Poison Oak and Poison Ivy Dermatitis
If you develop an itchy, red rash after spending time outdoors
you may have brushed against a poison ivy or poison oak plant. What should you do? According
to research or other evidence, the following self-care steps may be helpful:
- Cleanse exposed skin
- Wash the affected area with dish soap as soon as possible to limit
the reaction; wash clothing, pets, and anything else that comes in contact to prevent
re-exposure
- Apply plantain
- Reduce skin inflammation by covering the affected area with fresh
crushed plantain leaves or using a 10% ointment
- Steer clear next time
- Learn what poison ivy and its relatives look like so you can avoid
future contact
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full Poison oak dermatitis
article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and
dietary and lifestyle changes that may be helpful.
About Poison Oak and Poison Ivy
Certain plants in the Toxicodendron (formerly Rhus) genus contain a potent resin called
urushiol that, when it comes in contact with skin, can cause a severe allergic reaction in
people who are sensitive to it—approximately 85% of the population, according to the
American Academy of Dermatology.
Plants in this group include Western poison oak (Toxicodendron diversilobum),
Atlantic poison oak (T. pubescens), poison ivy (T. radicans), and poison
sumac (T. vernix).
Product ratings for Poison
Oak and Poison Ivy
What are the symptoms?
The skin rash caused by the plant resin urushiol is a form of “contact
dermatitis.” It is a red, swollen, blistering rash that is both painful and itchy. The
blisters can become weepy, but the fluid from them does not spread the rash. Once developed,
the rash is not contagious or spread by scratching. Scratching should nevertheless be
discouraged to prevent the blisters from becoming infected. The rash can be severe but it is
self-limiting, which means it will eventually resolve with no treatment. Most people seek
treatment anyway for relief from the symptoms.
Medical options
Prescription strength topical corticosteroid drugs, such as triamcinolone (Aristocort) and betamethasone (Valisone, Diprolene, Diprosone), are
often used to treat severe reactions to poison oak or ivy, as are oral forms, such as prednisone (Deltasone) and methylprednisolone (Medrol). Antihistamines, such as
hydroxyzine (Atarax), desloratadine
(Clarinex), fexofenadine (Allegra), and cetirizine (Zyrtec), might help relieve
itching.
A combination product containing deodorized mineral spirits (Tecnu Outdoor Skin Cleanser)
removes plant oils and prevents the spread of poison oak and ivy when used within eight hours.
Other over-the-counter drugs used to treat poison oak or ivy include hydrocortisone (Cortaid), calamine/pramoxine
(Caladryl), and polyethylene/nonoxynol-9 (Zanfel). Oral antihistamines, such as diphenhydramine (Benadryl) and loratadine (Claritin, Alavert), might reduce
itching.
The contact dermatitis caused by exposure to poison oak or ivy may be prevented if the
exposed area is thoroughly washed within the first five minutes following contact. Individuals
with a rash can soothe inflamed skin with cool compresses made from gauze or thin cloths
dipped in water. Clothing, pets, and other objects that have been exposed to plant oil should
be washed to prevent re-exposure.
Lifestyle changes that may be helpful
When it comes to poison oak and ivy, prevention is truly the best cure. An easy rhyme helps
one avoid touching these plants when venturing into the forests and meadows where they grow:
“Leaves of three, let them be.”
Contact with poison oak, poison ivy, and poison sumac can be avoided by staying out of
dense brush, wearing long clothes, and changing clothes after coming in contact with the
plants. Dogs should be prevented from roaming freely through such areas, because they can pick
up the resin on their fur and transmit it to people by direct contact or via furniture.
Toxicodendron plants must never be burned because the oil can severely damage the lungs or be
fatal if inhaled as smoke. The plant resin, urushiol, remains potent for years, even when the
plant itself has died.
Herbs that may be helpful
Jewelweed (Impatiens capensis) is the most popular herbal treatment for poison
oak/poison ivy dermatitis.1 2 It is widely believed that rubbing
jewelweed on the exposed area within 15 minutes of exposure may prevent the rash by binding
the resin. Custom advises crushing a few of the succulent leaves and stems and rubbing them on
affected skin, or crushing and soaking the leaves in water and then bathing the area with the
leaf-soaked water. However, most scientific studies have found jewelweed to be ineffective in
treating poison oak/ivy dermatitis.3 4 5 6
Nevertheless, the efficacy of the plant continues to be supported by numerous testimonials and
anecdotal reports, and is recommended in several classic botanical reference
guides.7 8 9 10
Gumweed (Grindelia spp.)is another plant popularly used to treat poison oak/ivy
dermatitis. It has a long history of use, including by Native Americans, and in
early-20th-century pharmaceutical preparations. 11 12 13
14 There are case reports of gumweed’s efficacy for poison oak dermatitis,
but no published, controlled clinical trials.15 Apply gumweed tincture directly to
the rash. It may also be mixed into marigold (Calendula officinalis) cream and applied several
times a day.
Plantain (Plantago spp.) is
another popular remedy for skin inflammation, and topical use of this plant may help soothe
the rash caused by poison oak and ivy. In one preliminary clinical trial, all ten people given
plantain for poison ivy dermatitis improved.16 There have been no controlled
clinical studies to date.
A great many plants have been used historically to treat skin inflammations like poison oak
and poison ivy dermatitis. Examples include
calendula (Calendula officinalis), blood root (Sanguinaria canadensis),
Virginia snakeroot (Aristolachia serpentaria), holy basil (Ocimum
tenuifolium), and chickweed
(Stellaria media). None of these remedies has been subjected to controlled clinical
studies to determine if they are safe and effective for this use. Cooling essential oils, such
as peppermint and menthol, have also been used topically to relieve
burning pain and itch. Such oils should not be applied full-strength, but should rather be
diluted (for example in lotion or gel) to avoid further skin irritation.
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
Holistic approaches that may be helpful
{Discussion}
References:1. Moerman DE. Native American Ethnobotany. Portland, OR: Timber
Press, 1998.
2. Kavasch EB, Baar K. American Indian Healing Arts: Herbs, Rituals,
and Remedies for Every Season of Life. New York, NY: Bantam Books, 1999.
3. Gibson MR, Maher FT. Activity of jewelweed and its enzymes in the
treatment of Rhus dermatitis. J Am Pharm Assoc 1950;39:294–6.
4. Guin JD, Reynolds R. Jewelweed treatment of poison ivy dermatitis.
Contact Dermatitis 1980;6:287–8.
5. Long D, Ballentine NH, Marks JG Jr. Treatment of poison ivy/oak
allergic contact dermatitis with an extract of jewelweed. Am J Contact Dermat
1997;8:150–3.
6. Zink BJ, Otten EJ, Rosenthal M, Singal B. The effect of jewel weed in
preventing poison ivy dermatitis. J Wilderness Med 1991;2:178–82.
7. Sanders J. The Secrets of Wildflowers: A Delightful Feast of
Little-Known Facts, Folklore, and History. Guilford, CT: Lyons Press, 2003.
8. Gibbons E. Stalking the Healthful Herbs. Putney, VT: Alan C.
Hood & Company, Inc., 1989.
9. Duke JA. The Green Pharmacy: New Discoveries in Herbal Remedies
for Common Diseases and Conditions from the World’s Foremost Authority on Healing
Herbs. Emmaus, PA: Rodale Press, 1997.
10. Robbers JE, Tyler VE. Tyler’s Herbs of Choice: The
Therapeutic Use of Phytomedicinals. Binghamton, NY: Haworth Press, Inc., 1999.
11. Moerman DE. Native American Ethnobotany. Portland, OR:
Timber Press, 1998.
12. Kindscher K. Medicinal Wild Plants of the Prairie: An
Ethnobotanical Guide. Lawrence, KS: University Press of Kansas, 1992.
13. Sollmann TH. A Text-Book of Pharmacology and Some Allied
Sciences. Philadelphia, PA: W. B. Saunders & Company, 1906.
14. American Pharmaceutical Association. The Pharmaceutical Recipe
Book. 2nd ed. Washington, DC: American Pharmaceutical Association, 1936.
15. Caranvan D, Yarnell E. Successful treatment of poison oak dermatitis
treated with Gindelia spp. (Gumweed). J Altern Complement Med
2005;11:709–10).
16. Duckett S. Plantain leaf for poison ivy. N Engl J Med
1980;303:583.