Today, Dr. Jo is going to address the following question submitted last week by a FamilySavvy reader:
Dr. Jo, my child got a horrible case of poison ivy, and nothing that I bought (including a very expensive over-the-counter wash) helped him. Our pediatrician was out of town, and the doctor we saw would not give him steroids. He itched horribly for days. What is a mom to do?
Dr. Jo Herzog, M.D.
There is a lot of poison ivy out there, so we all would benefit from a short chat about this. It is important to be aware of what it looks like and where it is so that you can avoid exposure. Avoidance is the first line of defense.
If you have poison ivy in your yard and are sensitive to it, have someone get rid of it for you. Do not burn the leaves, as you can have reaction to the smoke. The usual form of contact is with the resin that is on this plant (urushiol). This resin sticks to anything that contacts the plant (including your dog).
If you are planning to be out in the yard or woods where this is present, protect yourself. In addition to wearing long sleeves and pants, barrier creams such as Ivy Block or Stokoguard can be applied to the skin. Be aware that your clothes can have the plant resin (urushiol) on them, so you need to take them off carefully to avoid re-exposure.
If you do come into contact with poison ivy, wash your skin with soap and water. Ideally, wash within 10 minutes. Washing within an hour of exposure should work fairly well; however, after an hour, the oil will have adhered to the skin and will be more difficult to remove.
Once affected, contact dermatitis can begin, and you will get pink patches, lines, and some blistering . Of course, the worst part will be ITCHING, ITCHING , and more ITCHING. This will be when the novice will decide to intervene.
There are some products out (e.g. Zanfel) that claim to remove the oil from the skin and stop this reaction within minutes. Although it may provide some degree of relief which will vary from person to person, I do not believe that removing the allergen will lead to an immediate “cure ” of the rash and the symptoms. At this point, a reaction has already been set up in the skin, and it will have to run its course or be treated.
Treatment protocol will depend on the severity of the rash and the health of the patient. Steroids can be very effective in treating bad cases of poison ivy. For healthy patients with large areas affected (especially the face) and who are very uncomfortable, I believe that there is nothing more effective than steroids, oral or injected.
Topical steroids can help with milder skin reactions, and oral antihistamines can control itching. Drying agents like calamine lotion (do not use caladryl) can help in very mild cases, but I don’t usually recommend them. By the time patients come to me, they are already past the point of being helped by these products.
Re-exposure can keep this problem going on and on so do all that you can to get rid of the resin. Wash your clothes (even tennis shoes), gardening gloves, and any tools that were exposed to the plant. Don’t forget that your pets can expose you as well. If they go out and bring in the oil, they will rub it on you.
It is important to note that fluid from the blisters does not contain oil from the plant and will not spread the rash. Many people are afraid to get near someone whose rash is oozing fluid, but this fear is unfounded. The resin causes the rash; the fluid from blisters does not.
Sorry for your son’s experience; I hope this helps. Send any more questions to me through FamilySavvy, and try to stay out of the poison ivy!