Allergic Contact Dermatitis: Poison Ivy

Rhonda Goodman, PhD, ARNP, FNP-BC; Deborah Hollimon, MS, ARNP, FNP-BC

Disclosures

Dermatology Nursing 

In This Article

Treatment

Immediate (within 15 minutes of exposure) treatment begins with a thorough cleansing of the affected area with plain soap, especially the hands and palms. The urushiol may be carried on the palms for hours, unable to penetrate the thicker palmar surface of the skin. The patient should remove all clothing, including shoes, which may have come in contact with the urushiol. Cold, wet compresses may be applied to affected areas three to four times daily for 20 minutes. Burrow's solution may be used and can help to reduce itching and inflammation. Over-the-counter (OTC) products which are helpful are Aveeno® baths, calamine lotion, promoxine, and Sarna® lotion. Another effective OTC product is Zanfel®, which is used to remove the urushiol from the skin, providing relief from itching and erythema. In addition, topical steroids may be prescribed, such as a hydrocortisone 2.5% cream. If pruritus control is difficult to achieve, oral antihistamines may be used as well. Oral corticosteroids may be indicated in adults who have extensive lesions. If secondary bacterial infections occur, it may be necessary to prescribe oral antibiotic therapy (Graham, 2003). Infants and children who present with extensive lesions should be referred to a dermatologist. This patient was treated with topical hydrocortisone 1% cream applied twice daily for 7 days, cetirizine 10 mg once daily by mouth, Aveeno baths, and Zanfel. Within 3 days, the patient's rash was almost completely gone and the itching subsided. The patient's father cleared the yard of the poison ivy.

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