Summer rashes can interfere with summer fun

There’s everything we love about summer...and then there’s poison ivy.

Kristen Liska, MD, an emergency medicine specialist with Cape Cod Emergency Associates, sees summer’s itchier side when she works at Cape Cod Healthcare’s Urgent Care Centers and the Cape Cod Hospital emergency room.

“We see a lot of skin stuff,” she said. “We’re seeing a lot of poison ivy or poison oak – whatever else people are getting who are allergic to different plant oils.”

Poison ivy grows rampant throughout the Cape, although it loves sandy dunes where it’s actually a helpful buffer against erosion, according to the Cape Cod National Seashore. Poison oak, a low-growing shrub, is more common in the West but also grows in Eastern states. Poison sumac is more common in the South, although it also grows in northern, wet woodland areas. All have a substance called urushiol in their sap, which is what causes the itchy rash.

About 70-85 percent of the U.S. population has some allergy to urushiol, according to the U.S. Department of Agriculture. And people can become more sensitive with repeat exposure. The good news? Many people lose sensitivity to urushiol as they age, says the USDA.

There are a lot of myths about poison ivy and how the rash spreads around the body, Dr. Liska said. For example, many people believe that it spreads because of the fluid that comes out of the vesicles – the itchy bubbles on the rash – or that it’s contagious.

“What actually happens is that the oil gets on your clothes and your hands – wherever you came in contact with it from the plant – and you touch different parts of your body. It’s actually the concentration – how much oil you get in one spot,” she said. “The more you get in one spot, the quicker it comes up.”

The oil can stay on clothes for weeks, and people can pick up the oil from their pet’s fur, as well, she said.

The solution is to wash your body and your clothes within two or three hours of exposure. “Once the oil is gone, you’re not going to be spreading it or exposing anybody else,” she said.

Sometimes it’s hard to tell exactly what plant caused the rash, since people react in different ways, Dr. Liska said. “We call it poison ivy, but we don’t know that’s exactly the plant they got into. All contact dermatitis looks very similar.”

Most people can treat the rash with home remedies or over-the-counter, topical steroid creams and antihistamines, she said. The U.S. Food and Drug Administration recommends treatments such as:

• Cool compresses or soaking in cool water.
• Skin protectants, such as zinc acetate, zinc carbonate, zinc oxide, and calamine to dry the rash.
• Baking soda or colloidal oatmeal to relieve minor irritation and itching, or aluminum acetate to relieve the rash.

But that might not be enough for some people, Dr. Liska said. She suggests heading to an urgent care center if the rash doesn’t subside, if it becomes painful, or if it emits pus and appears to be infected.

“Remember poison ivy doesn’t go away overnight,” she said. “But, if you’ve been trying over-the-counter remedies and it's not getting better or it’s getting worse, then it’s time to come see us at urgent care and we can help you out.”

Urgent care doctors can prescribe a stronger topical steroid or an oral steroid, she said, adding that she’s learned that it usually takes a three-week course of prednisone to guarantee that the rash doesn’t come back.

“The treatment course is longer than a lot of people think,” Dr. Liska said. “So, if you have to go the oral steroid route, it’s a decent commitment. But people who need that are usually very uncomfortable from the itching and, because it’s so widespread, it’s hard to treat topically.”

The best defense is learning to avoid poisonous plants. The FDA has a video on identification as well as prevention tips, such as:

• Wash garden gloves and tools often.
• Wash your pet if you’ve been walking in an area with poison ivy.
• Wash your skin with cool water as soon as possible if you suspect you’ve been in contact with poisonous plants.
• Consider an over-the-counter skin protectant made with bentoquatam, a topical cream that forms a barrier against poison ivy, oak and sumac.

And Dr. Liska says, never put poison ivy, oak or sumac in burn piles. “The oil will get aerosolized and you breathe it in and people can have a really bad allergic reaction,” she said.