl Clear Topical Analgesic Skin Lotion, Itch-X Anti-Itch Gel with Soothing Aloe Vera, or Aveeno Anti-Itch Cream with Natural Colloidal Oatmeal
• oral antihistamines to help control itching, such as Benadryl or Atarax (hydroxyzine), a prescription strength oral antihistamine
• topical steroid creams, including prescription-strength medium- to high-potency steroids
• oral steroids, such as Orapred (syrup or disintegrating tablets) or Prednisone (pills), that are usually taken twice a day for at least 7 to 14 days
• a steroid shot, Kenalog (triamcinolone acetonide)

Keep in mind that oral steroids and steroid shots are typically reserved for children with moderate to severe poison ivy. These children have a poison ivy rash on several areas of their body, may have swelling of their face, or have an intensely itchy rash.

In addition to treatments from their pediatrician, some parents also try an OTC poison ivy medication, such as Ivarest Medicated Cream, IvyStat, Tecnu Extreme Poison Ivy Scrub, or Zanfel Wash For Poison Ivy, Oak & Sumac.

_Sources:

Habif: Clinical Dermatology, 4th ed.

Plant poisoning. Froberg B - Emerg Med Clin North Am - 01-MAY-2007; 25(2): 375-433