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Clinician’s Corner: Poison Ivy Treatment

Treatment of Poison Ivy:

Last week we discussed avoiding the Toxicodendron family of plants. I can easily identify the plant, when it appears growing on the side of a tree or along a hedgerow,  The challenge becomes  when the leaves are chopped up by a weed eater, or a lawnmower!  So let’s discuss the treatment of poison ivy when a patient comes into your pharmacy or clinic.

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-need at least 14 days!

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

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 hinders treatment and is of minimal value for poison ivy. 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.
  • Your Thompson pharmacist can recommend Domeboro solution which is available over the counter: Directions: dissolve 1 packet in 1 pint of water, and apply as a wet dressing using a paper towel for 15-30 minutes 3 to 6 times daily.  This product greatly relieves itching.
  • Topical prescription steroids 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.

Your Thompson Pharmacist is your best source for information about over the counter treatment options, he can also work with your doctor to see that you get the best treatment available.  At Thompson Pharmacy… it’s all for YOU.