FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

BLEACH IS NOT A GOOD HOME REMEDY FOR POISON IVY

Question: It's only spring, and I've already gotten poison ivy again. I usually don't break out with this rash until summer. Do you have any tips to help it clear up or to help prevent it in the first place?

Answer: What I say about poison ivy is also true for the plant's close relatives, poison oak and poison sumac. In about 85 percent of those who are exposed it, the body reacts to the chemical urushiol found within poison ivy's leaves, stems and roots causing the itchy blisters that are characteristic of the condition. In order for this chemical to get on your skin and produce a rash, the poison ivy plant must be broken. Unfortunately, it can be hard to tell whether or not a plant has been broken, since very small breaks caused by insects or other minor damage to the plant will let the urushiol seep out and cover a portion of a leaf's surface.

Once the chemical comes in contact with human skin, it begins to penetrate within minutes, but it takes from 12 hours to several days for the person to experience a full-blown poison ivy reaction. First there is itching, redness and swelling, followed by blisters.

Contrary to myth, poison ivy can't be spread by touching the oozing liquid in the blisters!!! This liquid is not urushiol, but your body's own fluid produced as part of its reaction to urushiol.

But as you know, poison ivy can be spread. Urushiol is sticky, so it can be carried on the fur of animals, garden tools, golf balls or anything else that comes in contact with a broken plant. Touching these objects or a poison ivy plant will transfer the offending chemical to your skin. Then, touching another part of the body or another person's body can transfer the chemical to that area. That's the reason poison ivy tends to turn up all over the body, even though the plants only came in contact with the exposed areas of the skin.

The area which has the greatest exposure to the urushiol will usually break out first. Areas which have thick skin or less urushiol on them will then break out a day or two later, giving the impression that the poison ivy was spread from the first group of blisters.

So how do you treat poison ivy: The best treatment is avoiding it. If you suspect that you have been in contact with poison ivy or one of its cousins, the first thing to do is to thoroughly wash with soap and water, since water alone will not remove the sticky urushiol. Any clothing that you were wearing should also be washed promptly. Handle the clothes carefully, preferably with gloves, to prevent any more skin contact with the sap. If more than 20 minutes have elapsed since the exposure, washing may not prevent the initial rash, but it can prevent you from spreading it further.

Those with a mild case of poison ivy may require no more than wet compresses or soaking in cold water to relieve the itching. But please don't use the old remedy of household bleach. I see quite a few individuals each year with severe skin irritation caused by this ineffective home remedy.

There are several non-prescription medications on the market that can help dry up blisters and relieve itching. Your physician or pharmacist can recommend one for you. None of the over-the-counter products should be used for more than seven days, and some should not be used on large parts of the body or on young children (read the instructions on the package).

Severe cases of poison ivy should be treated by a physician who may prescribe a few days worth of corticosteroids or other medications to relieve the swelling, blisters and itching. In many cases, these drugs can be highly effective and bring prompt relief.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.