HCN News & Notes

When It Comes to Poison Ivy, Prevention Takes Priority

PALMER — If you grew up in a rural area, you’ve probably heard the saying, “leaves of three, let it be.” This brief, descriptive warning is intended to keep you from touching or brushing against the poison ivy plant. The oily sap on the plant’s leaves, called urushiol, often causes an allergic reaction and rash. According to the Centers for Disease Control and Prevention (CDC), these plants can be found in forests, fields, wetlands, along streams, roadsides, and even in urban environments, such as parks and backyards.

“Problems with poison ivy are most prominent during the spring and summer. However, poison ivy can cause a problem any time of the year,” said Dr. Joe Sills, chief of Emergency Medicine at Baystate Wing Hospital.

“An allergic reaction to the oil in these plants, called urushiol, produces the rash,” he explained. “Exposure to poison ivy can happen when people are hiking, camping, or at home gardening, clearing brush, cutting vines, or carrying and burning wood. Every part of the plant — the leaves, stem, vines, flowers, and roots — contains urushiol. Once you’re exposed to urushiol, a rash can occur from several hours to three days after contact with the plant. While direct skin-to-plant contact with poison ivy, oak, or sumac is probably the most frequent cause of the rash, the irritants from the plants can also be passed on indirectly by pets, garden tools, shoes, or virtually anything that touches a plant.”

Sills added that “rinsing your skin immediately after touching the poison ivy, oak, or sumac, with lukewarm water, may help to rinse off some of the oil and lessen or avoid the rash. Beware that the oil can stick to clothing and other surfaces as well, so be sure to also wash the clothes you were wearing when you came into contact with the poisonous plant, as well as gardening tools, golf clubs, leashes, and even a pet’s fur.”

Most people (85%) develop a rash when they get urushiol on their skin. One’s first exposure to the oil may not cause a rash, but the second exposure can cause sensitivity, causing a rash to appear. About 15% of people do not become sensitive to this oil and never develop a rash. The rash caused by these plants is not contagious and does not spread. Scratching the rash or the leaking fluid from the blisters does not spread the rash, although it can cause scarring and potential infection.

“Urushiol can remain active for years. For that reason, even dead poison ivy, oak, or sumac plants must be handled with care,” Sills said. “Plants should never be burned or shredded, as airborne particles can spread the oil to sensitive areas like the face and eyes and may potentially cause damage to lungs.”

Prevention is the best approach, he noted. “Know what the plant looks like and teach your family to avoid it. If you do have contact with one of the poison plants and the rash has set in, the three main goals of treatment are to stop the itching, decrease inflammation, and prevent infection.”

He added that the rash from poison ivy, oak, or sumac usually lasts one to three weeks. “Most rashes go away without treatment, and while your skin heals, it more than likely will continue to itch. If the eruption is mild, applying calamine lotion three or four times a day can help with the itchiness. If the rash covers a large area of the body, oatmeal or baking soda baths may help reduce itching and discomfort. Avoid those preparations containing anesthetics or antihistamines, as often they can cause allergic eruptions themselves. Infections can occur if blisters break and bacteria enter the open wound. Keep the rash clean and any open blisters bandaged to help lessen the chance of infection.”

Sills noted that a rash from poison ivy, oak, or sumac can usually be treated at home. “If the rash is severe, on your face, on extensive parts of your body, seeing a doctor is important; you may need a prescribed steroid ointment that you can apply to the skin or to be placed on an oral steroid like prednisone.”

If you have any of the following symptoms, or if you have a serious reaction, seek immediate medical care by going to the emergency room: trouble breathing or swallowing; a rash that covers most of the body; many rashes or blisters; swelling, especially if an eyelid swells shut; a rash that develops anywhere on the face or genitals; much of your skin itches and nothing seems to ease the itch; or signs of a bacterial infection, such as pain, increased redness, or pus.

“There is no cure for the reaction once the rash starts,” Sills said. “Avoiding the plants is the best treatment. It is very important to learn what the plants look like and to not touch them.”