(Survival manual/6. Medical/e) Skin/Poison Ivy, Oak and Sumac)
Poison Ivy, Oak, and Sumac Overview
More than half the people in the United States are sensitive to poison ivy, poison oak, and poison sumac. If you are sensitive, you can develop an itchy, blistering rash by coming into contact with these plants.
Whether you are working or just enjoying the outdoors, look out for these plants:
• Poison ivy is generally found east of the Rocky Mountains, growing as vines or shrubs. The leaves can have either smooth or notched edges and are often clustered in groups of three.
• Poison oak is more commonly found west of the Rockies, usually as a small bush but sometimes as a climbing vine. Its leaves are smooth-edged and cluster in groups of three, five, or seven.
• Poison sumac is most often found in wet areas of the Southeast. The leaves are generally smooth and oval-shaped, with seven to 13 growing on each stem.
• The appearance of each of these plants can vary considerably from region to region, and with the seasons. Even dead plants in underbrush can transmit the toxic oil to your skin.
Poison Ivy mnemonic:
Leaves of three, let it be, berries white, take flight! (Poison Ivy develops white berries, Poison Sumac develops small white flowerets.)
[Poison ivy, above (L>R)
(L) Poison ivy as a woodland ground cover. (C) Climbing Poison Ivy- a climbing vine. (R) Poison Ivy–as a small free-standing shrub – vivid red fall colors.]
[Poison oak, above (L>R)
(L) Poison Oak as a woodland floor. cover. Poison oak may grow as a small one-stick plant, as a bush, or in a vine-like form up the side of a true oak or other tree. (C) Poison oak, is not actually an oak, but its leaves look somewhat like an oak leaf. (R) Poison oak – fall colors.]
[Poison sumac, above (L>R)
(L) Poison Sumac-limb. (C) Poison Sumac is a shrub or small tree, up to 20 feet in height, with 7-13 leaflets per pinnateleaf. (R) Poison Sumac-fall colors.]
[Above: Rash from Poison Ivy/Oak/Sumac is an allergic reaction caused by contact with the oil, urushiol, found in the leaves. The three poisonous plants are all basically the same, they cause the same dermatitis rash, itch, are treated the same and take 1-3 weeks to go away. Urushiols are among the world’s most potent external toxins. The amount of urushiol it takes to cause a reaction is measured in nanograms (one billionth of a gram.) It’s estimated that it would take only one ounce of urushiol to cause a rash on everyone on the earth!]
Causes of Poison Ivy, Oak, and Sumac Rash
The rash caused by poison ivy, oak, and sumac is an allergic skin reaction to an oil, called urushiol, which is in the plant. This oil is found in all parts of the plant, including the leaves, stems, roots, and berries.
Exposure to the oil occurs through any of the following:
• Touching any part of the plants.
• Touching clothing or other objects that have contacted the plants.
• Touching pets or other animals that have contacted the plants.
• Exposure to the smoke of burning plants.
Symptoms of Poison Ivy, Oak, and Sumac Rash
• Exposure to poison ivy, oak, or sumac causes an itching rash that usually appears within 24-72 hours.
• The rash usually starts as small red bumps, and later develops blisters of variable size. The rash may crust or ooze.
• The rash may be found anywhere on the body that has contacted the oil from the plant. It can have any shape or pattern, but is often in straight lines or streaks across the skin.
• Different skin areas can break out at different times, making it seem as if the rash is spreading.
• Contrary to popular belief, leakage of blister fluid does not spread the rash. It is spread only by additional exposure to the oil, which often lingers on hands, clothing and shoes (which are often overlooked as carriers), or tools.
• When to Seek Medical Care
See your health care provider if you have the following conditions:
• Large areas of rash causing significant discomfort
• Rash on your mouth, genitals, or around your eyes
• An area of the rash that becomes infected or drains pus
• A great deal of swelling
• People who are highly sensitive to these plants can get a severe reaction, called anaphylaxis.
• If you have swelling of the face and throat or difficulty breathing, feel dizzy or faint, or lose consciousness, you may be having an anaphylactic reaction.
• If you have any of these symptoms, go immediately to a hospital emergency department.
• Do not attempt to drive yourself; if no one is available to drive you immediately, call 911 for emergency medical treatment.
Treatment of Poison Ivy, Oak, and Sumac Rash
Usually self-care at home is all that is needed for a reaction to these plants.
Self-Care at Home: Treating Poison Ivy Exposures
If you are exposed, you should quickly (within 10 minutes):
• first, cleanse exposed areas with rubbing alcohol.
• next, wash the exposed areas with water only (no soap yet, since soap can move the urushiol, which is the oil from the poison ivy that triggers the rash, around your body and actually make the reaction worse).
• now, take a shower with soap and warm water.
• lastly, put gloves on and wipe everything you had with you, including shoes, tools, and your clothes, with rubbing alcohol and water.
• If you can remove the oil within 10 minutes, you are unlikely to develop the rash.
Symptoms from a mild rash can sometimes be relieved by the following:
• Cool compresses with water or milk
• Calamine – A nonprescription lotion
• Aveeno oatmeal bath – A product you put in the bath to relieve itching
• Oral antihistamines such as diphenhydramine (Benadryl) – Caution: these medications may make you too drowsy to drive a car or operate machinery safely
• Nonprescription corticosteroid (for example, hydrocortisone) creams usually do not help.
• Do not attempt to treat severe reactions or to “wait it out” at home. Go immediately to the nearest emergency department or call an ambulance.
__Take an antihistamine (one to two tablets or capsules of diphenhydramine [Benadryl]) if you can swallow without difficulty.
__If you are wheezing or having difficulty breathing, use an inhaled bronchodilator such as albuterol (Proventil) or epinephrine (Primatene Mist) if one is available. These inhaled medications dilate the airway.
__If you are feeling light headed or faint, lie down and raise your legs higher than your head to help blood flow to your brain.
__If at all possible, you or your companion should be prepared to tell medical personnel what medications you take and your allergy history.
• Topical corticosteroid creams (prescription strength) – These reduce the immune response and relieve inflammatory symptoms.
• Oral corticosteroid medication (such as prednisone) – These have effects similar to those of the creams but are needed for a more severe or widespread reaction. A course of steroids can run from three days to as long as four weeks.
• Oral antihistamines – For itching. The main advantage of the prescription antihistamines is that they do not make you sleepy, allowing you to carry on your normal activities.
• Antibiotics – These are needed only if the skin becomes infected after the initial rash.
• Avoid these plants. Learn what they look like in your area. Be aware that their appearance can vary with the seasons.
• Do not burn the plants. Burning can release the allergens into the air.
• Wear proper clothing to protect your skin, such as gloves, long sleeves, and long pants.
• Bathe pets that may have the oil on their fur. Use soapy water. Do not forget to wear protective clothing while doing this.
• Wash any clothing that might contain the plant oil. Unwashed clothes can retain the oil and cause a rash in anyone who wears or handles them.
• Before you go out in a potentially infested area, you can apply nonprescription products such as Ivy Block or Stokoguard, which act as a barrier to the oils.
• Remember that the oil can be transferred from people, pets, or objects. Thoroughly wash anything that may carry the oil.
• The rash and itching usually get better gradually and go away completely in two to three weeks. Treatment should be continued at least this long because the rash can come back if medicines are stopped too soon. You may have temporary darkening of your skin when the rash disappears.
• Surrounding redness, pain, and pus can indicate a skin infection, which your doctor can treat with antibiotics. This is more likely to happen if the rash is scratched so much that the skin is broken.
• You almost certainly will have another reaction if you come in contact with these plants again after a first reaction.