• July 2011

Avoid That Big Summer Threat—Poison Ivy

By Dr. John Jones
Medical Director
Simplicity Urgent Care

The path to my children’s elementary school leads me and my four little ones through a wooded park with a small bridge that takes us over a little brook. While it looks idyllic, I happened to glance off the path this month and spotted what appeared to be a field of poison ivy.

After many reminders that “leaves of three, let it be,” the kids have kept on the path. However, this experience encouraged me to share with you how to identify, avoid, and deal with a case of poison ivy.

What it looks like: Toxicodendron radicans (poison ivy) grows along stream banks, roadways, fields, and forests. The compound leaf consists of three pointed leaflets, usually two to four inches long, and the middle one often has a longer stalk. The edges—smooth, toothed, or lobed—are glossy and reddish when they emerge in the spring, then become yellow toward the fall. Also, yellowish-green flowers appear in June or July, followed by light-colored berries.

What you need to know: Poison ivy and poison oak are in the cashew family and are not actually made of ivy or oak. While direct contact with the plant itself is the most common method of exposure, you can also get the rash from indirect contact—such as by touching clothing, shoes, or pets that have been in contact with the plant’s resin, called urushiol, which is widely distributed throughout the leaves, stems, and roots. For those who are very sensitive, simply being downwind of burning poison ivy can cause a reaction, including inflammation of the lungs.

What to do if you have been exposed.

The rash usually develops within 24 to 48 hours, but can sometimes take up to a week. As is typical with any rash, it will be a very itchy, red rash that will develop into blisters that may be filled with clear fluid. Exposure to the fluid itself will not cause the rash to spread, or cause another person to have poison ivy, since the resin is not present in the fluid from the blisters. If left untreated, the rash usually resolves itself in seven to 10 days.

The initial symptoms of poison ivy/oak include:

  • Itchy skin, red streaks, or overall redness where the plant brushed against your skin.
  • A rash, small bumps, or bigger hives (larger raised areas).
  • Fluid-filled blisters that may seep or leak.

More serious symptoms include:

  • Swelling of the face, mouth, neck, genitals, or eyelids (which may prevent the eyes from opening).
  • Widespread, large blisters that ooze large amounts of fluid.

How to relieve the symptoms. The first line of treatment is placing cold, wet compresses on the rash for 15 to 20 minutes, several times per day. Baths with Aveeno Soothing Bath Treatment, made with oatmeal, can be very soothing and help minimize the itching. Benedryl tablets can also help with the itching.

Steroids are an option. In bad cases of poison ivy, steroids can also be helpful. Initial treatment is topical steroids; however, more serious exposures can require oral steroids such as prednisone. I always advise patients that occasionally after they finish their prescription, the rash can return if their body has not processed the resin entirely.

In a nutshell: Do enjoy your summer, but be careful to avoid poison ivy. If you are exposed:

  • Wash the area quickly with soap and water.
  • If you develop a rash, try cool compresses or Aveeno oatmeal baths.
  • If symptoms persist, or you are increasingly uncomfortable, do consult your physician.

As always, contact us any time with your urgent care questions: john.jones@simplicityurgentcare.com.

Photo credit: SheKnows.com

About John Jones, MD, FACEP, FAAP

An emergency physician at INOVA Fair Oaks Hospital who is certified in both pediatric and adult emergency care, Dr. John Jones is a graduate of George Washington School of Medicine with an undergraduate degree from Dartmouth College.

He earned several departmental awards in research and medicine during his course of study. He completed his residency in emergency medicine at George Washington University, then began working at the Quincy Medical Center in Quincy, MA, where he taught residents and was also a clinical instructor at Boston University.

Dr. Jones then completed a two-year fellowship program at INOVA Fairfax Hospital for Children, and is now boarded by the American Academy of Pediatrics and the American College of Emergency Physicians—one of the few physicians in the country who is double boarded in both emergency medicine and pediatric emergency medicine.

Most recently, he worked as an emergency physician at Shady Grove Adventist Hospital in Rockville, MD, in both the pediatric and adult emergency departments. He also taught residents and is a clinical instructor at Georgetown University. He maintains affiliations with several professional organizations, including the American Academy of Pediatrics and The American College of Emergency Physicians. He is also active with the Urgent Care Association of America.

For more information, contact Dr. Jones at john.jones@simplicityurgentcare.com.

Source: Fairfax County Government