North American Fruit Explorers mailing list at ibiblio

[tanis grif <tanisgrif@yahoo.com>]

Here's that poison ivy article I offered in May.  Sorry for the delay, but I 
asked
several people to preview it and my computer access for doing the polishing 
was less
than usual this summer.  

Please DO NOT post replies to the list if you are offering home-remedies & 
cures;
send those to me-- off-list-- and I'll compile those which don't sound 
familiar (see
websites, below) and post those later.  Of course, if this article contains 
anything
misleading or incorrect or medically hazardous, then PLEASE DO post your 
reply to
the list!  As chatted about in May, a long discussion on this topic could 
stress the
list archive & moderator, so I hope these suggestions are a good compromise.
 


-----------------------------------

"Notes from My Poison Ivy Studies"

Chances are you are not immune to poison ivy, oak, or sumac, even if you've 
never
developed the classic itchy rash.  People differ in their sensitivity to the 
toxin
"urushiol".  Individual plants differ in the amount of urushiol they contain 
and
deliver.  (And North America isn't the only continent with urushiol-containing
plants.)  We need to receive a "sensitizing dose"-- which alerts our body 
urushiol
is toxic-- but doesn't cause reaction.  Further doses cause reactions.  These 
are a
lot of variables!  Consider also the urushiol takes a day or two to cause the 
rash,
and it's a wonder people ever figured this out.

This article tries to organize what I learned when I recently sought info 
(mostly
via internet) for prevention or reduction of my own urushiol reaction.  
Disclaimer:
I intend no medical advice, I have no medical training, and I discard 
outright any
"treatments" which seem so brutal I get dizzy just reading them.  This article
assumes you are familiar with the rash.  However, even those who think they 
are
immune should use precautions in Steps 1 & 2 (below) to prevent getting the
sensitizing dose and the first effective dose!

My internet searches yielded many images of poison ivy, oak, and sumac in 
leaf.  I
found no graphic of the dormant stalks, yet you want to learn this if you can,
because dormant stalks cause rashes too.  The most important part of Step #1--
keeping your skin away from urushiol-- is to know what the plants look like, 
and
thus avoid them.

If you have reason to believe your hands have been contaminated, don't touch 
your
face, hair, or neck.  Urushiol can cause swelling and pain especially around 
the
eyes.  Also be careful of the crook of the arm, back of the knee, and crotch 
which
can all suffer severely.  Urushiol CAN transfer from pet/animal fur to human 
skin,
so keep track of your pets, too.

If you know you get severe reactions, you probably already have a plan.  If 
you want
some first-aid reading, try internet searches of phrases like
+"poison ivy treatment" +doctor +emergency
and then read the sections such as "When to go to the doctor" and "What is an
emergency".

Online you will find HOURS of reading on the MANY home-remedies, the several
over-the-counter (OTC) treatments, and the few prescription medications.  I
recommend you learn about the prescription meds BEFORE you become frantic with
severe itching or swelling, and BEFORE you visit a doctor and try to follow
instructions.  You want to know the side-effects of some of the stronger meds 
for
severe urushiol reactions.  I also want to know which of the OTC and 
home-remedies
treatments ARE and ARE NOT irritating to my skin when it is NOT fighting 
urushiol.

I kept finding brief mention of avoiding harsh treatments which open up the 
skin on
a micro- or macro-scale, but very little recommendation to pre-test small 
areas, so
be careful!

Product endorsement disclaimer: I doubt I found all the available product 
info, and
cannot and do not recommend any products in this article because I haven't 
tried
them.  Please do your own research.

I liked these websites and I felt they were the most reputable:
http://www.medscape.com/viewarticle/475190_6
http://www.poison-ivy.org/html/faq.htm
http://waynesword.palomar.edu/ww0802.htm

Yet even in these helpful sites I thought there were contradictions; and some 
links
to products didn't include ingredient lists; and some links lead to message 
boards
which didn't have much oversight or health warnings.

I admit I don't understand the gradient from urushiol being a potent skin 
irritant
to being an allergen.  Even though urushiol can put people in the hospital, I 
saw no
mention of anyone dying from anaphalaxis from it, but this is a question for 
your
doctor.  You DON'T want to breathe smoke from burning poison ivy, oak, or 
sumac. 
The upper and lower respiratory tracts can react in a life-threatening way.

For my own non-emergency self treatment, I decided there are 4 stages of my
reaction to urushiol and so 4 steps to reducing it:
Step 1= Avoid contact!  Stay out of it, or use skin protectants.
Step 2= You know you've touched the plants, so you must wash ASAP.
Step 3= Rash appears, probably expands, gets ugly, blisters weep.
Step 4= Blisters suddenly heal, and condition rapidly improves.


Step 1-- Avoidance

Stay away from plants containg urushiol.  This includes not mowing or 
chopping them.
 If you can't avoid the plants, then keeping urusiol away from your skin can 
include
protective skin coatings or blockers.  One article I found mentioned a study 
which
showed the best commercial blockers were Ivy Block, Stokogard Outdoor Cream,
Hollister Moisture Barrier, and Hydropel.  Some of these contain fine clay
particles, and from chats with acquaintances (including a chemist) I have to 
wonder
if some commonly available mineral powders might also be protective.  
Talc/baby
powder, chalk, kitty-litter, cosmetic powder, beautician's mud-mask, but NOT
portland cement (which dries and chaps skin.)  But if I search my house and 
garage
for protective powders, I'll probably find a long-sleeve shirt and gloves 
first! 
These assorted mineral powders might make sense as protective coatings and 
maybe as
cleansers if you are away from all other cleansers (see Step 2) and you can 
employ
the powder IMMEDIATELY after touching plants.  The gap in this logic as at the
microscopic scale: the particle size of the powder may be too large to touch 
the
tiny traces of urushiol on the skin.

Read the product labels, as there may be a waiting period between application 
and
effectiveness.  Also consider a "spot-test" before the product is needed, 
because a
lotion rash might increase urushiol action.


Step 2-- Washing

Washing has three really effective components: cleanser, water temperature, 
and
promptness.  Urushiol binds with skin quickly-- only 5 to 10 minutes!  
"Tecnu" is a
widely praised skin cleaner for urushiol, and is said to expand this time 
window,
but follow its label instructions.  A more widely available and cheaper 
cleanser is
soap/ detergent, but speed is important.  Water should be cool or cold, 
because warm
water might increase urushiol's entry to skin.  Soap is good if you know your 
water
source is rain or softened water, but detergents work better than soaps in 
hard
water, which most cold water taps and hose outlets are.  Try to use a plain
detergent-- a no-frills dish detergent or laundry detergent, and the 
strongest which
you know doesn't harm your skin.  I read several positive mentions of 
Fels-Naphtha
soap, but one said don't use it.

Water alone probably isn't adequate, as urushiol is not truly soluble in 
water.  It
may be spread around further by water, like if you take a nice relaxing soak 
in a
hot tub after your outdoor activity.

A couple of home-remedy washes might be rubbing alcohol, mineral spirits, 
other
common solvents, but the chemist friend worried these might suspend urushiol 
and
spread it further across the skin.  He was more comfortable recommending the 
finely
powdered minerals.  I found a couple references to washing with gasoline, but 
when
you are worried about a poison ivy rash are you paying proper attention to 
sparks? 
(This goes for any flammable common solvent.)

Bleach is considered THE all-purpose cleaner by enough people that I should 
mention
it, as something to never put on your skin undiluted!  Even in weak solutions 
it can
irritate enough to make urushiol rash worse.

Ammonia, though, may be helpful for washing urushiol.  It seems a bother to 
figure
out what dilution won't irritate, when on the occasions you need some your 
pre-mixed
dilution is probably on the same shelf as the possibly more effective 
detergent! 
But in remote situations, urine may suffice.  Alone, I would think VERY 
carefully
about, um, accessing this treatment for washing urushiol from probably my 
hands,
without incidentally spreading the urushiol to more and probably more 
sensitive
skin.  In remote situations with others, modesty and pride should already be
second-place to practicality and intelligence.

Re-contamination is often a problem.  Remember any clothes, shoes, tools, 
gear, even
the vehicle steering wheel should be cleaned.  Detergent again should be 
adequate; I
use the "heavily soiled" recommended amount of detergent when washing "poison 
ivy
clothes."  I also where rubber gloves for any of this cleaning work, and am 
not
worried about being called obsessive when doing it!

 
Step 3-- Itching, weepy rash

As the rash appears, spreads, and rages, the natural idea is to do something. 
 And
for many people the natural idea is to do ANYTHING to relieve the itching!  
This is
the stage for which there are so many poison ivy cures.  I doubt there 
actually IS
any true cure, except the body's own mending, but you may find something which
relieves symptoms.  If this stage causes symptoms which threaten your life or
livelihood, see a doctor.

Many home-remedies may be very drying or otherwise harsh for the skin.  I 
would
avoid applying anything which I don't know how it affects my skin without the 
rash. 
I also can't stand the thought of breaking open the blisters (this aversion 
even
prevents me from scratching them) because this can cause infection in the 
damaged
skin which in turn can send you to the doctor even if the initial problem 
didn't!

Because this a gardening group, here are some plant rememdies, just for 
gee-whiz
value.  Note, all these are topicals (apply to skin), not eaten except eat the
banana and put the inside of the peel on the rash.  I found ONE 
recommendation for
applying crushed rhubarb juice to the rash, but I think the acidic juice might
sting.  Also one person saying blend fresh honeysuckle leaves with water for a
paste; would be nice if that helps because honeysuckle is everywhere in my
neighborhood.  In many homes are aloe-vera and bananas, from one the juice 
and from
the other the peel may be soothing.  Where manzanita grows, some use boiled 
leaves
to dab on the rash.  Jewelweed and narrow-leaf plantain are Wisconsin plants, 
but
seasonal (fortunately seasonal with most urushiol rashes.)  One of the 
commercial
OTCs is a blend of jewelweed and other plants, but costs a lot partly because 
they
store it chilled and ship it overnight.  Also, it must be refrigerated.  For 
the
cost and bother, I'd buy more bananas!

Jewelweed may belong also in Steps 1 and 2, as one reference described it as
possibly grabbing urushiol better than skin does.
 
I found three main problems with most of the OTCs.  First is drying.  If you 
tend
toward dry skin anyway, products which "dry up the blisters" MUST be 
pre-tested! 
Second is active ingredients which may not work, but I found contradictions 
here. 
You may see notes in urushiol articles about cortizone creams and 
antihistamine
creams being ineffective on the rash, yet the same website or article may say 
do not
use cortisone creams on the face because they may be damaging, and don't use 
the
same antihistamine orally and topically.  Is my logic correct in reading 
these as
the substances enter the body through the skin, but don't have the desired 
effect
that way?  Antihistamines orally, and cortizones orally (when needed), ARE 
both
often found helpful.

Third problem with OTCs is sensitization.  May favorite rash soother has been 
the
common, analgesic-plus-antibiotic first-aid creams.  This topical, and an 
oral dose
of diphenhydramine, would allow me most of a night's sleep.  Imagine my
disappointment when I read some medical literature about these first-aid 
creams
possibly causing development of sensitization if used on a developing urushiol
rash.  This means the body could decide to react badly to them the next time 
they
are
used on a cut.

"Technu" (mentioned above in Step 2-- Washing) if I understand correctly is 
not for
the same use as "Technu Extreme".  I read that Extreme is that company's 
product for
soothing the rash.  I don't recall reading either praises or put-downs for 
it.  I
haven't tried either product.  Their difference is mentioned here only to 
reduce
confusion and to remind you to check labels.

Rash sufferers can become desperate enough to try some brutal and potentially 
more
damaging "treatments".  Before trying something odd or harsh, ask yourself 
"Does
this make sense?"  Ask a family member or neighbor too, as the antihistamine 
or
cortizone may be messing up your thinking.

The most benign treatment I read "colloidal oatmeal".  This is finely ground 
oatmeal
used in topical pastes and bathes.  In situations where this can't be 
acquired, dry
old-fashioned rolled oats whipped (dry) in a blender, fine as possible, then 
mixed
with water then applied to rash, might be soothing.

During the "weeping" stage, when the blisters leak, this liquid is not 
"contagious"
or otherwise able to spread any urushiol.  Blisters do not make the rash 
prone to
infection unless you are usually, or unless the blisters have been scratched 
or
damaged.  Keep the rash as clean as practical: frequent changes of clean 
clothes or
loose gauze bandages or clean soft kitchen towels.


Step 4-- Rash heals

The fourth part of the classic urushial rash is seemingly miraculous healing. 
 The
blisters stop weeping, the rash turns from the frightening crusty scab to, 
well,
skin!  Delicate and discolored, but still SKIN.  It seems to get better by 
the hour.
 This happens to my rashes whether I've treated them or not.

Such a change always seems to occur right after mine feels and looks the 
worst: "If
this isn't better in the morning, it's doctor time."  Perhaps I'm lazy, which 
lets
me just wait through this darkest-before-dawn part.  Or maybe mine doesn't 
itch as
much as other peoples' rashes.  I wonder how many of the "instantly cured" 
stories
about home-remedies actually relate what was a co-incidence between the 
sufferer
trying a different treatment just before the rash was getting better anyway.

This is the time when my rashes itch the most, so I usually resort to the 
first-aid
cream, especially for any spots slow to heal.  The "new skin" gets a light, 
plant-
based oil or very mild non-allergenic lotion.  If your rash events sound like 
mine,
instead of scratching try stroking or gentle massaging on these delayed itchy 
areas.
 It seems to give more relief, and is probably better for the tender skin.

No matter how careful I try to be, there's always a next time.  My big 
problem now
seems to be recontamination from surfaces I thought were not contaminated.  
Anyone
got ideas for making urushiol spots more visible?!
> 
> 



 





      
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