Prednisone for poison ivy: Effectiveness, dosing, and how it works

In this article:

• Does prednisone treat poison ivy?
• Treatment duration
• Dosage
• Side effects
• Alternatives

In this article

• Does prednisone treat poison ivy?
• Treatment duration
• Dosage
• Side effects
• Alternatives

Prednisone is a type of medication called an oral corticosteroid. It’s used to treat inflammation in the body, from conditions like allergies, asthma, arthritis, blood disorders, cancer, autoimmune diseases, and various skin conditions. Prednisone can also be used to calm an overactive immune system.

If you are dealing with an itchy, uncomfortable case of poison ivy, you might be wondering if you can use prednisone for poison ivy. While prednisone isn’t typically used if you have a small poison ivy rash, it may be used when the poison ivy rash has become widespread. Prednisone can be highly effective in these cases.

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Does prednisone treat poison ivy?

Poison ivy is a plant that grows across the United States. Poison ivy leaves grow in groups of three and their leaves can be identified by their smooth, almond shapes. These leaves contain an oily substance known as urushiol, which can cause a red, itchy rash if your skin makes contact with it. Most people who make contact with poison ivy will have an allergic-type of reaction called contact dermatitis. Some reactions are mild, but some are more severe. Sometimes it takes several exposures to poison ivy before you notice a severe reaction.

While smaller, less severe rashes can often be treated with topical steroid creams, when a poison ivy rash spreads, many doctors will prescribe prednisone for you. “In my experience, prednisone is often a game-changer for patients with moderate to severe poison ivy reactions,” says Hannah Kopelman, DO, dermatologist at DermOnDemand. “When the rash is widespread, extremely itchy, or involves sensitive areas like the face or genitals, a topical cream just isn’t going to cut it.”

 There are several ways that prednisone works to treat poison ivy rashes. Here’s what to know.

Reduces inflammation

Poison ivy rashes can cause widespread inflammation, which is why prednisone can be so helpful. “It is a potent anti-inflammatory medication that blocks the contact reaction caused by poison ivy,” explains Viktoryia Kazlouskaya, MD, PhD, CEO of Dermatology Circle PLLC clinic in NYC.

Relieves itching and discomfort

Additionally, prednisone can powerfully address the most difficult part of a poison ivy rash—the annoying itching and discomfort you experience. “It doesn’t ‘cure’ the poison ivy, but it gives the skin a chance to heal without the constant irritation,” says Dr. Kopelman, who says that prednisone usually significantly relieves itching within a day or two.

Calms the immune response

Finally, prednisone works to decrease the immune response that happens when your body reacts to poison ivy. “Prednisone works by calming the overactive immune response triggered by urushiol, the oil in poison ivy that causes the allergic reaction,” says Dr. Kopelman.

How fast does prednisone work for poison ivy?

How long it takes prednisone to clear poison ivy varies from one person to another. But it generally clears it up within a few short days. “I usually tell my patients to expect noticeable relief within 24 to 48 hours after starting prednisone,” says Dr. Kopelman. “The itching tends to ease up first, and then the redness and swelling begin to go down.”

Prednisone dosage for poison ivy 

The ideal dosing for prednisone for poison ivy isn’t well established, and generally determined on a case-by-case basis by a healthcare provider, according to Dr. Kazlouskaya. “Usually, the dose is calculated based on weight (0.5-1 mg/kg) and used for 6-21 days,” she shares. “For a longer duration of treatment, a slow tapering of the medication is often chosen by some specialists.”

Dr. Kopelman shared how she usually doses prednisone for poison ivy: “Typically, I start adults on 40 to 60 mg daily, depending on the severity, and then taper the dose over a week or two.” She emphasizes that tapering that drug—gradually decreasing the dose instead of stopping cold turkey—is important. “When tapered correctly, prednisone does a great job of controlling the inflammation and helping the rash fade,” she says.

Of note, research has found that taking prednisone for too short a time can cause poison ivy rashes to come back, even after they seem to be resolved. Dr. Kopelman has found this to be true in her practice, which is why she urges patients to take prednisone for as long as their doctor has prescribed it, even if the rash seems to be getting better.

“It’s crucial to take the full course—often 10 to 14 days—because stopping too soon can lead to a rebound rash,” Dr. Kopelman describes. “I’ve had patients come back thinking they were fine after just a few days, only to have symptoms flare right back up.”

What are the possible side effects of using prednisone to treat poison ivy?

Not everyone has side effects when taking prednisone, but they are possible, and can be challenging at times. The side effects of using prednisone for poison ivy won’t be different than if you are using prednisone for other conditions. “There are no specific side effects of prednisone used for the treatment of poison ivy dermatitis, as they are linked to the medication but not a condition,” shares Dr. Kazlouskaya. 

Some common side effects of prednisone include:

• Nausea
• Stomachaches
• Vomiting
• Puffy face
• Redness on your face
• Weight gain
• Mood swings
• Restlessness
• Anxiety
• Fluid retention
• Appetite changes
• Rashes/hives
• Increased blood pressure
• Increased blood glucose
• Headaches
• Insomnia (trouble sleeping)

Prednisone isn’t for everyone and you should talk to your doctor about any health conditions you have before taking it. People who have congestive heart failure, high blood pressure, liver disease, colitis, kidney issues, or other underlying conditions may not be good candidates for prednisone.

Alternatives to prednisone for poison ivy

Prednisone isn’t the only possible treatment for poison ivy. If you want to use an oral corticosteroid, you can ask your doctor about prednisone alternatives, such as dexamethasone.

If your case of poison ivy is mild, you can try a topical steroid first. Dr Kopelman recommends topical hydrocortisone. Other options include calamine lotion or colloidal oatmeal baths. Sometimes allergy medications can help. “Antihistamines like Benadryl can help with sleep and itching, but they don’t actually treat the inflammation,” shares Dr Kopelman.

There are also natural remedies to consider. “I’ve had patients find some relief with baking soda pastes, cold compresses, or aloe vera, but those tend to be more supportive than curative,” says Dr Kopelman. However, once the rash is severe or is spreading over a large area of the body, these types of remedies just aren’t enough. “That’s when systemic treatment like prednisone really makes a difference,” she says.

The bottom line

Predisone is an oral steroid that can be used to treat the inflammation and itching associated with a poison ivy rash. It’s usually prescribed by doctors when your poison ivy rash is widespread on your body, when it involves sensitive areas of your body,or when your rash is moderate or severe. It can reduce symptoms and clear up the rash within a day or two of using it.

You should only use prednisone for poison ivy under the guidance of your healthcare provider. It’s important to take the medication as prescribed, and only stop taking it when your provider tells you to. Stopping too soon may make your rash return. Likewise, you should report any negative side effects of prednisone to your provider; they may offer alternative medications or change your dose.