Poison Ivy Part 3

If you encounter that evil weed, poison ivy and were not able to get the urushiol washed off in time, you will begin to see the rash. It appears as red patches, that eventually blister and after a couple of weeks dry up and resolve. At Nickman’s we see lots of cases of this bothersome rash, here are our recommendations. Sometimes you will need to call on your physician for appropriate prescription treatment, based on the extent of the rash.

You need to see a doctor when:

  • Over 25% of body surface area is contaminated, or if any sign of infection.
  • Limited but disabling involvement (hands, face, area around mouth/eyes, or genitals)
  • If you have a history of severe reactions

Treatment of poison ivy-needs to be treated at least 14 days!

  • Oral prednisone: 0.5 to 2mg/ kg / day tapered over 14 to 21 day period. Usually start with 60mg per day, and taper down over 14-21day period. Using a 21-day regimen will decrease the likelihood of rebound dermatitis.
  • Medrol dosepak (6-day therapy) is not long enough of duration. This treatment is not long enough and may cause rebound symptoms.

Topical treatment of poison ivy

  • Oatmeal baths might be soothing but are not of much value. They might make the tub slippery and clog the drain!
  • Calamine actually hinders treatment and is of minimal value for poison ivy. It will help with the itching. Hydrocortisone 1% OTC is of limited value—use only in mild cases.
  • Avoid: topical antihistamines, topical anesthetics, topical antibiotics, as well as poison ivy extracts. Jewelweed (Impatiens biflora) extract is promoted for relief of poison ivy, but is of no value. Avoid oral antihistamines like diphenhydramine (Benadryl) and others because allergic contact dermatitis does not respond to this therapy.
  • Burow’s solution is available over the counter: (aluminum acetate): dissolve 1 packet (Domeboro®) in 1 pint of water and apply as a wet dressing for 15-30 minutes 3 to 6 times daily. Greatly relieves itching. Compresses with isotonic saline (one teaspoon salt per two cups water), diluted white vinegar (1/4 cup per pint water)
  • Topical prescription corticosteroids are most effective in early stages BEFORE the blisters form. They will help with itching and promote drying of the lesions. They are of little value once the blisters form.

Now for the good news from the Anacardiaceae family: This family also includes cashews, pistachios and mangos!