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Individuals who come in contact with the leaves, stem or root of poison ivy tend to develop rashes on the skin. In medical terms such a reaction noted on the skin is referred to as contact dermatitis.

What is poison ivy?

Poison ivy is a small shrub or rope-like vine which grows around lakes and streams in most of North America, the US and some areas of New England. The poison ivy plant has a typical appearance wherein a group of three leaves are present on the same stem. At times there may be 3-9 leaves in a group.

The rashes may also develop from indirect contact through clothes, shoes, tools, or pets that have been exposed to poison ivy. It has also been reported that smoke from burning plant has been associated with the occurrence of rashes over the body or lung irritation. 

Why do rashes develop?

The poison ivy plant contains a chemical substance known as urushiol which is an irritant. This may a defensive mechanism of the plant to protect itself from animals. This irritant substance is responsible for the occurrence of skin rashes. The rashes may develop with varying frequency following exposure to urushiol. It may occur immediately in some individuals who come in contact with the irritant for the first time in their life. In others, the rashes may not develop until the individual has been exposed to the irritant for about 4-5 times.

Estimates reveal that about 15–20% of healthy individuals are immune to urushiol and do not develop any skin reactions when exposed to it. Other 80% of the individuals may develop mild to severe symptoms based on the amount of exposure to the poison ivy plant or its other parts. Exposure to poison ivy is usually noted in individuals who are frequently involved in gardening, hiking, camping or playing in the woods.

Symptoms

The appearance of symptoms may occur either immediately after the exposure or later. In some rare cases, the symptoms have been noted to appear after about 7-10 days of the exposure. Generally the rashes are noted within about 8 h of exposure to poison ivy. Small elevations (referred to as rashes) develop over the skin that has come in contact with urushiol, the irritant substance in poison ivy. These rashes may appear all over the exposed areas and may be quite itchy. The affected areas of skin may appear red and inflamed. The affected areas may also be painful to touch in some cases. The rashes may then be filled with fluid or pus (such rashes are referred to as blisters). In certain instances the presence of a generalized swelling around the rashes may also be noted.

Treating Exposures

Immediately following exposure to poison ivy, the exposed areas should be washed thoroughly with water to remove any irritant that may be present on the skin. Cleansing the exposed areas with ‘rubbing alcohol’ whenever available, is also considered to be beneficial.  Soap application during the first wash should be avoided as it may lead to spread of the itchy substance. Following this, one may take bath with soap and water.

Care should be taken to wash the hands and clean the nails thoroughly as any irritant left behind may cause the irritant to be deposited on other parts of the body leading to the spread of the rashes. This process of cleaning usually prevents the formation of rashes. However, some individuals may have mild rashes even after thorough cleaning. No further treatment may be required for such rashes as they subside without any treatment.

Treatment Options

The rashes usually develop when one fails to clean the exposed areas immediately. Sometimes one may be unaware that an exposure occurred until the rashes appear. In such cases treatment may be required to reduce the intensity of the symptoms and obtain relief from pain or itching sensation.

Various over-the-counter creams and lotions are available for application over the rashes. These creams and lotions usually contain certain medicated substances such as corticosteroid, aluminum hydroxide or zinc carbonate which help in reducing the skin inflammation.

At home, application of a clean cloth or cotton dressing, soaked in cool water can provide relief from itchy sensation. A commercially available product known as Burow’s solution can also be used instead of cool water. The soaked dressing should be applied on the affected areas for about 4-6 times in a day until the rashes heal completely. This procedure has advantages such as reducing the itchiness, clearing the skin debris and prevention of any bacterial infection in the affected areas of the skin. Calamine lotion is another over-the-counter product that is also found to be helpful in minimizing the symptoms. Frequent baths with plain water or with a colloidal oatmeal (for example, Aveeno©) may be beneficial in cases of widespread rashes.   

Individuals who have severe reactions or other symptoms such as fever, tiredness along with rashes require a visit to the physician in order to prevent any further complications.

Prevention

Some of the steps that can be followed to prevent poison ivy rashes include:

  • Avoid contact with poison ivy plant. A general rule known as “leaves of three, let it be” is followed by many to identify and avoid poison ivy plant 
  • One should always remember to use protective gloves, wear long pants and shirts with long sleeves, and boots while working in shrubs, clearing plants in the garden, or when going on hikes/treks
  • Application of certain over-the-counter creams such as Ivy-Block on the skin before going for trek in the woods may prevent rashes when exposed to poison ivy. It should be noted that application of such protective creams should be made at least 15 min before the anticipated exposure. The cream is required to be reapplied after 4 h of the first application
  • Clean the objects such as shoes, clothing, bags etc that may be brushed accidently to the poison ivy plant during your outings.

Complications

Exposure to poison ivy generally does not result in any major complications. In certain instances when the rashes are very itchy, repeating scratching may cause bacterial infection. Such infections require the administration of antibiotics. In some rare cases, individuals who are allergic to plants in general may develop some severe reactions and may require immediate medical attention to prevent further complications. 

  • 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