First Aid for Poison Ivy, Oak and Sumac Rash

Contact with poison ivy, oak, or sumac exposes skin to urushiol oil, triggering an itchy, blistering allergic reaction. Prompt first aid can limit rash severity, reduce spread, and relieve discomfort.

Also, some creams or ointments can make your rash worse. Don’t use any of these:

• Antihistamine creams or lotions
• Anesthetic creams with benzocaine
• Antibiotic creams with neomycin or bacitracin

Why Does the Rash Occur?

A child will not develop an allergy to poison ivy until he has touched the plant at least once or twice before. Subsequent skin contact with the plant triggers these antibodies, causing certain skin cells to release the chemical histamine, which is responsible for much of the swelling, itching and blister formation.

The allergy-causing substance in poison ivy, oak and sumac is an oily resin called urushiol. All parts of the plants contain this resin. Urushiol can get on clothing, pets and (especially) hands and be easily spread from one part of the body to another, which is why poison ivy rashes are usually widespread.

Signs and Symptoms

• an itchy red rash that appears within 4 hours to 4 days after touching the plant oil
• blisters that ooze clear fluid
• bumps and blisters that may be different sizes and look like streaks on the skin
• rash may begin to look crusty as it heals

First Aid for Poison Ivy, Oak, and Sumac Rash

1. Immediate Actions

People who have come in contact with poisonous plants should do the following first aid steps:

1. Immediately rinse the skin with clean water, rubbing alcohol, or a specialised poison plant washer. If you prefer, you can also use degreasing soap (like dishwashing soap) or detergent and flush it with lots of water. Rinse it a few times to ensure that applied solutions do not dry the skin and spread the urushiol oil further. Do not forget to scrub under your nails with a brush.
2. Apply wet compresses, calamine lotion, or hydrocortisone cream to the affected area. Using these medications may help the skin to reduce itching and blistering. When using these items, follow the directions on the packaging. Do not apply to exposed or broken skin, such as open blisters. Oatmeal baths are also recommended to relieve itching.
3. Remove and wash all clothing, shoes, gloves, and tools that may carry oil; wear disposable gloves when handling contaminated items to avoid re-exposure.
4. If a pet was exposed, rinse its fur with mild soap and water while wearing gloves to prevent transfer of oil back onto skin or fabrics
5. Take antihistamines such as diphenhydramine (Benadryl) to help relieve symptoms. Follow the manufacturer’s suggestion on the package. If a small child also comes in contact with any item contaminated by urushiol, consult a pediatrician. They will help you determine the appropriate dosage for your child.
6. In severe cases of plant poison or if the rash starts spreading on the face or genitals, seek immediate medical care.

2. Symptomatic Relief

• Apply cool, wet compresses to soothe itching and reduce inflammation; use for 15–30 minutes, several times daily.
• Take short baths or showers in lukewarm water; add colloidal oatmeal or 1 cup baking soda to the bath to calm skin irritation.
• Use calamine lotion or a 1% hydrocortisone cream on affected areas to ease itch avoid stronger OTC antihistamine creams, anesthetic or antibiotic ointments, which can worsen rash.
• For nighttime relief, consider oral diphenhydramine (e.g., Benadryl) to help with sleep, though it does not alter rash duration or severity.

What to Do

• Remove any clothing that has touched the plant or rash and wash all recently worn clothing.
• Gently wash skin and scrub under fingernails right away with soap and water.
• Cut fingernails short to keep your child from breaking the skin when scratching.
• Place cool compresses on the skin as needed.
• For itching: add oatmeal to the bath; use calamine lotion on the skin (but not on the face or on the genitals); and, if needed, give your child the recommended dose of diphenhydramine (Benadryl or a store brand).

When to Seek Medical Attention

Only if large blisters develop over extensive areas, or if the rash is near the eyes. A rash that starts out resembling poison ivy but spreads over most of the body or fails to improve after a week or so also should be checked out by a doctor. In addition, medical attention is necessary if a baby under one year of age gets a rash that resembles poison ivy.

Prevention of the Rash

• Avoid poison ivy, oak and sumac plants, and teach your children to do the same. Poison ivy may be a low bush or vine, and its pointed leaves grow in clusters of three. It can be found practically anywhere east of the Rocky Mountains. Poison oak also grows in three-leaf clusters, but the leaves are more rounded than those of poison ivy. The poison oak plant is most common in the Western states. Poison sumac bushes have pointed leaves that grow in fronds. These plants grow mainly in the damp area of the Southeast.
• Have children wear long pants and sleeves when they walk in wooded areas with thick underbrush.
• Do not allow children to play in undergroomed areas at the edges of lawns and parks.
• Do not let pets roam freely, particularly if there are wooded areas in your neighborhood.
• Use a product called Technu soap to prevent a reaction in skin that has been touched by poison ivy or a similar plant. Rub the soap onto the skin as soon as possible after the exposure. Technu soap may be applied repeatedly.
• Remove clothing that has touched poison ivy, oak or sumac plants, and immediately wash it in hot water.

REFERENCES

1. RCHSD, First Aid: Poison Ivy/Oak/Sumac, https://www.rchsd.org/health-article/first-aid-poison-ivy-oak-sumac/
2. John Furst, First Aid Treatment for Poison Ivy, Oak and Sumac Rash, Updated July 2, 2018, https://www.firstaidforfree.com/first-aid-treatment-for-poison-ivy-oak-and-sumac-rash/
3. First Aid courses, Summertime First Aid: Poison Ivy, Oak, Sumac, August 7, 2020, https://thefirstaidcoursemelbourne.com.au/blog/summertime-first-aid-poison-ivy-oak-sumac/
4. Paige Fowler, Treatments for Poison Ivy, Oak, and Sumac, June 05, 2024, https://www.webmd.com/allergies/understanding-poison-ivy-oak-sumac-treatment

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