A Pharmacist's Guide to OTC Therapy: Poison Ivy/Oak/Sumac Dermatitis

Anyone who has ever had an allergic reaction to poison ivy, poison oak, or poison sumac will agree that immediate relief of the itching, burning, and pain associated with exposure to this dermatologic condition is a top priority. Poison ivy/oak/sumac dermatitis, also referred to as Rhus dermatitis, is the primary cause of allergic contact dermatitis (ACD) in the United States and exceeds the incidence of all other causes of ACD combined.¹ Approximately 50 million individuals annually experience reactions from poison ivy/oak/sumac.

Pharmacologic Treatments

Initially, individuals with mild-to-moderate cases may attempt to use the variety of nonprescription preparations currently available to assist in alleviating the pruritus and inflammation associated with this condition (Tables 1 and 2). Topical hydrocortisone is the most widely utilized product. Other nonprescription preparations include topical antihistamines, topical anesthetics, and other antipruritics. Individuals also may utilize topical astringents.

Topical preparations are available in several dosage forms, such as creams, ointments, sprays, lotions, and gels. Selection of the appropriate dosage form is dependent on several factors, such as the severity of the dermatitis and the presence of vesicles (dry or weeping). In order to avoid infections, patients should be advised not to apply ointments to open lesions. Patients also should be informed that the use of topical antihistamine and anesthetic products may cause additional inflammation in some areas. It is imperative that pharmacists effectively counsel patients on the proper use of these products and stress that they always should seek the advice of their primary care provider in the following cases:

• Fever is present
• Rash covers large portion of skin
• Swelling occurs around areas of the eyes or mouth
• Blisters appear infected
• Rash worsens and is not responding to treatment

Ms. Terrie is a clinical pharmacy writer based in Haymarket, Va.

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