If you've ever had a run-in with poison ivy (or its brethren, poison oak or sumac), chances are you remember the encounter all too well. The red, itchy blisters of the accompanying rash are unpleasant at best and unbearable at worst. The only good news is that you're not alone in this misery: More than 85 percent of people react to this pesky plant the same way.
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What most people don't realize is that a poison ivy outbreak is actually an allergy--contact dermatitis, to be precise. And the trigger is an oil secreted by the plants called urushiol. Some people are more sensitive to urushiol oil than others. And a few lucky people are not sensitive to it at all--they can literally roll in the stuff and not get a reaction. But our experts don't advise it. Sensitivity to urushiol can develop at any time. "We're not exactly sure why some people are sensitive to it and some aren't, but it seems to relate to exposure to certain chemicals," explains Richard Antaya, M.D. "If you're not exposed to the oil a lot, your rate of developing an allergy drops dramatically."
Another common misconception about poison plant allergies is that scratching them will actually spread the rash around. In reality, the oil has to make direct contact with the skin to cause the rash. And you can actually get the oil under your fingernails and spread it that way. Still, it's best not to tempt fate by scratching and further irritating your skin.
1) Know your enemy. Ideally, the best approach is to avoid getting a poison plant rash in the first place. You can try to avoid poison ivy, poison oak, and poison sumac simply by steering clear--if you know what the plants look like.
Poison ivy plants have clusters of three shiny leaves, the source of the saying "Leaves of three, let it be." It can grow as a vine or as a shrub, but it always has hair on its trunk. Poison ivy is found throughout most of the country.
The reason that poison ivy claims a lot of victims is that it likes to grow where we like to be: "On the sides of trails, in the rough of a golf course, behind a garage, or at the edge of a forest," says Thomas N. Helm, M.D. "The plants like the transition from forest to open land and are often at the edge of dense tree growth."
Poison oak can be a high-climbing vine or a shrub. Its notched leaves look like those of the common white oak tree. Its berries grow in clusters and are green in summer and off-white in winter. Poison oak grows mostly in the West and Southeast U.S.
Poison sumac stems each have 7 to 13 leaflets. It grows as a tall shrub, sporting green berries in summer that turn yellow-white in winter. The plant can be found in the northern part of the country and sometimes in the Deep South.
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2) Block that Ivy. If you know you're going to be around poison ivy, like when you're about to clear it from your yard, prepare yourself first. IvyBlock is a lotion that actually prevents urushiol from penetrating your skin. The lotion leaves a slightly visible film on the skin so that you can see exactly where you're protected. IvyBlock and similar products are available at drugstores.
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3) Wash up. If, despite your best efforts, you've been in contact, time is of the essence. "I don't know what the exact breaking point is, but I do know that you can stop an outbreak if you act quickly enough," says Dr. Antaya. If you have access to soap and water, wash any exposed areas as quickly as possible. Or pour rubbing alcohol over your skin immediately. Don't use a washcloth, however, as it just picks up the urushiol oil and spreads it around.
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4) Use what you have. If you don't have water, soap, or rubbing alcohol at your disposal, opt for several premoistened towelettes (like baby wipes) if you have them. If you have a cooler handy, rub ice on the affected area.
If you're really roughing it, Dr. Helm has a couple of tips for dealing with the rash. "If you are camping out and not much else is available, I would bathe in a pond or stream every 2 to 3 hours and apply a thin mud layer, which will dry up some of the blisters," he says.
5) Wash everything. These poison plants have a nasty habit of spreading their oil around, so it's not enough to just wash your skin, says Dr. Antaya. "You'll want to wash everything that may have come in contact with it, including your clothes, your pets,everything," he says. "I have patients that have reacquired poison ivy by wearing the same shirt a few days later."
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6) Pop a pill. It takes a few hours to a few days after exposure to the plants for the rash to develop, along with its maddening itch. Oral antihistamines are high on Robert Rietschel's, M.D., list of poison plant rash remedies. Two popular over-the-counter brands are Chlor-Trimeton, which contains the active ingredient chlorpheniramine maleate, and Benadryl, which contains the active ingredient diphenhydramine hydrochloride. "You even could take your hay fever medicine if it happens to be an antihistamine," he adds.
7) Use calamine lotion. The time-honored mainstay in poison plant treatment is calamine lotion, a popular skin protectant with a cooling, soothing action that distracts your skin from the itching sensation, says Dr. Rietschel.
With poison ivy, poison oak, and poison sumac, the blood vessels develop gaps that leak fluid through the skin, which then cause blistering and oozing, he explains. "When you cool the skin, the vessels constrict and don't leak as much," he says.
Most calamine lotions contain only about 5 percent calamine, which is actually a form of crystallized zinc. As the lotion dries on your skin, it leaves a powdery residue that absorbs the oozing, develops a crust, and keeps your skin from sticking to your clothes, Dr. Rietschel says. He recommends applying calamine lotion three or four times a day. To keep your rash from getting too dry and making the itch even worse, stop using calamine when the oozing stops, he says.
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8) Try a cool dressing or compress. Another simple way to bring relief is to moisten a sheet or pillowcase, and lay it over the affected area. "This produces a cooling, calming effect," says Dr. Antaya. "I tell my patients to leave it there until it dries."
Dr. Helm recommends adding a bit of tea to your dressing or compress for additional relief. "Any common black tea contains tannins that are very helpful," he says. "Let it cool, dampen a cloth, and apply it for 10 minutes every 3 to 4 hours."
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