Poison Ivy or Poison Oak Rash (Child)

Your child has a rash (dermatitis) caused by poison ivy or poison oak. This is an allergic reaction resulting in a skin rash caused by an oil (called urushiol) that's found in the poison ivy or poison oak plant. Symptoms can start in a few hours up to a few days after contact with the plant. They include an itchy rash, and red and swollen skin. Small blisters can form, which can then break and leak fluid. This fluid isn't contagious to others—only the plant oil can cause a rash. It's possible to come in contact with the plant oil again, if the oil is still on things such as clothes, pet fur, or under the fingernails. This can cause a new 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 can prescribe medicines to help ease itching and swelling. These can include steroid cream, antihistamines, and calamine lotion. For more severe cases, your child may need medicines taken by mouth (oral). These are often steroids. Or they may be given medicine by a shot (injection) into the muscle. Follow all instructions for giving these medicines to your child. A provider usually makes a diagnosis by looking at the rash and getting the child's health history. 

General care

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

  • Wash your hands with soap and clean, running 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 clean, running 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 stays on clothes, shoes, or other items can cause a rash even weeks later. Wash any clothes, shoes, or other items that touched the plant. Be sure to wash outdoor pets as well. The oil in poison ivy and poison oak can be transferred from their fur to your child's skin.

  • Tell 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 their fingernails with a nail brush, soap, and clean, running water. Also, keep their 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. Ask the healthcare provider if your child can take an oral over-the-counter antihistamine to ease itching, if needed.

  • 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 ease itching as well.

  • Expose the affected skin to the air so that it dries fully. 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 this advice for preventing poison ivy or poison oak rash:

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

  • The plant oils can stay on clothes, shoes, toys, or other items for weeks. So 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's poison ivy or poison oak, they should be cleaned. If not, they can rub the oils off on you and your children.

  • If your child is very sensitive, they should wear long shirts, pants, or gloves even when it's hot out. Learn what the plant looks like to prevent touching it.

  • If your child is very sensitive, think about using an ivy block skin product before they may be exposed. But there's no guarantee this will work.

Follow-up care

Follow up with your healthcare provider as advised.

When to get medical advice

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

  • Fever (see Fever and children, below)

  • Rash looks worse or doesn't 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 leaking or oozing from the blisters

  • Fussiness or crying that can't be soothed

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° (38°C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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