Friday, July 20, 2007


Poison Ivy: A summertime nuisance

Sam, 14 year old from Norwich loves golf. We were playing together at our local club recently, when one of his drives found the woods. We went looking for his golf ball. We were wary of the bushes, hoping not to come too close to poison ivy. We thought we were successful and went on with our round of golf. I met Sam three days later and noticed a red rash on his leg. After a close look, I said “Oops, there it is. Poison ivy.”

Various summertime activities take us outdoors and unfortunately do expose us to some of these nuisances. I generally see an increase in these rashes from spring through summer, although as hard as it is to believe, I do see some cases in the winter. About 25 to 40 million people in the United States need medical treatment for poison ivy rash every year. People of all ethnic background and skin types are at risk for developing a rash. Children, firefighters and farmers are at higher risk because of repeated exposure to these toxic plants.

What is Poison Ivy?
When the skin comes in contact with certain allergy-causing substances, a person may develop a condition called contact dermatitis.

Exposure to poison ivy, poison oak, and poison sumac cause this type of contact dermatitis. All these plants contain a colorless oil that is found on the fruit, leaves, stem, root and sap of the plant, more so when the plants are damaged by animals or wind or anything else.

A person can get poison ivy either by direct contact or indirect contact such as pets or garden tools. One can also get poison ivy by airborne contact when poison ivy is burned. Recently I saw a good example of this.

Gabrielle, a 15 year old, came in to my office with the left side of her face swollen and some blisters on her cheek. She said she hadn’t been in the woods, but admitted that she loves to sleep with her dog.

After contact, about 50 percent of people develop symptoms of poison ivy. It can take anywhere from four hours to four days before the symptoms appear. Most common symptoms are intense itching, swelling and redness. Some may develop blisters. Contacts around eyes or around private areas tend to be associated with lots of swelling. Redness and blisters may keep appearing over several days and I get a lot of calls from concerned parents stating ‘poison ivy is spreading’. The only true ‘spreading’ is by continued exposure either from clothes or pets or from residue left under fingernails etc.

If left untreated, the majority will get better over one to three weeks. But some severe lesions can get complicated with added infection.

Most people probably know about adding oatmeal to the bath, applying cool compression and possibly applying calamine lotion. These measures certainly help alleviating some discomfort. A soap mixture called Zanfel may help relieve some symptoms. These are measures any one can do prior to seeing a physician to get further treatment if needed.

Over the counter antihistamines like Benadryl or Claritin may help with the itching. Topical corticosteroids may be helpful if used in the first few days. Most people will need a stronger cream than cortisone cream available over the counter. When lesions are too many or when the face or genitals are involved, oral corticosteroids are useful in relieving the symptoms. Do not use neomycin or bacitracin creams or ointments as these may make the rash worse.

The best way to prevent poison ivy is to identify and avoid the plants that cause it. These plants can cause symptoms year round, and even years after the plant dies.

“Leaves of three, let them be” is a phrase used to help identify plants that cause poison ivy. Generally poison ivy and poison oak have three leaves with flowering branches positioned on a single stem. Poison sumac has five, seven, or more leaves that angle upward toward the top of the stem. Some leaves may have black dots on them.

Wear protective clothing and vinyl gloves while working on your yard or gardening. Wash with mild soap and water after exposure. Do not scrub or rub the area. Use of creams or commercially available Ivy Block, which might help as a barrier for some people who are frequently exposed to poison ivy. Finally, avoid burning poisonous plants as particles in the smoke can cause poison ivy rash.

Ravi Prakash, MD, is Chief of Pediatrics at Backus Hospital with a private pediatric office in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Dr. Prakash and all of the Healthy Living columnists at

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