Kid Tips: Itching to Know

Kid Tips:

Itching to Know—Being Poison Ivy Literate

I know, I know...so far, all of my posts have been about behavioral issues, or developmental considerations, or thoughtful reflections on cultural issues and influences...so what’s with the poison ivy?

Well, it’s almost summer here in the Midwest, and summer means poison ivy, and poison ivy means misinformation, myth, and misery for 70-75% of the population, including kids. This is one of those topics that I have learned a LOT about through painful necessity. I first had a serious poison ivy reaction when I was five years old, which landed me in the hospital for nearly a week with a solid mass of blistering pustules covering my entire thigh. As a teenager, I was bedridden for several days after I had been at a friend’s house where they were burning brush that included poison ivy, and the aerosolized oil basically coated my head, neck, arms, and hands—my eyes were swollen shut, my upper lip was about three times its normal size, my ears stuck out from the layers of rash behind them, and I couldn’t use my hands normally because of the huge blisters in between my fingers.

My apologies for the graphic description, but the point is...I know what I’m talking about. When parents come to me with concerns that their child got poison ivy from our back yard, I reassure them that we are VERY careful about making sure we clear any poison ivy from the fence line, and then I fill them in on what they will need to know for the rest of their child’s life, since poison ivy allergies persist (and sometimes get worse) over time. I am not a physician or a botanist, but here is what I have learned through my experiences over the last 50 years (if anyone has any further information, or if you believe anything I have said below is incorrect, please let me know—I do not claim to have all the answers):

ASSUMPTION #1: YOU CAN SPREAD POISON IVY BY SCRATCHING. Partly true, but misleading. The rash is caused by your body’s histamine reaction to the oil that is part of the plant. This oil is known as urushiol, and is contained not only in poison ivy, but also in poison oak, poison sumac, and in smaller amounts in other plants such as mango trees, pistachio trees, cashew shells, and gingko biloba. Once the oil contacts the outer skin layer, your body begins to react. For people with serious sensitivities (like, for example, me), that reaction can be almost immediate when the urushiol density is significant. If your immune system triggers itching before you have removed the oil, the action of scratching MAY spread the oil over a larger area. Once you have washed off the oil, however, you cannot spread it anymore simply by scratching. Most importantly, you CAN NOT spread poison ivy by scratching open the blisters, and no one else can “catch” poison ivy from coming into contact with the fluid in the blisters. The fluid that forms inside the blisters is NOT urushiol—it is the fluid that is naturally produced by your body as part of the histamine reaction. The main danger of scratching is not spreading the allergic reaction, but causing a bacterial infection. As the blisters open and release their fluid, make sure you keep the area clean and covered to prevent infection.

ASSUMPTION #2: YOU CAN’T WASH AWAY THE OIL. False. If you know you have contacted poison ivy, you must thoroughly wash away the urushiol as soon as possible, before it bonds with the skin layer (within 10 minutes or so). This can be accomplished with commercial products (such as Ivy Dry or Zanfel, which can also be used after the urushiol has bonded), or with COOL/COLD water and soap or common household detergents that are good at breaking up oil (such as many dish detergents or, my favorite soap for this purpose, Fels-Naptha, a bar soap that can also be used as a laundry detergent to remove the oil from clothing—be aware, however, that, since it is very, very good at breaking up oil, it should probably not be used for routine bathing, as it will strip your skin of beneficial, natural oils as well). DO NOT shower or wash with hot or very warm water, as this will open the pores and make it easier for the oil to penetrate, and can actually spread the rash by making the oil flow easier.

ASSUMPTION #3: IF I DON’T TOUCH IT, I WON’T GET IT. False. Big false. In fact, in many cases, initial or subsequent reactions are not from the plant itself, but from pets or clothing that have the oil on them. We had a student several years ago whose parents were convinced that he was repeatedly getting poison ivy at school, because they had not been in ivy-infested areas for several weeks, but their son kept getting new rashes. After some questioning, we realized that, several weeks prior (when he got the first exposure), it had been in an area with lots of poison ivy, and that, since the initial contact, they had not washed his shoes. He had walked through the field with the poison ivy, and since they hadn’t washed his shoes, he kept re-contacting the oil every time he put on his shoes. If you have been exposed, make sure you not only wash yourself, but also be careful to launder all of your outer clothing, including your shoes and jackets, with a detergent that will break up oil. If you can’t launder an item (like hiking boots, for example), clean them as thoroughly as you can, then wash your hands immediately after you put them on, or just don’t wear them for several weeks (though urushiol can remain viable for several months, so exercise caution and continue to wash your hands).

Similarly, if you take your dog for walks in the woods or fields, or if your dogs or cats have access to areas where there may be poison ivy, be aware that they can carry the oil on their fur. If you or someone in your family is allergic, be sure to give your dog a bath when you return from your walk, and keep your yard clear of poison ivy.

ASSUMPTION #4: THE BEST TREATMENT FOR POISON IVY IS CALAMINE LOTION. Hmmm....maybe. Calamine lotion, or other topical lotions and creams, can help relive the itching for minor reactions, but if the reaction is moderate or severe, topicals will not be very effective. In extreme cases, you may need to see a doctor for a prednisone injection to combat the inflammation and help prevent scarring. For moderate cases, the thing to keep in mind is that you want to dry the rash, which will help to alleviate symptoms. There are a variety of astringent products that can help with this process. My favorite is a powder called Domeboro solution, which you use by mixing with cool water, then soaking a washcloth or gauze compress with the solution and applying the compress to the rash for 10-20 minutes, several times a day. Not only does this help to dry out the histamine fluids (which is what causes the itching), the cool compress also soothes the skin and helps make it less miserable. Taking antihistamines may help a little, but will be limited in their effectiveness. Whatever approach you take, it generally takes a week or two for the reaction to fully run its course and for the rash to disappear (it may take longer with severe cases).

ASSUMPTION #5: YOU CAN ONLY GET POISON IVY IN THE SUMMER. Definitely false. In fact, poison ivy can be most potent in the spring, when the plant is coming out of winter dormancy and the oil is dense and active (think of the way the “sap rises” in maple trees in the early spring—same idea). Summer drought and heat can “dry up” the vines to a certain extent, though the oil will still be present. However, even when the plant is “dormant” (during the winter in cold climates), the oil can still be present in sufficient quantity to cause a reaction. If you’re one of the 70% that reacts to urushiol, don’t think you can yank the vines out in the winter without getting a rash. It may be less potent, but it can still be enough to cause a rash.

ASSUMPTION #6: IF I’M NOT ALLERGIC TO IT NOW, I WILL NEVER BE. Dangerously false. As with any other allergy, repeated exposure, or natural changes to body chemistry over time can lead to new allergies.

ASSUMPTION #7: ANY PLANT WITH THREE LEAVES IS POISON IVY. Frustratingly false. There are many plants that resemble poison ivy, such as maple tree saplings, catalpa tree saplings, Virginia creeper, box elder, pepper vine, etc. This link provides a lot of photos of poison ivy and various “impostors”: http://poisonivy.aesir.com/view/picqna.html. Identifying poison ivy can be confusing, but here are some things to remember:

·       Poison ivy is a vine, not a tree. It rarely grows straight and tall by itself. It prefers to be anchored to another tree, a rock face, or a wall for support, but can also grow without support, looking more like a bush or ground cover.

·       The vine is woody (and sometimes “fuzzy”) on mature plants anchored to trees, but can be smooth and red or green on new growth.

·       The leaves can be toothed or smooth, but are not usually lobed.

·       The leaves are reddish in the spring, green in the summer, and can be various shades of orange, yellow, red, or brown in the fall and winter.

·       The center leaf usually is larger than the two side leaves, and the center leaf almost always grows from a small stem that grows from the end of the vine, whereas the side leaves grow directly from the vine itself, without a separate stem.

Bottom line: if it has three leaves and you’re not sure what it is, don’t touch it.

So, keep your eyes open, stock up on soap, and good luck!