Poison Ivy, Oak and Sumac - Health Tips

If you venture on the trails often, particularly in the foothills of the Cascades or in the oak woodlands around the Gorge, you should be on the lookout for poison oak. Know its many forms ...and stay clear.

If you come into contact with poison oak, there are some tips for cleaning the area before the rash appears.

• Gently clean the area that came into contact. Don't shower or bathe your whole body, just clean the affected area.
• Do not scrub. This can drive the irritating chemical, uroshiol, deeper into the skin
• Wash with cold water, not hot.
• Use dish soap or alcohol. This may be more effective for lifting the oils than standard body soap.
• Consider using Tecnu to clean the area.

Your doctor will recommend a treatment plan depending on the severity of the rash.

Never apply to the skin creams, lotions, ointments, or sprays containing benzocaine (examples: Solarcaine and others), antihistamines (examples: Benadryl, Caladryl, and others), or zirconium. These frequently produce allergic rashes.

Treatment options for mild to moderate rash:
Soaks: When the skin is weeping, oozing or crusted (or if bathing causes stinging or burning), use this technique:

1. Lie in a comfortable position, usually in bed, with a waterproof material over the mattress to prevent wetting the mattress.

2. Obtain dressings, which do not need to be sterile. These may be 2-4 inch wide Kerlix, soft gauze, or soft linen such as old sheeting or pillowcases, handkerchiefs, or shirts.

3. Moisten the dressings by immersing them in a solution of two Domeboro Blueboro tablets or packets per quart of lukewarm water. Alternatively, you may use a solution of ¼ cup of vinegar per quart of water.

4. Gently wring them out so they are sopping wet, but not dripping. Wrap loosely several layers on affected skin so that rapid drying does not occur. Cover with a towel.

5. Remove after ____ minutes. If dry, it may be necessary to re-moisten dressings to remove adherent crusts. Re-apply with the following frequency: __________.

6. Discard or launder dressing material daily

7. Do not treat more than one-third of the body at a time in order to avoid excessive chilling.

Baths: take baths with Aveeno colloidal oatmeal added to bathwater (one cup to ½ tub), 2-3 times per day.

Antihistamines: Itching can be reduced with the use of oral antihistamines. There are many effective medications in this class. These are typically started at a low dose and gradually increase until relief is obtained or intolerable side effects occur, which ever occurs first. Drowsiness is the most common side effect at higher doses. However, this and other side effects sometimes resolve after a few days even while continuing to take the medication.

Caution must be used when driving or performing sensitive tasks. Use of alcohol should be avoided or limited due to increased side effects and Never used before driving. Caution must also be used if other medications that can reduce one’s alertness are used (for example Valium, Librium, Xanax, and barbiturates. The combination of these medications may cause decreased alertness).

Calamine lotion: This is non-prescription item also reduces itching and is soothing. Apply as often as needed.

Topical corticosteroids: Immediately after bathing and also one other time during the day, apply to the involved skin. Wait until after the blisters have subsided before starting this treatment.

Treatment option for severe rash
Oral corticosteroid: Prednisone, a corticosteroid medication taken by mouth, is dramatically effective in treating a severe rash. It’s safe to take for a short period (three weeks). If taken for too short a time, a “rebound” effect may occur when it is stopped, where the skin suddenly gets worse. Thus it is important to precisely follow the instructions given. If you have a peptic ulcer, high blood pressure, or diabetes, you should inform your doctor.

Improvement in your rash should be prompt and steady. It depends on getting enough steroids. If you don’t improve steadily, please call your doctor so treatment can be modified.

Avoidance is the best prevention against the rash we get from coming in contact with poison ivy or its cousins, poison oak, and poison sumac.

We are not born with an allergy to the oil in the poison ivy/oak/sumac leaft. After exposure to the oil, our body develops an allergy. This may take as little as one exposure or many exposures. Because it can take several exposures, you will meet people who brag that they can roll around in it and it does not affect them. (FYI- not the best idea!)

Some homeopathic physicians and naturopaths claim that you can become desensitized to poison ivy by taking small doses of it by mouth. These preparations are not standardized and could cause a severe allergic reaction. I do not recommend them. Besides, the poison ivy oil would travel all the way through your GI system. All the way. Think about that before you put it in your mouth.

Since the oil causes the rash, as soon as you wash the skin with soap and water, the oil is gone. After washing, you cannot “spread” the rash by scratching. The rash breaks out first in areas that had a large amount of the oil deposited, or where it stayed on the skin for a longer time before being washed off, it takes longer for it to break out in areas with little dose or a short contact time. Thus, it may appear that the rash is “spreading.” The liquid in the blisters is your own serum (like the plasma portion of blood) – it is not infectious or allergenic.

After working in the yard, or being out in the woods, make sure that you wash all your tools and clothing that was exposed to the poison ivy – the oil can remain on them for a long time and cause a rash next time you handle them.

Also, be aware that your dog may come in contact with the plant and carry the oil on his coat and expose you to it.