December 15, 2022
Dr. Jerry Williams of Urgent Care 24/7 discusses poison ivy.
When we talk about poison ivy, it's just not poison ivy, it's actually a plant related contact dermatitis where your skin is exposed to. Actually, a couple of plants are the most common ones in the US that the oils on the exterior of the plant and enter the plant for that matter are very, very irritating to the skin. We're talking about Poison Ivy, but that also includes poison sumac, because quite frequently when patients present with these contact dermatitis symptoms, they'll typically have a history of having been out doors and been working out the yard or clearing brush, but they don't know exactly what they came into contact with.
This is something we see very commonly at our national Urgent Care 247 when patients will present and of course, it can be anything from a mild rash to people just being absolutely miserable. It seems that there are people who are more susceptible to poison ivy and poison sumac than others. For sure, it's a miserable condition. Poison Ivy and poison sumac are in the same family toxicodendron, these plants have a phenol compound in the sap of the plant which is very irritating to the skin.
These oils, when they get on your skin, are hard to get off. If you think you've been exposed to poison ivy or poison sumac, Dr. Williams would encourage you to go to your local drugstore and get one of the over the counter poison ivy, poison sumac, washing soaps or products and use that immediately. As per the package instructions, we have found that these products and these over the counter products can be very very effective, limiting the spread of the contact dermatitis by removing those oils, those phenol compounds off of your skin and that cuts down on the spreading of the of the contact dermatitis. We see these patients and they're usually pretty miserable, a lot of itching and pain and a lot of blistering. There's also a risk for secondary bacterial infections of these primary contact dermatitis areas that can be weepy and and have access to a lot of excess drainage.
Part of what we have to do is control the symptoms because the itching can be so difficult that the patient scratches it in that it spreads. The phenol compounds if they haven't washed it yet, spread them even further, thus expanding the contact dermatitis. So what we'll typically do in patients where there are no contraindications, these medications will give them intramuscular steroids with steroids by mouth to follow, and sometimes even a topical steroid to problem areas to help with those symptoms. We also use antihistamines and we also use h2 blockers, which are medications that are used to block the h2 receptors which is the histamine type two receptor, which is stomach acid secretion and medications such as Pepcid famotidine.
They will also use the antihistamines such as loratadine, or or Benadryl, or are two commonly used ones, but we use the h1 and the h2 blockers together, because we now know that by blocking both of those histamine receptors that Dr. Williams talked about in another video, but when you block the h1 and the h2 receptors at the same time, one plus one does not equal to one plus one equals three, you get a potentiation of effect by blocking both those receptors at one time it really amp up as the effectiveness of the medications, so the the steroids and the anti histamines are very important. We also have medications that will help with the itching as well.
The side effects of these anti histamines and anti aging medications can be sedation, which can be a problem and then the complications with steroids on short-term use. A lot of people will get quite revved up and have difficulty sleeping with the steroids in some people if they're prone to anxiety disorders, or panic, they'll notice an exacerbation of those symptoms. The steroids, histamines, and topicals are by far the mainstays. The takeaway from this is if you think you've been exposed to poison ivy is or poison poison sumac, you need to go get one of the over the counter poison ivy washes and follow the directions and wash very thoroughly because that can really put a halt to the spreading of the symptoms.
Immediately treat yourself with antihistamines, like Benadryl, and famotidine and topical steroids. If the symptoms are too severe, seek medical care immediately and expect intramuscular steroids and steroids to take by mouth which can be really helpful for more advanced cases. If you have Poison Ivy, Dr. Williams hopes it's limited in how much you've been affected by it. We hope that your course of contact with dermatitis is is shorter, and hopefully the advice I've given you today will be helpful.
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