Poison Ivy, Oak, and Sumac: Online Diagnosis and Treatment

Poison ivy, oak, and sumac all produce urushiol oil, which causes skin rashes in sensitive people. If you’ve ever experienced the itchy, blistering rash that comes with poison ivy/oak/sumac exposure, you know you want to avoid contact with these plants, but you also know that being outside is good for your mental and physical health. Knowing what the plants look like and how to avoid and treat the rash can help reduce your chances of developing plant-associated contact dermatitis.

The weeping, itchy rash caused by poison ivy/oak/sumac is the most common contact dermatitis suffered by people living in North America. It affects between 10 and 50 million people each year. The peak frequency for urushiol sensitivity is between 8 and 14 years of age. About 50% to 75% of the U.S. adult population is urushiol sensitive. In urban areas, about one in five adults is sensitive.^1,2 Poison ivy and other allergic contact dermatitis result in an estimated 43,000 emergency department and 100,000 clinic visits yearly.³

Scheduling a consultation with a virtual doctor on the Telegra MD telehealth platform for poison ivy/oak/sumac diagnosis and treatment is simple and convenient. You will receive a diagnosis, personalized treatment protocol, and an appropriate online prescription to ease your symptoms. Telehealth for poison ivy/oak/sumac treatment makes it easy to consult with a virtual doctor and receive prescription medication to treat your poison ivy/oak/sumac quickly and easily, even if you don’t have insurance. Schedule an appointment today. Without treatment, your rash is likely to last several weeks.

What Is Poison Ivy/Oak/Sumac?

Poison ivy, oak, and sumac cause allergic contact dermatitis (rashes). They are members of the plant family Anacardiaceae in the genus Toxicodendron (formerly Rhus). Plants in this family include poison ivy, poison oak, and poison sumac. They are ubiquitous in North America. They all produce the highly allergenic plant produce oleoresin urushiol, an oil in the plant’s leaves, stems, roots, and fruit. Urushiol is colorless, with a slight yellowish hue, but turns black when exposed to air. It retains its ability to cause an allergic rash indefinitely. Even minimal contact with the leaf in the fall (red leaves) and winter (dried-out plant parts) can cause severe dermatitis.¹

Poison ivy leaves have three leaflets, poison oak has 3 to 5, and sumac can have 7 to 13 leaflets. All three plants have clusters of green fruit that grow at the angle between the twig and the leaf.¹

What Are the Common Symptoms of Poison Ivy/Oak/Sumac?

After exposure to poison ivy/oak/sumac, a sensitized person can expect:

• Red, intensely itchy rash within 48 hours of exposure
• Streaks of redness
• Vesicles and larger fluid collections called bullae
• Swelling
• Respiratory symptoms if urushiol is aerosolized in smoke

Without treatment, the rash typically lasts for three weeks but can last as long as six.¹

Can Poison Ivy/Oak/Sumac Be Treated Through Telehealth?

Consulting a medical professional via telehealth is a convenient way to diagnose and treat poison ivy/oak/sumac. You can schedule an online medical consultation appointment with a virtual doctor using the Telegra MD platform and receive a personalized treatment plan. Your virtual doctor can give you tips on managing your symptoms and call your online prescription to a local pharmacy. Online doctors who prescribe poison ivy/oak/sumac treatment medications provide 24-hour appointment access, which means you can expect doctor access whenever you need it, leading to an earlier diagnosis and treatment.

Why Do You Get Poison Ivy/Oak/Sumac?

You get poison ivy/oak/sumac if you are one of the millions of people whose immune system has been sensitized to urushiol. The urushiol is similar in all three plants, so if you react to one, you will probably react to all three of them.

After initial contact, urushiol catechols bind to and penetrate your skin. They are oxidized to quinone intermediates and bind to surface proteins on antigen-presenting cells in your skin’s immune system. The antigen-presenting cells stimulate T cells, forming a clone of urushiol-specific effector T cells and memory T cells. Memory T cells mount a faster immune reaction the next time you are exposed to urushiol.¹

The severe itch from poison ivy/oak/sumac triggers scratching and further skin injury. Scratching increases inflammation and stimulates nerve fibers, resulting in more itch. This cycle of itching and scratching can lead to skin infections.⁴

Contrary to popular opinion, vesicular fluid does not contain the immune sensitizer or antigen that causes the rash. Touching a blister does not spread poison ivy/oak/sumac.

So why does the rash appear to spread? Poison ivy rash appears on various body parts at different times depending on how much urushiol comes in contact with the skin and skin thickness. Thinner-skinned areas with large exposure to the oil will break out more quickly than thicker-skinned areas with lower exposure.

Urushiol oil is stable indefinitely and can be found under fingernails, on gloves, clothing, tools, equipment, and on pets. Touching these objects and transferring the oil to your skin can cause new skin rashes.

Are Some People at Increased Risk for Poison Ivy/Oak/Sumac?

Anyone who is sensitive and spends time outdoors is at risk of poison ivy/oak/sumac. Avoidance is key to reducing your risk but is frequently impractical. Light clothing can be protective but be very careful when removing and cleaning clothing as it may harbor urushiol and can cause the rash. Wear dry, loosely woven fabrics and vinyl gloves to protect yourself.⁵

Desensitization programs to reduce sensitivity to urushiol have not been successful. Consuming poison ivy/oak/sumac leaves or injecting plant extracts has not worked and can result in serious rashes. Your sensitivity to urushiol varies throughout your lifetime. This is likely the reason for anecdotal reports that people have outgrown or are no longer sensitive to urushiol.

Children of parents who are allergic to poison ivy are 80% more likely to be sensitive as well.⁵    As researchers investigate the pathophysiology behind the itch/scratch cycle, the possibility of more effective poison ivy treatment or prevention becomes more likely.⁴

How Do You Diagnose Poison Ivy/Oak/Sumac?

Poison ivy/oak/sumac is typically diagnosed based on a history of exposure and having the characteristic rash.

How Do You Treat Poison Ivy/Oak/Sumac?

Once your skin has been exposed to urushiol, you have minutes to remove it before being sensitized.

• At 10 minutes after exposure, washing with soap and water will only remove about half of the urushiol.
• At 15 minutes, only 25% of the oil can be removed.
• At 30 minutes, only 10% of the oil can be removed.
• After 30 minutes, all the oil has been absorbed.¹

All exposed pets, clothing, and tools should be washed with soap and water.

Over-the-counter products that may remove urushiol after exposure and prevent or reduce rash include the following:

• Tecnu (Tec Laboratories): an organic solvent that prevents clinical symptoms in about 70% of sensitized people if used within 2 hours of exposure. Goop and Dial Ultra Dishwashing soap may provide equal protection.⁶
• Zanfel (Zanfel Laboratories): in a small study, symptoms were improved when participants with poison ivy rash washed at 48, 96, and 144 hours.⁷

Symptomatic treatment for itching from poison ivy/oak./sumac:

• Take colloidal oatmeal or baking soda baths using lukewarm water.
• Use cool compresses to ease itching.
• Apply calamine lotion if you are not sensitive to it.
• Take oral histamines such as diphenhydramine or hydroxyzine to relieve symptoms at night by making you sleepy. Oral antihistamines are not helpful in reducing itch.⁸
• Apply Burrow’s astringent solution to cool and dry poison ivy rash.

Prescription medications to reduce symptoms and rash include the following:³

• High-potency topical corticosteroids can be used to treat a mild rash that involves localized areas.
• Oral glucocorticoids are prescribed to treat more extensive rashes or when the rash extends to the face, eyes, hands, or genitalia.
• Antibiotics may be needed if scratching leads to secondary infection.

When treating poison ivy/oak/sumac, taking the following steps is not beneficial and may be harmful:⁹

• Using a heavy-duty skin cleanser, alcohol, or other strong solvent.
• Scrubbing your skin excessively.
• Using corticosteroids prescribed for other uses. They may not be strong enough, and the course may not be long enough to treat allergic dermatitis, leading to a rebound flare-up.
• Using topical antihistamines because they can cause a sensitization rash.

When Should You See a Doctor for Poison Ivy/Oak/Sumac?

If you are unsure whether your rash is due to poison ivy/oak/sumac or it is moderate to severe in intensity, make an appointment to see your doctor. See your doctor if you have:

• A rash on your face or genitals
• A widespread rash
• Yellowish honey-colored crust over the rash
• Painful rash
• Swelling in your mouth, lips, tongue or airway
• Difficulty breathing
• Fever
• Itch and other symptoms that cannot be controlled with over-the-counter medications

Telehealth for poison ivy/oak/sumac treatment is the perfect option. You can schedule an online appointment with a virtual doctor using the Telegra MD platform and receive a diagnosis based on the appearance of your rash and a history of exposure. Your virtual doctor can give you tips on reducing your symptoms and call in a prescription to a local pharmacy. Online doctors who treat poison ivy/oak/sumac provide 24-hour appointment access, which means you can expect doctor access whenever you need it, leading to an earlier diagnosis and treatment.

Obtaining a poison ivy/oak/sumac treatment plan after seeing a doctor online through telemedicine is similar to seeing your local doctor. In both cases, you would:

• Make an appointment: Typically, appointments to see virtual doctors through telehealth are much easier to make and are more convenient than in-person appointments, as many telemedicine companies provide online telehealth services for poison ivy/oak/sumac treatment at any time, day or night.
• Provide a medical history: Whether completing forms in your local doctor’s office or online before consulting with your virtual doctor, you will need to provide a medical history.
• Consult with your doctor: After reviewing your medical history forms, your virtual doctor will discuss your poison ivy/oak/sumac treatment options.
• Treatment: After deciding on an optimal and personalized treatment plan for poison ivy/oak/sumac, your virtual doctor will transmit your prescriptions to your local pharmacy.

Disclaimer

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

References

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2. Kim Y, Flamm A, ElSohly MA, Kaplan DH, Hage RJ Jr, Hamann CP, Marks JG Jr. Poison Ivy, Oak, and Sumac Dermatitis: What Is Known and What Is New? Dermatitis. 2019 May/Jun;30(3):183-190. doi: 10.1097/DER.0000000000000472. PMID: 31045932.

3. Butt M, Flamm A, Marks JG, Flamm A. Poison Ivy Dermatitis Treatment Patterns and Utilization: A Retrospective Claims-based Analysis. West J Emerg Med. 2022 Jun 30;23(4):481-488. doi: 10.5811/westjem.2022.March.55516. PMID: 35980412; PMCID: PMC9391006.

4. Liu B, Tai Y, Achanta S, Kaelberer MM, Caceres AI, Shao X, Fang J, Jordt SE. IL-33/ST2 signaling excites sensory neurons and mediates itch response in a mouse model of poison ivy contact allergy. Proc Natl Acad Sci U S A. 2016 Nov 22;113(47):E7572-E7579. doi: 10.1073/pnas.1606608113. Epub 2016 Nov 7. PMID: 27821781; PMCID: PMC5127381.

5. Argo KA, Massey RC, Luth SK, Herrington JM, Lane AQ, Murray KA. Evaluation and Management of Toxicodendron Dermatitis in the Emergency Department: A Review of Current Practices. Wilderness Environ Med. 2023 Apr 27:S1080-6032(23)00046-7. doi: 10.1016/j.wem.2023.03.001. Epub ahead of print. PMID: 37120383.

6. Stibich AS, Yagan M, Sharma V, Herndon B, MontgomeryC. Cost-effective post-exposure prevention of poison ivydermatitis.Int J Dermatol.2000;39:515–518

7. Davila A, Lucas J, Laurora M, Jacoby J, Reed J, HellerM. A new topical agent, Zanfel, ameliorates urushiol-in-duced Toxicodendron allergic contact dermatitis [abstract364].Annals Emerg Med.2003;42(suppl 4):s98.

8. He, Alice et al. An assessment of the use of antihistamines in the management of atopic dermatitis

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9. Buttaravoli PM, Leffler S, and Herrington RR. Toxicodendron (Rhus) Allergic Contact Dermatitis: (Poison Ivy, Oak, or Sumac) in Minor Emergencies. Chapter 184, 813-817