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Poison oak is a common cause for occurrence of rashes when individuals come in direct contact with the leaves, stem or root of the poison oak. Such rashes are otherwise referred to as contact dermatitis.

What is poison oak?

Poison oak is a shrub related to the poison ivy family, which is found commonly across many regions of North America, the US and some areas of New England. This plant is a common cause for occurrence of rashes when individuals come in direct contact with the leaves, stem or root of the poison oak.

Such rashes are otherwise referred to as contact dermatitis. Indirect contact through clothing, shoes, tools, pets and even smoke from burning plant has been associated with the occurrence of rashes. 

Why do rashes occur?

These rashes occur owing to the presence of a substance known as urushiol in the poison oak plant. It has been estimated that about 15–20% of healthy individuals are immune to this substance and do not develop any reactions. However, other healthy individuals who are not immune may develop mild-to-severe symptoms based on the amount of exposure to the plant or its other parts.

Healthy individuals can develop rashes either with the first exposure itself or after repeated exposures over a period of time. Exposure to poison oak usually occurs when you are gardening, hiking, camping or playing in the woods. Wondering why you got the rash after wearing a jacket that you hadn’t worn until last week after the trek last year? The answer is simple. Urushiol, which if rubbed off the poison oak plant onto other things like your jacket, can dry and stay potent for years together and still cause rashes when you come in contact with it.

Symptoms

The symptoms of exposure to poison oak may develop within about 8 h of exposure to it. The symptoms may vary from mild to severe. The exposed areas develop small elevations (rashes) on the skin, which may be quite itchy. Redness and inflammation over the skin may also be observed in the areas that have come in contact with poison oak. The skin may be tender to touch and painful at times. In some cases, these rashes may be filled with fluid or pus. In some cases, a moderate amount of swelling may also be noted in the region near the rashes. In severe cases, which are quite rare, there may be a widespread appearance of the rashes.

Treating Exposures

The area exposed to poison oak should be washed thoroughly with water to remove any irritant that may have been left behind. Some suggest the use of ‘rubbing alcohol’ to cleanse the exposed areas before cleaning with water. Nevertheless, the main aim is to remove any irritant present on the skin. Remember to wash your hands and clean your nails after washing the exposed area, as any irritant left behind can cause the rashes to spread when you touch other parts of your body.

Application of soap while washing for the first time should be avoided as it leads to spread of the substance responsible for the itchy reaction. After cleaning the exposed areas with plain water or ‘rubbing alcohol’ thoroughly, one needs to take a bath with soap and warm water. This procedure will prevent the irritants from entering the skin and causing adverse reactions. In some cases, mild rashes may still appear. No further treatment may be required for mild poison oak rashes, as they tend to subside without any treatment.

Treatment Options

If not cleansed early, the exposed areas of skin can develop rashes that may be quite troublesome. Such conditions may require additional treatment if the symptoms are causing discomfort. These treatment options soothe the area and reduce the symptoms. Application of certain skin creams or lotions that contain a medication known as corticosteroid is commonly advised for severe rashes and it helps in reducing the inflammation in the affected region.

Other options that also seem to have a beneficial effect include, application of wet dressings, anti-itch creams or lotions (that are available as over-the-counter medications) on the affected areas of the skin. Absorbent materials such as cotton dressings soaked in cool water or Burow’s solution can be applied over the affected areas for about 4–6 times a day.

This process helps in preventing infections, clearing of the skin remnants and also reduces the itchiness. Application of calamine lotion may also have a similar effect. Individuals with widespread rashes may have symptomatic relief with frequent baths or bathing with colloidal oatmeal (for example, Aveeno©).  

Individuals experiencing severe reactions may have to visit a physician in order to prevent any complications. The physicians generally prescribe certain oral medications that need to be consumed for about 2-3 weeks depending on the severity of the rashes.  

Prevention

Prevention of exposure to poison oak is always better than suffering from rashes. Some of the simple steps that can be followed to prevent poison oak rashes have been listed below.

  • Try to observe how a poison oak plant looks like and avoid contact
  • Use protective gloves or other barriers while working in shrubs or clearing plants in the garden 
  • Wear long pants and shirts with long sleeves, boots and gloves while playing in wooden areas, in areas around lakes, or when going on hikes/treks
  • Application of certain creams such as Ivy-Block to exposed areas of skin may be beneficial. This cream forms visible, clay like coating after application. It should be applied at least 15 min before the anticipated exposure. Repeat application is required after 4 h of first application
  • Wash the exposed areas thoroughly with water
  • Clean contaminated objects such as shoes, clothing, bags etc.

Complications

No major complications are noted in most of the cases of exposure to poison oak. Secondary bacterial infection of the inflamed areas of the skin due to repeated scratching may be noticed in some cases. 

Some individuals may develop severe allergic reactions following exposure to poison oak. Such individuals may develop generalized swelling over the body. This may or may not be associated with other signs and symptoms such as fever, headache and body ache. A physician should be contacted immediately if such signs and symptoms are noted following exposure to poison oak.

  • pediatrics.about.com/cs/conditions/a/poison_ivy.htm
  • bodyandhealth.canada.com/channel_condition_info_details.asp?disease_id=193&channel_id=139&relation_id=10827#Symptoms
  • www.nlm.nih.gov/medlineplus/ency/article/000869.htm
  • www.mayoclinic.com/health/poison-ivy/DS00774/DSECTION=treatments-and-drugs
  • www.pubmedcentral.nih.gov/picrender.fcgi?artid=1308758&blobtype=pdf