(This article originally appeared in the Lockport Union Sun & Journal on June 16, 2023)
Contact dermatitis is a skin rash that can happen when your skin touches something that irritates it or if you are allergic to it. Substances that can cause this are soaps, cleansers, perfumes, make-up, certain types of jewelry, or plants such as poison ivy, poison oak or poison sumac. Poison ivy is the most common cause of contact dermatitis in America, affecting 10 million to 50 million people.
Leaves of Three, Let them be is the classic warning about poison ivy. The oleoresin “urushal” is the allergic substance found in poison ivy, oak and sumac. Contact with these plants, even if damaged or dead, can result in a skin reaction; this includes the roots, sap, leaves and stems. In addition, we can get poison ivy from our pets. If your dog or cat is exposed to poison ivy they can carry the oleoresin on their coat and expose you to it when you pet or groom them.
The classic rash is red, linear streaks on exposed areas, most often the arms and legs, but it can be anywhere on your body and face. It often has small raised bumps (papules), small blisters (vesicles) and larger blisters. It is very itchy.
There are several ways to avoid dermatitis from poison ivy:
- Avoid exposure to the plants.
- Wear protective clothing on your arms and legs.
- Wear vinyl gloves if you are working or gardening outside.
- Wash your hands and any areas you think might have been exposed with a detergent soap. Washing is best immediately after exposure, but can still reduce symptoms up to two hours after exposure.
Should you develop a rash, treatment will depend on the severity of the disease. Initial symptomatic treatment includes cool/wet compresses, oatmeal baths and topical astringents like calamine lotion. Oral anti histamines such as Benadryl have a limited role in reducing itching.
Mild, localized rash can be treated with topical steroids. Over-the-counter medication such as 1% hydrocortisone may be too weak to effectively treat the rash and itching. Higher strength topical steroids started early on may be effective. This can be obtained from your primary care doctor, or a visit to an Urgent Care center or Emergency Department.
Severe or extensive poison ivy rash requires oral steroids to effectively treat. Treatment is generally a two- to three-week course of steroid (most often prednisone) that is tapered from a high dose to a low dose over the treatment duration. Shorter treatment courses can result in initial improvement followed by reoccurrence of the rash. Oral steroids will also require a visit to a health care provider for a prescription.
It is important to point out that sensitivity to poison ivy, oak or sumac can develop over time. It is possible to have multiple exposures without symptoms prior to developing active dermatitis.
In general, poison ivy (oak and sumac) is not contagious. You cannot spread the rash. You can only get it by contact with the oleoresin.
It is important to seek medical care if, with or without treatment, the rash lasts longer than two weeks, it continues to get worse and spread, or you develop signs of infection: increased redness, swelling, pain, thick drainage, fever or shortness of breath.
Earlier I mentioned an oatmeal bath. This can give some symptomatic relief while waiting for the steroids to kick in. There are over-the-counter oatmeal baths you can buy. You can also make a bath at home if you have oatmeal:
- Blend 1 cup of oatmeal (quick cooking, old fashioned or instant) into a fine powder.
- Put one teaspoon of the ground oatmeal in water to see if it absorbs the water. If the liquid turns milky then the oatmeal is ground enough; if not, then grind it some more.
- Pour the powder into a tub of running warm water. Soak for 15 to 20 minutes and gently rub into your skin.
In summary, the best way to treat poison ivy rash is by preventing exposure. If you are exposed the treatment will depend on the severity of the rash and symptoms. If you have any concerns it is always best to see a health care provider.