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The Untouchables
Although you can get
poison ivy (pictured below), oak or sumac at any time of
the year, it
seems like we are always plagued with the awful rash in the spring and fall.
Perhaps this is because we do most of our yard work at those times. In any
case, spring is a good time to refresh your memory on the subject.
Approximately 85 percent of the population will develop an allergic reaction
if exposed to poison ivy, oak or sumac, according to the American Academy of
Dermatology. Sure, we all know people who claim they don’t get poison ivy
even if they touch it. If they knew what agony they were risking they would
stay away anyway!
Usually, people
develop sensitivity to poison ivy, oak (pictured at right) or
sumac only after several encounters. However, reactions can occur after the
initial exposure. Each subsequent exposure can cause the reaction to get
worse. The cause of the rash, blisters, and overwhelming itch we call
‘poison ivy’ is the oil in the sap of the poison plants, called urushiol
(pronounced oo-roo-shee-ohl). Because urushiol is inside the
plant, brushing against an intact plant will not cause a reaction. But the
plants are very delicate, and undamaged plants are rare.
Those of us who have developed hypersensitivity to the poisonous oils are unwilling to take any risk of getting the rash. In my case, I can see red marks that look like scratches within an hour of exposure. If I begin cleansing with Tecnu (Oak-N-Ivy Brand) outdoor skin cleanser or rubbing alcohol as soon as I see that sign, I can usually avoid a full-fledged 21-day bout of itching rash. Tecnu and alcohol break down the oil and remove it from the skin. Urushiol can penetrate the skin within minutes, so there's no time to waste if you think you may have been exposed. The sooner you remove the oil, the greater the chance that you can remove the urushiol before it gets attached to the skin. Cleansing may not completely stop the initial outbreak of the rash if more than 10 minutes has passed since exposure, but it can help prevent further spread and decrease the severity of the rash.
If you think
you've been exposed to poison ivy, oak or sumac (pictured at left), if possible, stay outdoors
while you cleanse all exposed skin with generous amounts of either isopropyl
(rubbing) alcohol or Tecnu outdoor skin cleanser. Then rinse off skin with
cool water. Then remove your exposed
clothing and be sure to wash it all with Tecnu, or something else that can
break down the oil, to remove any contaminating oils. Wash any hand tools or
other objects that you may have contaminated with it as well.
I usually cleanse and rinse with Tecnu or rubbing alcohol another time after getting rid of clothes and tools that might have been contaminated, to ensure that I have not missed any potentially exposed areas. Next, take a regular shower with soap and warm water. Do not use soap before this point because soap will pick up urushiol from the surface of the skin and move it around, causing more rash. Only use soap after you have removed the oil as completely as possible.
Avoiding direct contact with the plants reduces the risk of getting a rash, but doesn't guarantee against a reaction. Urushiol can stick to pets, garden tools, or anything else it comes in contact with. If the urushiol isn't washed off those objects or animals, just touching them can cause a reaction. Urushiol that's rubbed off the plants onto other things can remain potent for years. A cleanser such as Tecnu can break down the oil, where regular soaps can just spread it around. Also, working with mulch can cause exposure, as it can even contain pieces of poisonous plants.
Almost all parts of the body are vulnerable to getting the rash. Because the urushiol must penetrate the skin to cause a reaction, areas where the skin is thicker, such as the soles of the feet and the palms of the hands, are less sensitive to the oil than areas where the skin is thinner. The severity of your reaction may also depend on how big a dose of urushiol you get.
If you don't cleanse quickly enough, or your skin is so sensitive that cleansing doesn't help, redness and swelling will typically appear in about 12 to 48 hours. Blisters and itching will follow. For those people who react after their very first exposure, the rash appears after about a week.
Despite what you may have heard, the oozing blisters are not contagious. Even though they look terrible they don’t cause further spread of the rash. Nevertheless, don’t scratch the blisters. Even clean fingernails may carry germs that could cause an infection. Scarring from the blisters and rash can be permanent, and scratching will make this worse.
The rash will only occur where urushiol has touched the skin; it doesn't spread internally through the body. The rash may seem to spread because it appears over time instead of all at once. This is either because the urushiol is absorbed at different rates on different parts of the body or because of repeated exposure to contaminated objects.
The rash, blisters and itch normally disappear in 2 to 3 weeks without any treatment. But few can handle the itch without some relief. For mild cases, wet compresses or soaking in cool water may be effective. Oral antihistamines can also relieve itching and allow sufferers to get some rest.
Hydrocortisone creams, such as Cortaid and Lanacort, can provide a safe and effective temporary relief of itching associated with poison ivy. For severe cases, prescription topical corticosteroid drugs can halt the reaction, but only if treatment begins within a few hours of exposure. After the blisters form, topical steroids cannot reverse the rash. Severe reactions can be treated with prescription oral corticosteroids. These drugs must be taken for 14-21 days, however. Shorter courses of treatment can cause a rebound effect, resulting in a more severe rash.
There are a number of products available without a prescription to help dry up the oozing blisters, such as:
-
zinc acetate
-
zinc carbonate
-
zinc oxide
-
aluminum acetate
-
baking soda
-
Aveeno oatmeal bath
-
aluminum hydroxide gel
-
calamine lotion or cream
But, take it from someone who has tried it all over the years, none of these helps much. It still takes 2-3 weeks for the itching and blisters to subside. Your best defense is to avoid the plants. If you still get exposed, wash immediately with the alcohol or Tecnu to remove the oil. For those of us unwilling to take any risks, keeping a bottle or two of Tecnu handy at the lake is standard operating procedure. I typically wash with it after doing yard work or being in the woods, whether I think I have been exposed or not. Better safe than sorry!
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