Poison Ivy

Definition

Poison Ivy is the WORST! The poison ivy rash occurs when a person comes in contact with the oil (urushiol) from the poison ivy, poison oak, or poison sumac plant.  These plants have 3 leaves coming off a single stem, hence the saying, "leaves of 3, let them be." Leaves start out green, but can turn red or brown, and even dead plants can cause the rash.   To cause the rash, the plant does not necessarily have to touch your skin, but instead could touch your shoes or clothes, the hair of a pet, or even a garden tool.  Then when you touch these objects, the oils are transferred your skin, causing the reaction to begin. 

Rash progression

After contact with the plant, it may take 1-4 days for the rash to develop.  It begins as red streaks and then turns into blisters. The rash is incredibly itchy!  It may appear in new places for up to 2 weeks.  This gives the impression that the rash is spreading,  but in fact any area where the rash appears is from the original contact with the oil.  Of course, if you are continuing to touch the oil (for example, if it is on shoes still being worn), the rash can spread. The rash is not spread by scratching, by fluid in the blisters, or by person to person contact.   It may take up to 3 weeks for the rash to fully go away.

Symptom prevention and treatment  

Wash off:  As soon as possible, take off clothes and shoes worn when poison ivy was contacted and wash all skin with very warm water and mild soap or dish soap. The more expensive “poison ivy soaps” don’t seem to work any better than dish soap. Wash clothes and shoes (if possible) in washing machine.  If shoes can’t be washed, clean shoe surface well with dish soap before wearing again.

Home remedies to alleviate symptoms:

• Use oral antihistamine medications. These may not be significantly helpful as the itch from poison ivy isn’t related to histamine.  The best non-sedating antihistamine for daytime use is Zyrtec (Fexofenadine).  The once daily dose can be taken in the morning and evening, for severe itching.  Before bed, Benadryl (diphenhydramine) can also be taken.  Oral antihistamine dosages can be found here:  Allergy Medication Dosages
• Apply cool compresses for symptomatic relief of itching.
• Try over the counter Zanfel. Zanfel (Polyethylene Granules/Sodium Lauroyl Sarcosinate/ Nonoxynol-9), though pricey works amazingly well to temporarily alleviate itching.  The sooner after exposure it’s used, the more helpful it will be, but even days or weeks after the rash begins, it can still help with itching.
• Try a topical steroid ointment. Try OTC 1% Hydrocortisone OINTMENT twice a day until rash resolves. If using on face or groin, use sparingly, and for no more than 7 days in a row.
• Try topical Calamine lotion, “the pink lotion.” This can be applied as often as needed and can help with itching.

Avoid the following: topical anesthetics containing benzocaine, topical antihistamines like Benadryl cream, and topical antibiotics that contain neomycin or bacitracin. These could make the rash worse.

How can I prevent getting poison ivy again?

• Learn what the plant looks like and stay away, even if the plant is dead
• Wear long sleeves and pants when hiking or if working in the garden near the plant.
• Wash clothes and shoes right away after being around the plant
• Wear thick vinyl gloves when working in the garden. Thick vinyl gloves protect much better than latex and rubber gloves.
• As soon as possible wash all skin with very warm water and mild soap or dish soap (do not rub or scrub).
• Avoid burning poison ivy plants or being around those being burned

 Call If...

• You think your child needs to be seen
• Your child becomes worse or symptoms are not slowly improving
• Your rash is severe
• Most of your body is affected or the rash affects your face or genitals
• You have a lot of swelling
• Your rash oozes pus or gives other signs of being infected