Taking The Itch Out Of Poison Ivy

poison ivy armWhich remedies work, and which should be avoided.
By Kelly Ann Butterbaugh
Poison Ivy Article PDF

The simplest solution to the itchy after-affects of poison ivy is to avoid the plant, but to the 10 to 50 million Americans suffering from rashes each year, this isn’t so easy. Home remedies aren’t any easier either, since some remedies cause more harm than help. So what really works? And more important, why does it work?

Poison Ivy Remedy 1Identifying the Culprit

The three types of poison common throughout the United States are poison oak (Rhus diversiloba), poison sumac (Rhus vernix), and poison ivy (Rhus radicans). All belong to the Anacardiaceae family. Poison oak and poison ivy grow three leaves per stem while poison sumac has seven to thirteen leaflets per stem.

Unknown to many is that it’s not the plant that causes the rash: it’s the urushiol oil present in the plant’s sap that causes the allergic reaction. Vaguely yellow in color, the saf will flow fram any broken, crushed, or bent part of the poison plant, and even trace amounts can cause the skin’s allergic reaction. Often animals carry the oil on the fur, transferring it to humans through touch.

Poison Ivy treamtent 2Because the poison rash is an allergic reaction, some people react more severely than others. Tolerance decreases with each exposure, and those who experience severe reactions most likely have been repeatedly exposed to the plant.

Preventing the Problem

The key to prevention is to avoid contact with the urushiol. While outdoors, wear protective clothing and thick garden gloves, as urushiol is easily carried on fabrics.

Try to work outside during cooler weather. Hot weather not only opens pores, which allows further oil absorption, but also causes sweat that can act as a transporter of the oil to other areas of the skin. Similarly, hot showers and baths also open pores. After being around poison, wash the exposed areas with cool water and soap. Be careful not to spread the oil onto towels or other surrounding surfaces, and wash all clothes in hot water after working outside. The oil is resilient and can last for months, cause a later reaction.

Poison Ivy home remediesMichael P. Zimring, M.D., Director for the Center for Wilderness and Travel Medicine at Mercy Medical Center in Baltimore, Maryland, and author of Healthy Travel: Don’t Travel Without It advises, “It is important to note that if you wash off the urushiol or the resin that contacts your skin within 10 to 20 minutes after exposure, you might avoid an allergic reaction unless you are highly sensitized the urushiol.”

Contrary to popular belief, the blisters caused by the rash do not further spread the rash; thought they may seem like they do. Thicker skin absorbs and reacts differently than more sensitive areas, meaning areas such as the palms may show the rash hours if not days later than areas such as the inner arms. That, partnered with the spread of urushiol though clothes and other fibers’ contact, can make the rash seem like it’s spreading through the exposed blisters.

Poison Ivy At Home things“Your skin has natural enzymes that break the urushiol down over four hours, so the rash you see of poison ivy really represents the areas of skin that were touched, and retouched other areas during the first four hours until the oil itself is no longer able to act as an allergen…. After that, it really can’t spread, and the fluid in blisters doesn’t spread the condition either,” says Charles E. Crutchfield III, M.D., Clinical Associate Professor of Dermatology at the University of Minnesota Medical School and medical director of Crutchfield Dermatology.

Dr. Adeliaide A. Hebert, Professor of Dermatology and Pediatrics at the University of Texas-Houston Medical School also adds, “Many patients (and many physicians) do not realize that scratching the blisters is not what spreads the poison ivy. Rather, it is the original contact with the urushiol that causes the reaction. Once can touch poison ivy once and still break out in new areas over the course of the next two to three weeks.”

When Relief is Harmful

Home remedies span from logical and harmless to irrational and hurtful. One harmful plan is to apply caustic products to the skin to “draw out the itch.” Solutions made with products such as bleach are dangerous and should never be applied to the skin. Similarly, hot water will only injure the skin and open pores–two things that will further the degree of the allergic reaction.

Scratching the area is the most common action. While it’s difficult to control, scratching can invite infection and damage healing skin. Instead, try to calm the itch.

“The most effective home remedy is over-the-counter hydrocortisone one percent cream,” advises Dr. Crutchfield. While they may seem like a good idea, avoid using other over-the-counter medications for the rash. Antihistamines, anesthestics, or antibiotic creams should be avoided.

“Dermatologists typically do not recommend Lannacaine or Neosporin because they contain potential skin sensitizers. Applying an agent like this to broken skin may allow enhanced penetration and greater absorbtion. neomycin is the ungredient in Neosporin that can cause an allergic reaction. Many individuals in the United States are allergic to this ingredient,: says Dr. Herbert, who was suffering from a case of poison ivy at the time.

Stopping the Itch–The Right Way

There are safe measures for relieving the discomfort of poison. The easiest is to apply cool compresses that will relieve the itching by lessening the inflammation that causes it. Aloe vera gel or ice packs work well without causeing further damage.

A variety of skin soothing lotions can also be applied to the skin. The common pink calamine lotion works well, as does a home mixture of buttermilk, vinegar, and slat in equal portions. A paste made of baking soda mixed with water will also relieve the itching.

If applied within the first few hours of exposure, a mixture of half isopropyl rubbing alcohol and half vinegar, the key ingredients found in most poison ivy soaps, may help wash away urushiol. Follow this with a wash in cool, soapy water.

Some plants can soothe the rash as well, and while they may not work 100 percent, they also are not harmful to try. Aloe plants will cool the skin and relieve the itch. Jewelweed, also known as touch-me-not (Impatiens capensis), has a jellylike sap that can be spread onto the skin.

When to See the Doctor

Most poison ivy rashes can be treated at home; however, there are times when medical help is needed. If the rash has spread over what seems to be the entire body, the swelling and blisters are on the face or near the eyes, or an infection is suspected, more than a home remedy is needed. In some cases breathing may become difficult, especially if the plant was burned sending urushiol into the air. If breathing is laborious, visit the emergency room immediately.

While benign home rememdies might work for some and not for others, it is important to care for the damaged skin. Harmless if tried and precious if effective, these remedies just might give some relief to the otherwise maddening itch of poison ivy.

Poison Ivy in Frigid Winter & Spring Months Is Actually Common

Imagine a patient enters your clinic in February, complaining about a red and itchy skin rash. Your first thought is that it looks like poison ivy, but the patient insists it couldn’t be. After all, it’s winter, and the last time he visited his cabin, he stayed mainly indoors, except for a couple of times to quickly move around some old cinder blocks in the yard, chop a bit of wood or do some other quick outdoor task.

Continue reading Poison Ivy in Frigid Winter & Spring Months Is Actually Common

7 Practical Tips Combating Common Skin Problems

By Charles E. Crutchfield III, M.D.

Trying to choose the right skin care products can be absolutely bewildering. In department stores alone, it’s dizzying to see the hundreds if not thousands of choices. Salespeople wearing white coats, looking like either mad scientists or doctors, are all-too-eager to recommend the 34-step skincare program offered exclusively by their company that will solve of all of your complexion woes.

Even at home in your own living room, you’re flooded with a bevy of late-night infomercials touting the latest and greatest of skincare products.

Here, I’ll cut through the clutter and give you some practical tips on combating seven common skin problems.

UNSIGHTLY SKIN PORES

Pore size is genetically determined. You can no more change it than the size of your hands or the color of your eyes.

What you can do is improve their appearance by making sure they’re not clogged. Try a product with salicylic acid (which can penetrate pores and help clean them out) or an alpha-hydroxy acid, such as glycolic or lactic acid (which can help slough off residue in the pore openings). Be sure to put on a sunscreen after using such products.

CIRCLES UNDER THE EYES

I find this to be one of the most challenging skin conditions to treat. I am often disappointed by the commercials on late-night TV about creams and lotions and potions that promise cures. The reason is there are three major causes for dark circles, and you have to choose your treatment based on your particular problem.

  1. A deposit of melanin (pigment) in the skin, called hyperpigmentation. Sometimes, lightening products, such as those that contain kojic acid or hydroquinone, will work on this. You can get them over the counter or, for stronger products, by prescription. Alternately, there are some newer lasers that may work for you.
  2. Visible veins. If the skin is thin or your veins (which carry deoxygenated blue blood) run close to the skin, the area appears darker. Over-the-counter products with vitamin K may help. My preference is to inject a filling agent, like hyaluronic acid, to thicken the area so the veins are not as apparent.
  3. A concavity that actually casts a shadow under the eye, making the area look darker. Once again, injecting a filler can help this.

You can also try eye creams with alpha-hydroxy acids, which may help get rid of darkened skin or, over time, stimulate collagen production, thickening the skin in that area.

To get an idea of what’s causing the circles under your eyes, using good lighting, look in a mirror and pull the skin taut. If your problem is hyperpigmentation, it will remain dark. If there are veins under the skin, you will see those. If there is a concavity, it will disappear.

BUMPS ON THE ARMS

Affecting approximately 40 percent of adults and even more adolescents, keratosis pilaris is a common condition. It’s what results in those tiny red bumps that appear on the back of upper arms and sometimes the tops of thighs and cheeks. (They’re actually hair follicles that are clogged with a skin protein called keratin.)

Because keratosis pilaris is so common, many dermatologists think of it as a normal skin variant, and it’s difficult to treat things that are normal. But people still don’t like rough, red bumps on their skin.

The approach on this is to improve the appearance rather than eradicate the condition. I recommend over-the-counter alpha-hydroxy acid lotions such as AmLactin and LactiCare. The Glytone Keratosis Pilaris Kit is a product with a special moisturizing lotion and loofah.

Though there’s no cure for keratosis pilaris, it does tend to disappear with time.

PUFFY EYELIDS

Puffy eyelids, along with swelling, flaking and itching, are oftentimes a sign of skin allergy.

Because the skin around the eyes tends to be the thinnest on the body, it is the most sensitive to ingredients or products to which one may be allergic. Most dermatology offices have readily available allergy testing to evaluate and treat such conditions. For short-term relief, you can try cooling compresses.

CELLULITE

When fibrous strands under your skin tug on some fat and other fat pops up around it, the skin dimples, and you have what we call cellulite. It’s perfectly normal; the vast majority of women and even a few men have it. Nonetheless, people want to get rid of it. Unfortunately, there’s no proven, safe way to accomplish that yet.

There are a couple of newer contraptions that somewhat work: the laser-based TriActive and the light-based VelaSmooth. But they don’t get rid of all the cellulite, and their effects are temporary, requiring monthly maintenance sessions. Plus, at around $1,000 to $2,000 for an initial series of treatments, they’re not cheap.

Genes determine whether you have cellulite. Losing weight may improve its appearance but won’t banish it. I’ve seen many Olympic-caliber athletes in their early 20s with dimply skin.

BLOTCHY SKIN

Skin irritation or inflammation (from allergies, eczema, dry skin, acne) can activate cells that produce color, resulting in blotchy skin. The best way to prevent this is to keep the skin gently cleansed and well-hydrated.

For dark spots you already have, you can try lightening products with kojic acid or hydroquinone. The strongest of these are by prescription only.

ACNE

Entire textbooks have been written about acne. There are four points to consider when treating it: plugged pores, bacteria, inflammation and excess oil.

When you have acne, dead skin cells and oil are clogging your pores. Bacteria can feed on this banquet and cause pimples. Alternately, the stuff in your pores can oxidize, just like rust on a car, and turn black. These are blackheads.

Even better, all this time, glands under the plugged pores are producing oil.

To unclog the pores, salicylic acid and benzoyl peroxide, the most common ingredients in over-the-counter acne treatments, work well. If they don’t fix your problem, your dermatologist has prescription options.

Prescription meds can also help with excess oil. (On some patients, I use the Aramis laser, which shrinks oil glands.)

Finally, people often wonder whether what you eat matters when it comes to acne. The textbooks say no; however, everyone has different triggers. I tell patients that if they know that when they eat a certain food it causes their acne to flare, then they certainly should avoid that food.

Board-certified dermatologist CHARLES E. CRUTCHFIELD III, M.D., is a professor at the University of Minnesota Medical School and medical director of Crutchfield Dermatology in Eagan, Minn.

New Tools To Examine Moles

Epiluminescense Microscopy and Dermatoscope

Crutchfield Dermatology uses new, painless method to detect and prevent skin cancer

Crutchfield Dermatology, in Eagan, is employing a new tool for the improved detection and prevention of skin cancer.

Called the Dermatoscope, it not only improves the ability to detect skin abnormalities, but it also vastly improves the comfort of the patient while being examined. Continue reading New Tools To Examine Moles

Epiluminescence Microscopy and Dermatoscope

Crutchfield Dermatology uses new, painless method to detect and prevent skin cancer

Crutchfield Dermatology, in Eagan, is employing a new tool for the improved detection and prevention of skin cancer.

Called the Dermatoscope, it not only improves the ability to detect skin abnormalities, but it also vastly improves the comfort of the patient while being examined.

The Dermatoscope contains an illuminated magnifying lens that allows physicians to look deep inside the mole, making the identification of suspicious moles easier without the need for a biopsy.

“This is a very special skin-surface microscope. You can do a much better job with this than with the naked eye,” said Dr. Charles E. Crutchfield III, founder of Crutchfield Dermatology and nationally recognized authority on the Dermatoscope.

In fact, studies show that dermatologists have an greater than 80 percent accuracy rate when they visually examine moles. But when thy use a Dermatoscope, it dramatically increases their accuracy to more than 95 percent, Crutchfield said.

“It greatly enhances the ability of dermatologists to make a correct diagnosis,” he said. “It’s a terrific tool for the evaluation of moles to let you know if they are either harmless or suspicious enough to warrant a biopsy.” It’s also a patient-friendly way to examine moles, he said.

“The beauty of this is you don’t have to do a biopsy,” he said. “And patients love it because they don’t have to get a shot or stitches. It’s quick and painless.”

The examination takes only 15 to 30 seconds per mole. A thin layer of mineral oil is applied to the mole first, causing the top layer of skin to become completely transparent and allowing physicians to look deep inside the lesion in question.

“It’s very beneficial in cases where people have dozens or even hundreds of moles because it allows you to evaluate the most suspicious ones,” he said. “Most dermatologists think this is a great addition to the field, and it’s becoming a standard of practice.”

Dr. Crutchfield is willing to be interviewed to discuss the success of this new form of skin cancer detection.

Charles E. Crutchfield III, M.D. is a graduate of the Mayo Clinic Medical School and Mayo Clinic Graduate School of Medicine. He finished his internship year at the Gundersen Clinic. He completed his dermatology residency at the University of Minnesota. He is a Diplomat of the American Board of Dermatology and a Fellow of the American Academy of Dermatology. Dr. Crutchfield is a Clinical Associate Professor of Dermatology at the University of Minnesota, in addition to running his private practice in Eagan, Minnesota.