Corticosteroids and poison ivy, oak, or sumac rash

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Corticosteroids and poison ivy, oak, or sumac rash

High-dose prescription corticosteroid medications can reduce the symptoms of a poison ivy, oak, or sumac rash (allergic contact dermatitis ) and sometimes shorten the length and severity of a rash. These medications are usually reserved for more severe cases of the rash, such as when it covers about a quarter of the body's surface skin or when the face, hands, and genitalia are significantly affected. Prescription corticosteroids are available as tablets, as creams, gels, or ointments, or as injections.

• Tablets taken orally (usually prednisone) can dramatically reduce the symptoms caused by a moderate or severe reaction to poison ivy, oak, or sumac. Oral corticosteroids generally are more effective than other forms of these medications for poison ivy, oak, or sumac and are usually taken until the symptoms are gone. How much medication you take and for how long often depends on how soon you seek help after the rash appears.
• Creams, gels, and ointments applied to the skin may help reduce itching and redness. These types of corticosteroids have no effect on blisters but may be useful after blisters have disappeared.¹ They should be used for the recommended amount of time because the rash can reappear if they are stopped too soon. None of these products should be used on the face or genitals because they can cause the skin to become thin and fragile.
• Injections (triamcinolone diacetate) are sometimes used when you cannot take oral medication. Improperly injected corticosteroids can cause skin damage such as skin discoloration and scarring.

Prolonged use of oral and injected corticosteroids can cause serious side effects, such as thinning of the bones (osteopenia), slowed growth in children, and increased risk of an ulcer or infection. Talk with your health professional about your risks when using these medications.

High-dosage corticosteroids should not be confused with nonprescription, short-duration hydrocortisone creams, gels, or ointments, which may soothe itching in mild cases of poison ivy, oak, or sumac rash. These nonprescription products are not recommended for severe cases because they are not strong enough and may not be used long enough to be effective. They may appear to work for a time, but the rash often suddenly flares up again, sometimes worse than before.

References

Citations

1. Peate WF (2002). Occupational skin disease. American Family Physician, 66(6): 1025–1032.

Credits

Last updated:	January 12, 2006
Author:	Colleen Cronin
Reviewed By:	Patrice Burgess, MD - Family Medicine, H. Michael O'Connor, MD - Emergency Medicine
Editors:	Susan Van Houten, RN, BSN, MBA, Tracy Landauer