Understanding the Poison in Poison Ivy

By Elijah Sadaphal, MD

photo of poison ivyNow that summer is in full swing, many are enjoying the pleasures of the outdoors with friends and family. However, by spending more time outside and wearing clothing that exposes more skin, new cases of poison ivy are on the rise.

What is it?
Poison ivy is a plant that can cause an allergic contact dermatitis, or a reaction in which your skin becomes red and inflamed after coming into direct contact with urushiol, clear liquid found within the sap of the plant. The plant itself is highly common in suburban areas of the northeast and typically is found along wooded areas.

Unsure if a plant is poison ivy? No problem. The leaves of the plant typically are light to dark green, almond-shaped and occur in groups of three. Each group of three leaflets attaches to its own stem, and the vines of the plant have no thorns.  The leaflets themselves are about 3-5 inches in length, have a smooth surface (but don’t touch!) and can often be shiny. A common mnemonic to remember the 3-leaf configuration is, “Leaves of three, let them be.” View photos

Once you have come in contact with the plant, you can expect to develop symptoms within 24 to 48 hours. There is a select group of people – about 10% – will develop no symptoms at all. Typical symptoms include a red, hot, burning, highly itchy rash that often forms blisters and oozes. If you develop shortness of breath, tongue swelling, throat closing and swelling of the eyelids or face, these are symptoms of a potentially life-threatening emergency and you should call 9-1-1 or visit your local Emergency Department. Rest assured that poison ivy is NOT contagious and you will NOT spread the rash by rupturing the blisters.

Treating Poison Ivy
Thankfully, while poison ivy is a nuisance, it is a very treatable and common skin condition.

  • If you think you may have come in contact with the plant, wash your skin with soap and water immediately. If the urishiol is washed away before it has time to begin reacting with your skin (15 minutes) a reaction may be prevented.
  • Avoid touching other parts of your body with exposed skin, as this may actually spread the plant’s oil to other areas.
  • There are several homemade and over-the-counter skin preparations available for use, including Calamine lotion, Burow’s solution, oatmeal, baking soda, Epsom salts and hydrocortisone cream. All of these treatments are placed directly on the rash to alleviate discomfort and itching.
  • Benadryl, or diphenhydramine, can be taken by mouth 3 to 4 times a day. It will not only stop the itching but also will work from within your body to counteract the allergic component to the poison ivy.
  • If you think your rash is in some way unusual, if you’re unsure of what is it is, or if you’ve tried all the remedies mentioned with no relief, you may need a prescription. Visit our office to have a physician evaluate your skin rash and determine the need for oral steroids. Commonly given as Prednisone or a Medrol dose pack, these medications are potent weapons to fight off stubborn cases of poison ivy.
  • You should also see a physician if you are experiencing excessive itchiness that is not relieved with over-the-counter preparations, signs of infection (pain, pus or expanding redness) or a rash that involves a very large part of the body.

Elijah Sadaphal, MD, FACEP, is a physician at eMedical Urgent Care in Berkeley Heights, N.J., and is an emergency physician at Hudson Valley Hospital Center in Cortlandt Manor, N.Y. He received his undergraduate degree from the University of Pennsylvania and his medical degree from Drexel University in Philadelphia. He completed his residency training at Thomas Jefferson University Hospital in Philadelphia and is board- certified in emergency medicine.


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