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Poison Ivy – 5 Tips For Effective Treatment
The itch is driving you crazy! Need help now!
The rashes caused by poison ivy, poison oak, and poison ivy look much the same—raised, red bumps with blisters in the areas of exposure. All are caused by hypersensitivity to plants containing urushiol. Rash and itching begin 24 to 48 hours after exposure, worsening over the next few days. Assuming you showered before the rash appeared, poison ivy is not contagious. The only way to share it is if the vegetable oil is still on your skin and you touch another person. The fluid from the blisters is not contagious.
Although in some cases people are concerned about their appearance, for most it is the itching that prompts them to seek medical attention.
Here are 5 tips for quick relief.
1. Use an OTC antihistamine. Over-the-counter antihistamines are just as good as prescription antihistamines. The primary benefit of using these is to reduce itching, although they may reduce swelling slightly. The main side effect is drowsiness with certain antihistamines, although this can be helpful if itching is keeping you awake. Non-sedating antihistamines include Claritin (loratadine) and Zyrtec (cetirizine). Sedating antihistamines include Benadryl (diphenhydramine), chlorpheniramine, and doxylamine (found in sleeping pills and Nyquil). If these are effective in reducing your symptoms and the rash is not a concern, an antihistamine may be all you need. The rash will go away on its own if you can wait – which usually takes 2 to 4 weeks.
2. Use an OTC topical preparation. Calamine lotion and oatmeal baths help relieve itching, but they don’t actually reduce the rash. 1% hydrocortisone cream is effective in reducing itching and treating rashes in mild cases. A more severe reaction may require prescription medication. Hydrocortisone reduces the body’s reaction to the harmful oil, making the rash look less red and irritated. Any of them can be used in addition to an antihistamine.
3. Call your doctor for a prescription. Your doctor may be willing to prescribe medication over the phone, or may require you to come in for an appointment to check that your self-diagnosis is correct. Prescription options include stronger steroid creams, steroid injections, and steroid pills. For small areas of rash, creams are most suitable. However, for larger areas or a rash on the face (especially if the eyes are swollen shut), steroid injections or oral medications are appropriate. Usually, the rash starts to improve 24 to 48 hours after starting treatment. Don’t make the mistake of stopping the medication as soon as the rash improves – it’s likely to come back if you stop too soon. A five-day treatment plan is the minimum, but 10 to 14 days of medication is often recommended.
4. Watch out for secondary infection. Any exposed part of the skin can become infected. If the area of redness increases, or especially if you see pus (not just clear fluid from the blister), see your doctor to find out if you need an antibiotic.
5. Do not use triple antibiotic ointment or Benadryl cream. When applied to the skin, both the neomycin in triple antibiotic ointment and the active ingredient in Benadryl cream (diphenhydramine) can cause a rash that looks like poison ivy. Many patients have worsened the problem or confused the diagnosis by using these over-the-counter preparations. (Diphenhydramine (Benadryl) taken by mouth does not cause this problem.)
In the end, an ounce of prevention is worth half a pound of cure. Avoid contact with the leaves, stems and roots of plants, as they all contain urushiol. If you pull out plants, use disposable gloves and throw away both the plants and the gloves. Burning the plant can put the chemical into the air and cause a serious rash in anyone exposed to the smoke.
Copyright 2010 Cynthia J. Koelker, MD
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