Pediatric Poison Ivy, Poison Oak and Poison Sumac

Poison ivy, poison oak and poison sumac are types of American plants. They each grow in different parts of the country. The plants cause allergic contact dermatitis in most people who touch them. The rash is caused by the body’s reaction to an oil in the plants called urushiol.

The first time your child touches one of the plants, they may not get a rash. This is because the body’s allergic response is not yet sensitive to it. The next time your child touches one of the plants, their body may react in 24 to 72 hours. The rash can’t spread from one person to another. But plant oils on skin and clothes can pass from one person to another and cause a rash.

The plants make an oil called urushiol. This oil gets on your child's skin if they touch the plants. And it’s easily spread from the plants to other objects. These include garden tools, clothing, toys and pet fur. Children can also inhale it from smoke if the plants are burned. Urushiol can stay active on any surface for a year or more and still cause skin rash. The rash doesn’t show up right away. But a child can spread the oils around their body without knowing it.

Poison ivy, oak and sumac rash is not contagious. It can’t be spread from person to person by touching the blisters, or from the fluid inside the blisters. But oil that remains on skin, clothes or shoes can be spread to another person and cause a rash.

Children are more at risk for the allergic rash if they:

• Go outdoors in an area where poison ivy, oak or sumac grow
• Don’t know how to identify and stay away from the plants
• Touch clothing or objects of someone with the rash
• Touch a pet who has been outside in contact with the plants

Symptoms can occur a bit differently in each child. The symptoms most often include a red, bumpy, itchy rash with fluid-filled blisters. The blisters break open, ooze fluid and then crust over. The area of skin may also be swollen. Swelling can mean the allergic reaction is more severe.

The symptoms of poison ivy, oak and sumac rash can look like other health conditions. Other plants and chemicals can cause a similar rash. Make sure to see your child's healthcare provider for a diagnosis.

Your child's healthcare provider will ask about their symptoms and health history. They will give your child a physical exam. The physical exam will include looking closely at your child's skin.

Treatment will depend on your child's symptoms, your child's age and their general health. It will also depend on how severe the condition is.

Treatment is done to reduce itching. Itching can be treated with any of these:

• Calamine lotion
• Steroid cream
• Baths with baking soda or colloidal oatmeal
• Steroid medicine by mouth or shot

Your child's healthcare provider may also prescribe antihistamine medicine. This medicine won’t relieve itching. But it may help your child sleep better and let them ignore the itch. Check with your child's provider if you have questions or concerns about taking an antihistamine. 

In some cases, your child may need urgent treatment if they have a severe reaction and swelling.

Talk with your child's healthcare providers about the risks, benefits and possible side effects of all medicines.

In some children, a severe reaction can occur. This causes swelling or trouble with breathing or swallowing. This is a medical emergency and needs treatment right away. If your child has a severe reaction, make sure this is documented in their medical records.

Infection is another possible complication. The areas can also become infected from scratching. Your child's healthcare provider may prescribe an antibiotic medicine to take by mouth.

To help prevent poison ivy, oak and sumac rash:

• Find out which of these plants grow in your area.
• Teach all family members to recognize the plants.
• Teach all family members to stay away from the plants when outdoors.

When your child goes outdoors:

• Encourage your child to wear long pants and long sleeves when in the woods or yard.
• Wash all clothes and shoes right away after being outside.
• Teach your child not to touch a pet that may have been in contact with one of the plants. Use gloves to wash your pet’s fur, if possible. Your pets can pass the oil on to you.
• Teach your child to wash their hands well, including under their fingernails.
• If your child is very sensitive or is often exposed to these plants, your child can use bentoquatam 5% cream (Ivy Block) on all exposed areas of their skin. This makes a layer of protection between their skin and any sap oil they may touch. Follow directions, because your child may need to reapply the cream. Even if they use the cream, still wear long pants and long sleeves.

If your child comes in contact with the plants:

• Remove the oil from your child's skin as soon as possible. This includes under their fingernails. The sooner they wash, the better chance of removing the oil (urushiol). This may help to make the reaction less severe.
• Gently wash your child's skin with lukewarm water (not hot) and plain soap three times. Rinse after each wash.
• If you don’t have soap, use alcohol-based wipes to remove the oil.
• Wash the clothes and shoes your child was wearing. The oil can stay on their clothes and spread from person to person.
• Teach your child not to scratch. Scratching can cause infection.

Call the healthcare provider right away if any of these are true:

• Your child has inhaled smoke from a burning plant
• The rash is on your child's face
• The rash is near your child's genitals
• The rash covers a large part of your child's body
• Your child has large blisters
• Your child has swelling
• Nothing relieves the itching
• Itching keeps your child from sleeping
• Your child has a fever of 100.4°F (38°C) or higher, or as directed by your child's provider
• The rash doesn't go away in a few weeks

Call 911 or take your child to the emergency room if your child has:

• Trouble swallowing
• Trouble breathing
• Swelling on their face or near their eyes