Poison Oak Dermatitis (Child)

Your child has poison oak dermatitis. This is an allergic reaction resulting in a skin rash caused by the oil found in the poison oak plant. 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 healthcare provider can prescribe medicines to help relieve itching and swelling. These can include steroid cream, antihistamines, and calamine lotion. For more severe cases, your child may need oral medicines (usually steroids), or an injection into the muscle.  Follow all instructions for giving these 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.

  • Plant oil that remains on clothing, shoes, or other items can cause a rash even weeks later. Wash any clothing, shoes, or other items that touched the plant. Be sure to wash outdoor pets as well. The oil that causes poison oak can be transferred from their fur to your child's skin.

  • Instruct your child not to scratch the rash. Scratching can lead to infection. It can also cause the rash to spread if any plant oil remains under the fingernails. To help prevent problems, have your child scrub under the fingernails with warm, soapy water and a nail brush. Also, keep the child’s fingernails trimmed short. You may need to put mittens 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.

  • Have your child bathe in cool water. Adding oatmeal powder or aluminum acetate powder to the water may help soothe itchy skin. These are available over the counter. Applying cool, wet compresses to the rash, 3 to 4 times per day can help relieve itching as well.

  • 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.

  • Watch for the signs of infection listed below.

Prevention

Follow these recommendations for preventing poison oak dermatitis:

  • Over-the-counter products can help remove the plant oil from the skin after exposure. The sooner you remove the oils, the better. Although the oils can start penetrating the skin quickly, it can still help hours later.

  • Since the plant oils can remain on clothing, shoes, toys, or other items for weeks, wash anything that touched the plant.

  • The oils can also get on your pet fur. If your pet has been in an area where there is poison oak, they should be cleaned, otherwise they can rub the oils off on you and your children.

  • If your child is very sensitive, he or she should wear long shirts, pants, or gloves even when it is hot out. 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. However, there is no guarantee this will work.

Follow-up care

Follow up with your healthcare provider as advised.

When to seek medical advice

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

  • Fever (see Fever and children, below)

  • Rash appears to worsen or does not respond to treatment after 1 week

  • Rash spreads to the face (especially around the eyes) or groin areas, causing swelling

  • Signs of infection, including pain, increasing redness or swelling, or cloudy fluid drainage or oozing from the blisters

  • Fussiness or crying that can't be soothed

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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