Poison Ivy Dermatitis (Child)

Poison ivy dermatitis is a skin rash. It is caused by the oil found in the poison ivy plant. The oil is called urushiol. Symptoms can start within a few hours to a few days after contact with the plant. They include an itchy rash, redness, and swelling of the skin. Small blisters can form, which can then break and leak fluid. This fluid is not contagious to others. Only the plant oil can cause rash. The rash usually starts to go away after 1 to 2 weeks, but it may take 4 to 6 weeks to fully clear.

Home care

Your child’s healthcare provider may prescribe medicine to help relieve itching and swelling. These may include steroid cream, antihistamines, or calamine lotion. For more severe cases, oral medicine or medicine injected into a muscle  may be given. Follow all instructions for giving medicines to your child.  The diagnosis is usually made by the clinical appearance and the history.

General care

  • Follow the healthcare provider’s instructions on how to care for your child’s rash.

  • Wash your hands with soap and warm water before and after caring for your child.

  • The rash can spread if traces of the plant oil remain on your child’s skin and under fingernails. Gently wash the affected areas of the skin and under fingernails with soap and warm water. If needed, over-the-counter products can be used to help remove the plant oil from the skin shortly after exposure.

  • Bathe your child in cool water. Adding oatmeal powder or aluminum acetate powder to the water may help soothe itchy skin. These are available over the counter.

  • Expose the affected skin to the air so that it dries completely. Don't use a hair dryer on the skin.

  • Dress your child in loose cotton clothing.

  • Make sure your child does not scratch the affected area. This can delay healing. It can also cause a bacterial infection. You may need to use soft “scratch mittens” that cover your child’s hands. Keep your child’s nails trimmed short. You may need to put gloves on small children to prevent scratching. Hydrocortisone cream (1%) is available over the counter and can reduce itching. Benadryl may be given by mouth if the itching is bothersome.

  • Put cold compresses on your child’s sores to help soothe symptoms. Do this for 30 minutes 3 to 4 times a day. You can make a cold compress by soaking a cloth in cold water. Squeeze out excess water. You can add colloidal oatmeal to the water to help reduce itching.

  • You can also help relieve large areas of itching by giving your child a lukewarm bath with colloidal oatmeal added to the water.

  • Make sure to wash the clothes your child was wearing when in contact with the plant. This washes away the plant oil that gave your child the rash and prevent more or worse symptoms.

  • If you have pets that play outdoors, be sure to wash them as well. The oil that causes poison ivy can be transferred from their fur to your child's skin.

  • Check your child’s skin every day for the signs of a worsening rash or infection listed below.

Prevention

Follow these steps to help prevent poison ivy dermatitis:

  • If your child is exposed to poison ivy, use a poison ivy wash to remove the plant oil from the skin. Poison ivy wash can be bought in a drugstore with no prescription. The sooner you remove the oil, the more it will help prevent rash. The oil can irritate the skin quickly, but a wash it can still help hours later.

  • Wash anything that may have touched the plant oil. This includes clothing, shoes, and toys. Oil can stay on these items for weeks if not washed.

  • The oil can also get on a pet’s fur. If your pet has been in an area where there is poison ivy, clean your pet’s fur. Otherwise the animal can rub the oil on you and your children.

  • If your child has very sensitive skin, he or she should wear long shirts, pants, or gloves even when it is hot outside. Learn what the plant looks like to avoid touching it.

  • If your child is very sensitive, consider using an ivy block skin product before they are potentially exposed. There is no guarantee that this will work, however.

Follow-up care

Follow up with your child’s healthcare provider, or as advised. Contact your child’s healthcare provider if the rash is not better in 2 weeks.

Special note to parents

Wash your hands well with soap and warm water before and after caring for your child. This helps prevent infection.

When to seek medical advice

Call your child’s healthcare provider right away if any of these occur:

  • Redness or swelling that gets worse

  • Symptoms that don’t get better after 1 week of treatment

  • Rash spreads to the face or groin, causing swelling

  • Pain, redness, or swelling that gets worse

  • Foul-smelling fluid leaking from the skin

  • Fussiness or crying that cannot be soothed

  • Fever (see Fever and children, below)

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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