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August 22, 2018

Health talk: Poison ivy dermatitis

It’s that time of year again when patient’s start clamoring for steroids to treat their poison ivy.

However, oral corticosteroids are not always appropriate for treating poison ivy dermatitis. Oral corticosteroids have significant side effects that can change your mood, increase your appetite and disrupt your sleep, as well as affect the metabolic processes in your body. If dosed incorrectly or taken for too short an interval, it can result in a “steroid flare” with the poison ivy dermatitis returning worse than it was originally.

Learn how to identify poison ivy and avoid it. It typically has clusters of three leaves, color can range from green to red, and it grows as vines, single stalks or shrubs. A Google search will provide images to improve your identification skills.

If you know you are going to be exposed to poison ivy, wear long clothing, although the resin from these plants can soak through clothes and come in contact with skin. Heavy duty vinyl gloves are the best option to avoid exposure.

After possible exposure wash all of your clothes (don’t forget your footwear) and clean any tools that may have been exposed to the resin with detergent. The resin can remain on objects for days and each time you contact it, you re-expose yourself to the allergen. Shower and wash with a mild detergent, such as Dial dishwashing detergent — we keep a bar of FELS-NAPTHA laundry soap in the shower and use it after any possible contact with these plants (commercial products are available but are more expensive).

The resin from poison ivy is highly allergenic. It typically takes 12-96 hours to develop a rash, with symptoms peaking between one and 14 days after exposure. Symptoms are redness and intense itching with development of raised bumps and vesicles, often in a linear pattern. The time to develop a rash and the severity of the rash depends on how much resin you were exposed to and the thickness of your skin. This is why people often think the rash is “spreading.” However, the liquid from the vesicles does not spread the rash, and it cannot be spread to someone else. You can continue to re-expose yourself if something has the resin on it, such as your clothes, garden tools or even your pets.

Treat symptoms with cool baths and calamine lotion. Popping blisters can be treated with Burrow’s solution. Contact your physician if you are concerned about secondary bacterial infection, or if the rash is severe, involves your face or genitals or if you do not improve after 2-3 weeks.

Medical treatment with high dose topical corticosteroids can relieve symptoms and shorten the course of the reaction. Oral corticosteroids may be prescribed if the rash is severe covering a significant portion of the body or if it is on the face or genitals. Once again, corticosteroids — topical and oral — can have significant side effects and are often only used in severe situation, so let’s try to prevent “the poison” this summer and avoid side effects of treatment.

Dr. Lara Kauffman is a board certified family physician at Carlisle Family Care. She graduated from Penn State College of Medicine in 2005 and has been practicing in Central Pennsylvania for the past five years.

Kauffman is one of five Carlisle Regional Medical Center staffers contributing to the weekly Health Talk column, to appear in The Sentinel every Sunday.

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Health talk: Poison ivy dermatitis

Poison Ivy An old enemy lies in wait for the unsuspecting

Poison ivy is out in full force, and will be hanging around until a hard frost sends it away.

“Every five years or so, I get poison ivy,” said gardening expert Margaret Hagen of the University of New Hampshire Cooperative Extension. “It usually takes me four to six weeks to get rid of it. It’s awful, so I try hard not to get it.”

Exposure to urushiol, an oil produced by the plant and found in its leaves and stems, causes an allergic reaction — the itchy rash. Some people have reactions so severe they need medical attention or even hospitalization.

There are three types of poison ivy common to the Granite State, according to Helaine Hughes, owner of The Poison Ivy Removal Company in Greenfield. There’s the Eastern climbing variety that can take over trees and power lines, Western ivy that grows like a shrub, and Rydberg’s, a creeping variety of poison ivy.

“The biggest problem that people have is they don’t know how to identify poison ivy,” Hughes said.

In the spring, the three-leaved plant is reddish-green and shiny. In the summer, it becomes a dull, matte green almost like poinsettia leaves, Hughes said. And in the fall, poison ivy takes on the quintessential fall colors, turning brilliant red, orange and gold.

Poison ivy thrives in the edges between two landscapes, according to Hagen. The space between a forest and a field, the border between a garden and a lawn, or banks of a riverbed on the side of the road are all prime locations.

“For some reason, poison ivy likes edges,” Hagen said.

The plant spreads through underground runners, said Hughes, but also with the help of birds who eat the seeds from poison ivy berries in the fall and drop them into stone walls or garden beds or into rivers, where they travel downstream and take root.

Getting rid of it

Getting rid of poison ivy is a chore, said Hagen, because the plant is hardy, will grow in just about any conditions, and is invasive. With a small infestation, she recommends going after the plant and its roots with loppers and applying weed and brush killer to the open cut on the stem. Larger patches can be fought back with some persistence and some Roundup or an organic acid-based herbicide — both of which come with drawbacks and controversy.

What Hughes does to remove poison ivy from her clients’ properties is to go after the plant at the roots. Dressed in Tyvek suits with thick rubber gloves taped at the wrist, and overshoes, Hughes and her all-female team seek out the poison ivy and follow it to where it began, yanking it out and depositing it in black plastic bags that will then be hauled to the dump.

Persistence is necessary because it can keep coming back if people aren’t watching for it.

“Poison ivy thrives when people aren’t paying attention,” said Hagen.

When it comes to disposing of poison ivy, the most important rule is to never, ever burn it, said Hagen. When burned, the oil from the plant becomes airborne and can be inhaled into the lungs, causing an internal case of poison ivy that could require hospitalization.

It’s also unwise to put poison ivy into a compost heap; anywhere it’s thrown, it can take root and grow anew. The best advice Hagen and Hughes offer is to bag it and bring it to the dump, being careful not to get the oil on the outside of the bag.

Precautionary measures

Hughes and her employees are all susceptible to poison ivy, so they use extreme measures to ensure the urushiol oil doesn’t contaminate their equipment, vehicles or skin.

After handling the ivy, Hughes and company carefully strip off their protective clothing and throw it away, and then scrub with Tecnu, a product that binds to the oil and prevents it from being absorbed into the skin.

“We follow the 15-minute rule,” said Hughes. “You’ve got to get the oil off of you in 15 minutes or less if you’re going to avoid getting the rash. And it’s less than that for people with sensitive skin.”

Using cold water, not hot, is best for washing the oil off the skin, said Dr. Christine Doherty of Balance Point Natural Medicine in Milford. Hot water can open the pores of the skin, allowing the oil to get in.

Another product that helps is Ivyblock, said Doherty. It creates a barrier and keeps the oil from being absorbed into the skin.

Anything that comes in contact with the oil should be washed immediately after exposure — including clothing, shoes, and especially pets, who can track the oil around the house. Unless it’s exposed to rain or some sort of solvent like rubbing alcohol, urushiol can hang around for years, Hughes said.

nfoster@newstote.com

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Poison Ivy An old enemy lies in wait for the unsuspecting

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