Leaves of 3: Let Them Be

Memorial Day ranks as the #1 day for exposure to poison ivy. Synonymous with gardening, picnicking, hiking and sending your kids off to camp, poison ivy, oak and sumac seem like a ubiquitous outdoor plague. That means come Tuesday, an itchy, blistery rash may accompany your post-holiday blues. This year, plan ahead. Stock up on your poison ivy prevention and use it. If poison ivy plagues you each and every summer, it doesn't hurt to gather your remedies – just in case.

Posted on | Audrey Kunin, MD | Comments ()

Memorial Day ranks as the #1 day for exposure to poison ivy. Synonymous with gardening, picnicking, hiking and sending your kids off to camp, poison ivy, oak and sumac seem like a ubiquitous outdoor plague. That means come Tuesday, an itchy, blistery rash may accompany your post-holiday blues. This year, plan ahead. Stock up on your poison ivy prevention and use it. If poison ivy plagues you each and every summer, it doesn't hurt to gather your remedies – just in case.

Poison ivy, oak and sumac for all intents and purposes are one and the same, as they each contain the same "poisonous" oil or resin known as urushiol. Each plant creates the same characteristic "poison ivy" type of rash.

You won't know when the resin gets onto the skin; it's not noticeable. But give yourself 1-2 days (for those with a past poison ivy history) or as long as 9 days (for those novices) and you will begin to experience the discomfort of itching, swelling, redness and finally watery groups of blisters.

Often the rash appears in streaks. This streakiness is really mirroring where each branch or leaf came into contact with the skin.

A Rash Move?

It doesn't take much of the plant oil to cause a rash. Fun fact of the day: it would take only 1/4 oz of urushiol to cause everyone on earth to break out, so you can understand that it doesn't take much contact with a plant to cause a rash.

The rash breaks out first and is most severe where the largest concentration of the resin contacts the skin. Where smaller and smaller amounts of the plant resin are spread, these areas can break out over approximately a 3 week period. Touching the actual rash will not spread the rash! The most common myth associated with poison ivy is probably the mistaken notion that scratching the blister fluid creates a contagious situation. Only contact with the resin causes the allergic reaction, and I would hope that it would be long washed off before the rash breaks out. This is another reason to wash well immediately after coming indoors.

Toss your dirty clothing immediately into the washing machine and wash them. Too many moms find themselves with poison ivy after doing the family laundry that has been drenched in poison ivy sitting in the hamper for several days or more.

Botany Lesson

"Leaves of 3 let them be” is an old time saying that is certainly still up-to-date. Both poison ivy and oak plants typically have 3 leaflets per stalk. Poison sumac on the other hand actually can have anywhere from 7-13 leaves. If you live on the west coast, you are far more likely to encounter poison sumac, so be wary! The rest of us in the U.S. and Canada are probably going to stumble across poison ivy or oak.

Block It

What can you do about it? First of all, if you know in advance you'll be in an area likely to have one or more of these plants, so prepare! Shop for a preventative lotion containing the active ingredient bentoquantum, which has been shown in studies to help neutralize urushiol and prevent the rash of poison ivy. When applied to the skin at least 15 minutes before contact this lotion helps prevent or diminish the gum from causing the actual dermatitis. Of course, wearing long sleeves and pants helps as well. Do not apply to areas already blistering from poison ivy; it’s meant for prevention, not treatment.

A Jewel of a Weed

A cousin to those garden impatiens, jewelweed has long been touted by alternative medicine supporters as a natural alternative for helping wash away plant oils and also helping reduce itching associated with full blown poison ivy. A study published way back in 1958 in the Annals of Allergy showed that of 115 patients treated with jewelweed, 108 responded well to treatment. Jewelweed is thought to contain tannin, the active ingredient in tea leaves that helps reduce swelling and inflammation in skin tissues (remember those tea bag compresses for under eye puffiness?).

Soaps containing a blend of jewelweed, clay and pine tar to help gently cleanse the skin and helps remove the grime left behind from your foray into the great outdoors (or your own backyard!). Hopefully it will wash away some of the unwanted plant oils along with it. While the FDA has not evaluated jewelweed as an active therapeutic agent for treating poison ivy, if poison ivy is the bane of your summertime existence, it might be worthwhile to try as an inexpensive soap after being outside participating in "high risk" activities (gardening, hiking, etc.).

A Little Night Therapy

When its midnight Saturday and you realize that despite your best intentions (or perhaps the lack of planning) that poison ivy is your new best friend, there is something you can do as you wait to get in to the doctor’s office after the holiday weekend.

  • Try washing with jewelweed-based soap.
  • Compress blistered areas for 20 minutes twice a day with an astringent solution containing aluminum acetate. It works to rapidly dry out blisters. Several brands are on the market.
  • Apply a topical steroid (preferably prescription if you have it on-hand to the non-facial areas of rash twice a day).
  • Apply a topical 1% hydrocortisone cream (nonprescription) to facial outbreaks, making certain to keep out of the eyes.
  • Stop the itching with oral antihistamines.
  • Use a topical anesthetic.
  • Apply a topical antibacterial ointment to any raw, open skin to prevent the possibility of infection.
  • Try applying a poison ivy cream containing Nonoxynol-9 to help dissolve and lift away the poison ivy oils.
  • When all else fails, call your dermatologist!

Don't let this Memorial Day weekend or any other time of the summer be overshadowed by a battle with a plant. Always remember – leaves of 3, let them be! Plan ahead if possible, and know there are options to help you obtain comfort and peace of mind (along with a good night's sleep) should you stray into a patch of poison ivy.

Blog written by Audrey Kunin, MD
Dr. Audrey Kunin is a board-certified dermatologist, author, clinician, educator and President of DERMAdoctor, Inc. Dr. Kunin...