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with Rod Moser, PA, PhD

Stories from behind the examining room door, as told by Rod Moser, PA, a primary care physician assistant with more than 35 years of clinical experience.

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Monday, June 27, 2011

Home Remedies: Adventures with Poison Oak (and Ivy)

poison oak

As a part of this blog series on summer maladies, one must mention poison oak (or poison ivy or sumac depending on the area of the country that you live). Although you can get poison oak dermatitis any time of year, it is more prevalent in the spring and summer months.

When I asked a patient yesterday about things at home, she candidly told me that her husband had a bad case of poison oak. She isolated him to the garage for the last two days, were he was sleeping on an army cot, watching a black/white television, and eating off of paper plates. Why? Because she thought, like many people believe, that poison oak is highly contagious. I had to inform her that it was not. The expression on her faced changed and she challenged me.

“The poison oak plant is contagious, but the rash on a person is not. That clear oozing, characteristic of the rash, is not the ‘poison’. Your husband is not contagious.”

I proved my point by showing her a medical text and an article about poison oak (Rhus) dermatitis to further disprove this very common misconception.

“He is going to kill me”, she said. “What do I tell him?”

“Tell him that he can come back in the house again, and hope that he doesn’t do any independent research.”

Today, I saw a ten-year old with poison oak dermatitis all over his face, arms, and legs; the result of a Father’s Day weekend hiking trip in the mountains. Again, the family had been treating him like a leper and isolating him from any direct contact with others. Unlike the Dad that was sleeping in a garage for two days, he was pleased to be able to return to family contact immediately.

In my opinion, there is no such thing as a “mild case” of poison oak dermatitis, if you happen to be the person who has it. This skin reaction is miserable. The intense itching can last for weeks. If you don’t have any idea where you got it in the first place, you may get it again…and again.

The oil of the Rhus plant is so stable that it can remain on unwashed objects for years. People who stack firewood in the summer may get poison oak. The oil (oleoresin) may remain on the outside of the fireplace logs, only to give it to you again when you build a fire months later. The family dog can run through a patch of poison oak, get it on his fur, and easily transfer it to you when you pet him. Mom may not have trampled through the woods like her children with poison oak, but will be surprised when she suddenly comes down with it, too. Mom most likely picked it up from washing the kid’s contaminated clothing or moving those oil-laden shoes.

Poison oak can be prevented (sort of), but nearly everyone on this planet is sensitive to it. I know, you will find many people who claim they are immune, but get them to take a wad of crushed poison oak leaves and rub it all over them, or use it as toilet paper…and then call them in a few days to see how things are going.

Leaves of Three. Let it be.” The first step is to recognize the plant. However this may not be an easy job since it changes by season.  The leaves are beautifully red in the fall, but the plant may just look like a plain ‘ol stick in the winter. Remember, it is the oil of the plant that is the culprit, so when those leaves (or sticks) are crushed or burned, trouble will surely ensue. Poison oak loves to be around water — ponds, streams, wet areas — but can be anywhere. We have it growing in the wooded area near our home. We try to hit it with Round Up, but even a dead poison oak plant is a threat.

When I am out and about in poison oak areas, I just assume that it is all over me. I wear long sleeves. This is not easy when the weather is over a hundred, but I would rather sweat than itch.  If I am dealing with weeds, I wear gloves. When I come home, I strip off those potentially-contaminated clothes and put them directly in the washer (the oil is water and detergent soluble). Then, I head for the shower, soaping up over and over again, trying not to miss a spot.  The longer the oil remains on the skin, the sooner it will react.

Many people use Ivy Block, a commercially-available cream that you apply to your skin about 30 minutes before exposure. I have never used it because it is pricy, but perhaps it does work. I can’t endorse the homeopathic pills that are supposed to prevent poison oak, either. It just doesn’t make sense to my allopathic mind.  I have heard stories that Native Americans used to make tea from the plant, and take progressive amounts of it over time to reduce their sensitivity. I can’t recommend that approach either.

If I am in an area where water and soap is scarce, I use some of those alcohol swabs — the one’s we wipe your arm with before an injection — and swab off my exposed skin. With my history of poison oak sensitivity, I have put this plant in the same fear category as rattlesnakes, rabid skunks, and attorneys.

I have to end this blog with a true story of my own childhood experience with poison oak. I will make it short.

I was about ten years old. It was summertime and Tom and I were bored. We decided to steal some of my mother’s cigarettes and “have a smoke”. We were caught and the cigarettes were apprehended. What were two boys to do? We made our own tobacco.

With my mother’s favorite cast iron skillet and a good campfire, we scoured the woods near my home for an appropriate blend of leaves to cook (and dry) in the skillet. After we had an impressive blend of tobacco-like plant material, we rolled it up in a big piece of typing paper — an eight inch long doobie — that we proudly smoked. We coughed, mostly. Little did we know that most of the leaves were poison oak. A few days later, we were both covered head to toe (including those sensitive areas in between) with poison oak. My eyes were swollen closed. My mouth was frozen in a carp-like appearance. Perhaps in retribution for the use of her best skillet, my mother sent me to school everyday. I was treated like a leper, and had to excuse myself to go to the bathroom numerous times per day just to scratch those special parts.

My mother gave me a Clorox bath. I don’t recommend it. Maybe that is why my hair is white. And like the perpetually popular marijuana, I also do not recommend smoking poison oak. As a matter of fact, this was the last thing that I smoked…ever. No weed in college and never a cigarette.

In conclusion:

If you can’t take the risk, stay out of the woods. If you do live in an area (most of the United States, except the high mountains and desert) that has poison oak, sumac, or poison ivy, then you would be wise to exercise some preventative measures.

I assume there are HUNDREDS of home remedies to treat poison oak if you get it.

I am itching to hear about your home remedies…

Read the Series:

Photo: iStockphoto

Posted by: Rod Moser, PA, PhD at 9:00 am

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