Treating Poison Ivy, Poison Oak, or Poison Sumac

My boyfriend has had poison ivy for four days now and has been using Hydrocortisone to stop the itch. He claims that it will cure the rash. I refuse to see him until he sees a doctor. Am I overreacting?
Silver Spring, Maryland

Treating Poison Ivy, Poison Oak, or Poison Sumac

Dr. Greene’s Answer:

From the tone of your question, I’m guessing that you have had poison ivy at some time in your life and that it was not a pleasant experience. If this is the case, you are not alone — by the time most people reach adulthood they have had some type of unpleasant rash caused by a contact allergy. These allergic reactions can be caused by contact with metals (such as nickel), shoes, fragrances (found in creams and lotions), preservatives (found in cosmetics), topical medications, and by certain types of plants.

Poison ivy, poison oak, and poison sumac together produce more cases of allergic contact dermatitis than all other allergens combined. The resulting rash can range from mildly unpleasant to a true emergency with intense swelling, blistering, and oozing. With even a moderate case, as you may have experienced, the itching can seem unbearable.

In a previous answer, I described some surprising facts about where this rash comes from and how it might spread. In this answer I will focus on what to do once you have been unfortunate enough to contract poison ivy, poison oak, or poison sumac. Most of the treatments are aimed at reducing the itching, until the self-limited rash runs its course, which takes about two weeks. Since easing the itching is the important result, trial and error works very well. If one of these suggestions seems to work, by all means, stick with it.

Most people find that cool compresses in one form or another are quite soothing. Try using a towel or wash cloth soaked in either plain tap water or Burow’s Solution (an astringent solution — you can make it yourself using Domeboro tablets or powder packets available over-the-counter). This can help relieve the intense itching and remove dry crust that has formed as a result of the rash. A fan blowing over the cool compress will diminish some of the heat of the itching and help to dry up some of the ooze coming from the rash. As the skin is cooling, the blood vessels compress and that cuts down on the itching and the new ooze. This is especially good during the two or three worst days of the rash. Along the same lines, some dermatologists recommend rubbing an ice cube gently over the rash several times a day, then letting the skin air dry. Soaking in a tub, particularly using an oatmeal bath such as Aveeno, can also be very soothing to the itch. Be sure the bath is cool or lukewarm — but not hot — as heat tends to make the rash even more inflamed.

After the cooling (using any of the forms mentioned above), coat the rash with a shake lotion such as calamine. This continues to relieve the itching and helps to dry up the blisters. Be sure to check the expiration date on an old calamine bottle in your medicine cabinet, since it may not be effective after the expiration date. Be sure the shake lotion does not contain benzocaine, zirconium, or a topical antihistamine, such as benadryl. These can actually make the rash worse by producing their own allergic reactions when applied to already sensitive skin.

Smearing on hydrocortisone (as your boyfriend has done), or other topical corticosteroids, will help suppress the itching and give temporary relief, but does little to hasten the drying up of the rash. Similarly, taking an oral antihistamine, such as benadryl, can help with the itching quite a bit, although it does not speed up resolution of the rash. Taking benadryl at nighttime will make most people drowsy and help them sleep through the night without itching. Again, don’t use benadryl cream or spray topically, because this can cause its own reaction.

The goal of reducing itching is brought about by cooling (by constricting the blood vessels), by drying the rash, or by quieting down the allergic response.

In severe cases of poison ivy, poison oak, or poison sumac, it is a good idea to see a doctor. Sometimes large blisters need to be drained, and sometimes an oral steroid such as prednisone may be useful. Systemic steroids produce rapid resolution of both the itching and the rash. If they are needed, a gradually tapering dosage over about 12 days should be given. The dosage needs to be tapered to avoid side effects after discontinuing use, and the entire course should be taken since stopping earlier may result in a rebound rash as bad as the original.

Allergy shots are available to help prevent recurrences of the poison ivy, poison oak, or poison sumac rash. Unfortunately, the shots for this are frequently ineffective and should be reserved only for those who are extremely sensitive. Prescription pills containing small amounts of extract from the plants have been used for immunization. However, these pills can cause uncomfortable side effects. The pills are recommended only if given before contact with the plant and only for individuals who come into frequent contact with the plant. Using topical creams (such as Ivy Shield, IvyBlock, Hollister Moisture Barrier, Stokogard Outdoor Cream, or Hydrophil) can also help protect against contracting the rash.

So, to answer your questions —

1) Hydrocortisone cream will certainly help relieve the itching for some people — obviously your boyfriend is one of them.
2) Most poison ivy rashes will self-resolve within 14 days without treatment; probably your boyfriend’s will as well.
3) If his rash is severe or if it doesn’t resolve within 14 days, he should see a doctor.
4) As for whether you are overreacting — having had poison ivy myself, I can understand your reaction, but I’m not sure if your boyfriend does :~>.

By the way, though, the rash itself is not contagious.

Dr. Alan Greene

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

  1. kim mascari

    I am highly allergic to poison ivy oak and sumac.what’s worse I’m allergic to almost every steroid Neosporin ointment and lots of pain meds.Went to Dr last year and they almost killed me with steroid shot what can I do.think in air eyes swlled and cheeks

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    • Larry

      Are you in Charleston West Virginia I have tried everything to get a shot and take pill

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  2. Michelle

    Hi, I’m curious as to the connection between benzocaine and poison ivy. I had a horrible outbreak of poison ivy when I was 16, my entire legs were covered in blisters and swollen for over a month. Since then I have had an occasional random rash break out.

    I was tested to see what else I may be allergic to and topical benzocaine came up. Did the poison ivy cause this?

    I was also told that since I can handle numbing agents that are injected it’s probably actually a preservative in the ointment.

    Has anyone had strange breakouts after their experience with poison ivy? I’m recently battling a situation where I’m taking 4 types of antihistimes a day to keep rashes and hives under control with no known cause…I was in urgent care 2xs and the ER due to extreme joint pain and swelling and rashes…

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  3. Jason

    For those with long bouts, please make doubly sure you are not reinfecting yourself via garden tools, wallets, steering wheels, door handles, or any other common surface you may be touching. If the oil is there, you are possibly reinfecting.

    I worked with poison ivy a week ago, and did not get it. Four days later, I moved the shears in the trunk of my car and whammo — I have it, but mildly.

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    • Phil

      Keep in mind, it often takes hours, to few days, before symptoms of poison ivy appear. So you could have still had it in the first contact.

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  4. Dawn Davis

    Yes it is contagious my fiance has it and if you were in contact with him and he still had oils of the plant on him you will surely get it it may take a couple days after contact with him but you will get it

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    • Ion Health

      The “rash” itself is not contagious. The oil, Urushiol is, only if it has not been properly washed off the contaminated person. Using dawn detergent and a wash cloth for some friction (to ensure your actually wiping it off, as it sticks like a grease would), wash the areas 3 times. That is typically enough to ensure there is no residual oil left on the body. Also, 3 washes within 2-8 hours, on the person that came in contact with the plant, can avoid the rash altogether, in most cases. It is not an instant rash, so wash every area thoroughly and you may not have to suffer any symptoms. Any items such as clothing and shoes/boots may also contain the oil, so proper cleaning of anything that may have come in contact with the oil is also necessary. Best to you….

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      • Sally

        What is the proper way to wash away the poison ivy oil from
        door knobs, phones, steering wheels etc. ?

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        • You are right that it is very important to get the oil off of all surfaces that may have come in contact with poison ivy oil. (This is true for poison oak and sumac as well.)

          You can use a product that is sold just for this purpose. Most sporting goods stores and some drug stores have them. If that’s not readily available, use full strength dish washing liquid and a rough towel. The friction from the towel is a big help. Then rinse with water.

          Be sure to wear gloves while you clean and either use disposable towels or wash them thoroughly before using them again.

          I hope that’s helpful.

          @MsGreene

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  5. Amy

    Well that’s a nice long reply to a question–wonderful thing about the Internet. :-)

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  6. Thomas guest

    I’ve always got poison ivy since I was a little kid use to get it bad I hadn’t got it in years till I just started working for a tree service company I started about a week ago it was just on my right arm then I got it on my left arm then a guy from work told me to pour bleach on my arm and that it would dry it up well I did that and it started to work but later in the week it started to get really bad it had turned into a rash on both arms and on my stomach and on my lower back how can I prevent from getting it again because I always work around it

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  7. Matthew

    I get a poison ivy rash just about every other time I mow the lawn. (6-8 times since June) I live on 5 acres that has a lot of places for this vine to grow happily. I have found the best thing you can do is take a cold shower. Just stand in the shower and let the water rinse it all off. Soaps, especially with degreasers like dawn does makes it spread worse. It takes 2-3 days before it shows up on me, so sometimes I’m past the point of taking a cold shower. When this happens I wash EVERYTHING I have touched. Pillow case, sheets, clothes, shoes, door knobs, the shower, and all the parts I’ve touched in my vehicle. Washing some of them multiple times if I can’t rinse freely. I.e. Steering wheel seat belt. Don’t forget any garden tools you may have used. Shovels, the whole lawn mower, the wheel barrel, and anything else you may have used/touched.

    Once you wash the original oils (urishiol) it will not spread. It doesn’t spread from the rash or the pus from it. By following this I have not spread it to my wife or any of my 3 little girls. And I stay home with the youngest so I have to touch her alot when changing clothes, diapers, and cleaning up after eating.

    To keep it relatively itch free I rotate between witch hazel, calamine lotion, and quick shot cortisone spray. If its on more than just my arms and hands I usually go to the doc to get a cortisone shot and/or a benadryl shot.
    Steroid creams help also.

    Its usually itch free 3-4 days after I start my regimine and I can quit everything except a steroid cream to help heal the rash at this point and its completely gone about a week after that.

    Keep in mind if you identify the place you got it from, it will ALWAYS have the oil on it. Leaves, stems, and roots in every season. Even winter.

    Hopefully this will help y’all out

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  8. Doreen

    We live on an Island where the major plant is the famous Poison Ivy Vine. I kept using all these costly creams/antidotes and still itched (it drives you crazy trying not to scratch). Then a very good friend told me to take a warm baths using Fels-Naptha Soap (its a long yellow bar of soap). It works like a charm every contact of Poison Ivy!!

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  9. Robert

    I am an American living in the mountain jungles of Panama. I recently began to notice a poison ivy like rash on my hand. Knowing that it was not poison ivy, I was perplexed as to how I got it. Except for picking a few mangoes off my backyard tree, I had been glued to the computer for 2 days. The irritation grew and I headed to the internet with only a notion that it could be from the mangoes. Well, good news, not from mangoes, bad news SAP from mango tree that squirted all over my hand was the culprit. Seems the same bad poison chemical in poison ivy/oak, is found in some varieties of mango trees.

    Any hoo, I’m trying Domeboro. All the locals say this is the best for that poison “urushiol” which is found in poison ivy, oak, and now mango trees. Good news…trees are easy to spot…they are the ones with the mangoes hanging from them! :)

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    • Thanks for the heads-up. I’m sure glad mango trees tend not to attach humans — unless they are stealing their fruit ;)

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  10. Maddie

    I just moved from the city to the country & caught poison ivy….. I use a liquid product called “grape fruit seed extract oil”. I use it topically with a Q-tip & ingested it to help prevent it from spreading.

    Hope this helps

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  11. Wayne McQueen

    I had gotten into poison sumac this spring cleaning up my yard. I’ve tried all the lotions and even the steroid pack that a friend gave me, several times it had almost cleared up but not completely, I’m going on the THIRD MONTH of symptoms from this weed and have finaly made a Dr appointment, but after reading other comments I am in disbelief that I have had it for this long, considering ER

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    • Mimi

      My boyfriend has had it for nearly 2 months now. He’s tried otc creams and scrubs….and it just kept getting worse. Finally went the doctor because we were going to be leaving for vacation soon. The doctor gave him a shot, some oral meds, and a prescription cream. It helped a little but now it is worse than ever.
      What’s the next step to go about ending this misery? I feel so bad for him.

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      • Jeanie

        What got rid of it?

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    • Lct

      Though my comments are too late to help you, I hope you received oral steroids from your doctor. Poison sumac is much worse than poison ivy. I was on oral prednisone for SIX months after contracting it.

      >To kill the plants <
      Spray them with vinegar – plain white vinegar is fine (and cheap). It is otherwise environmentally benign.

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  12. fred

    Many years ago there was a product available that worked very well to relieve the effects of poison ivy rash. It was even issued to linemen working for the telephone company. It’s name was AntIvy, and one of the active ingredients was a zirconium compound. It also had an antihistamine in the mix. I see that it was discontinued because apparently in some cases it was reported to have caused some sort of skin irritation. Poison ivy rash IS a skin irritation. Anyway, I obtained some zirconium oxide and made up my own poison ivy lotion and for me, at least, it works. It isn’t an instant remedy but it helps quite a bit. AntIvy lotion worked for many other people too. I do not understand just why your advice specifically warns against it.

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  13. Garnet

    Can you get poison oak by drinking surface water. We are on a spring and our water runs on the surface and then is collected in our spring box. We have two filters and a UVA light. I have broken out with a rash for the last two years at the same time of the year. June. We live in Oregon

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  14. Reyna Ortiz

    I have had poison ivy for 2 days — today will be the third. Anyways the rash is on my face on my lips and on my cheeks. I also have it in some other parts. Is it good to use hydrocortisone? Please get back, thank you!

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    • Jackson

      No I would recommend going to a local quick aid asking for a steroid shot and a pack of steroid prescription pills you will see improvement with in the first day and it will be gone in 4 days

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  15. Nicole

    I’ve had poison ivy for a week and a half now and it’s been soooo itchy. The otc cream hasn’t been very helpful in that regard. However, I’ve also been having a bad bout of seasonal allergies and took an Allegra today and it seems to have really helped the itch as well as the respiratory symptoms I’ve been having from the unrelated allergies.

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  16. Jill Hinckley

    I had a small round spot in the inner aspect of my right elbow for over a month. Because I had had eczema in the past, I was convinced this was eczema. It didn’t itch.

    One day I developed this angry, raised rash on the inner aspect of my left arm, below the elbow.
    I associated this with eczema and began treating it with as such, with lotions, keeping moist. (This was first mistake because need to keep poison ivy rash dry.)

    It spread, the itching was unbearable, and I tried countless OTC treatments. The rash continued to spread. I finally got an appointment with a dermatologist 5 days out. M.D diagnosed me with poison ivy. He prescribed two medicines. A steroid ointment and hydroxizine. Well, the ointment was over $100 a tube, so I did not get it.

    I ended up self-treating and found that lukewarm soaks, calamine lotion, vinegar-soaked compresses, hydrocortisone cream helped temporarily. (Tried many things, including alcohol and witch hazel.)

    What did help the most? I think bathing with Dawn dishwasing liquid once to get rid of urishiol oil from plant may have helped. Then soak in astringent helped dry some. Happened upon a remedy that I believe helped. I had an old clay masking agent for face. I used this on rash and I believe this dried out some of the rash.

    This is day 9 and still I have some spreading and itching, but do feel better. But I had to endure the rash and itching for the course of the rash.

    Everything I read said that it didn’t spread from scratching or oozing blisters, but as much as I bathed and laundered, I can’t imagine how else it spread.

    MISERABLE!

    This affliction has been maddening. I don’t know when I was exposed, but possibly on my dog’s fur.

    I do believe I did have eczema.

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    • SJW

      I actually mixed baking soda with a little water and used it like calamine lotion. It really helped to cool the blistered area and seems to be helping dry it up. I read on another site that the substance that causes the rash actually gets into your blood and attach to your white blood cells and thats what makes it pop up on other areas of your body. Also said if you catch it within the first few days you can get a steroid shot or a dose pak and this will block your white blood cells to keep the itchy bumps from spreading.

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  17. beth

    My boyfriend we believe got poison ivy in the back yard Monday. We noticed the rash Wednesday and blisters. He’s covered from his arms, few on face and all over stomach and underarms. The blisters on his arms are huge and stick way up off his skin. Should he go to the ER? In can I catch it, I have slept on couch and try not to touch him, but I get allergy shots weekly. I didn’t this Wednesday due to him having rash and I didn’t wanna have a reaction, but can I catch this from him or by what he touches in the house?

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  18. Stanley Kimmett

    I have poison ivy, which has formed the small blisters. Should I drain/pop and treat these or do whatever I can to not “pop” them?

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    • Colton

      I have always been told by my physician to not pop the blisters. Doing so tends to lead to more spreading do the rash. The blisters themselves are actually sterile and will prevent any infection when left alone. I have had this stuff over 25 times and I am highly allergic… I guess I’ll never learn my lesson ha-ha.

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  19. piper

    I have poison oak and I was wondering what temperature should the shower be?

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    • Smokey@aol.com

      The colder the better. Hot water opens the pores and allows for the rash to spread.

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      • Dr Rob Wilkins, MD

        The rash does not spread that way. The only way the rash can spread is if those other parts of your body also came in contact with the oil from the plant.

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  20. jonathan

    what do you use to treat poison sumac

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    • Sean Deehan

      Poison sumac, oak, and ivy can all be treated the same way…. with disdain! No seriously, you can treat sumac just like you’d treat oak.

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