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Leaves of three...let it be!
Leaves of three...let it be! The poison ivy plant is a bit elusive in that it may not always be recognizable. The one distinguishable characteristic, however, is that the leaves, almost always, grow in clusters of three. Remember (and follow) the old adage: "Leaves of three; Let it be!"

Like most people in the Midwest, I am looking forward to the warmer days and the anticipation of beautiful spring blooms. Like many others, I also look forward to "spring cleaning" my yard and weeding my flower beds to prepare for summer. What I do not like, however, is the possibility of encountering that "dreadful" poison ivy! Unfortunately, it has started to grow in my landscaped beds, through my hostas, alongside the base of my front porch. Of course, I found out about it the hard way! (Are you starting to itch, yet?)

The Plant
The poison ivy plant is a bit elusive in that it may not always be recognizable. The leaves may have smooth or notched edges (or both). The surface of the leaf may have a shiny or a matte finish. It grows in a vine in an upward direction or in a bush-type cluster. It may have groupings of green or creamy, white berries. The one distinguishable characteristic, however, is that the leaves, almost always, grow in clusters of three. Remember (and follow) the old adage: "Leaves of three; Let it be!"

The "poison" or causative agent from the plant is the oil contained inside the plant, which is called urushiol. All parts of the plant have secretory cells which contain urushiol, so contact with any part of the plant, and its oil, can cause an allergic reaction. This allergic reaction is referred to as contact dermatitis.

Urushiol can remain active for years. Plants that appear to be dormant, or even dead, can still transmit urushiol. Urushiol is considered one of the most potent external toxins around. It can remain on garden tools, shoes, and gloves for years if not washed off. Pets can transfer it to humans from brushing up against the plant and bringing it into the house. Burning it can release the oils into the air.

Once exposed to the poisonous oil, reactions can be quite varied. Typically, the exposed areas begin to itch within 24-48 hours. One to two days later, fluid filled blisters arise and a few days after that, the blisters will break open and begin to ooze. All of this is accompanied by intensifying itching. To refrain from scratching the affected area is the most important (and hardest!) part. Scratching and opening the blisters makes the skin more prone to secondary infections. For this reason, parents should immediately cut their children's fingernails after exposure to reduce the risk of infection.

Treatment of poison ivy should start immediately after exposure (within 10 minutes). This will prevent the urushiol from bonding to the cells in your skin. If the poisonous oil can be removed quickly, the reaction can be thwarted. Usually, the quickest way to remove the oil is to rinse the skin with cold water. Do not rub with a washcloth, rinse under running water so that the oils run off of your skin. Because oil and water do not mix, the rinsing must happen before the oil has bonded to the skin and it must continue for a significant amount of time to ensure that the oils have been removed. Another effective way to remove the urushiol is to apply a solvent to the skin. This type of treatment is usually successful but, on the other hand, caution must be used because solvents will also remove the protective oils from your skin and may irritate it, as well. This should also be done as soon as possible after exposure. Some common household solvents include: acetone, mineral spirits, rubbing alcohol, witch hazel and bleach (which should be diluted). Technu®, an over-the-counter (poison ivy specific) solvent has recently become available and is also an effective alternative. If solvents are not accessible, regular dish soaps such as Dawn®, Joy® or Palmolive® can be tried, but, again, these should be used as soon as possible after exposure. There are also several poison ivy specific soaps on the market that claim to wash away the urushiol from the skin, as well. Examples of these include: Zanfel®, Burt's Bees®, Marie's®, and Poison Ivy Soap®. Zanfel®, according to the manufacturer, has special ingredients which attract and dry the oils even after it has bonded to the skin. It claims to provide relief ANY time after poison ivy contact.

Once the reaction has occurred, there are many over the counter poison ivy treatments which focus on reducing the itch and drying the blisters. Antihistamines, like Benadryl®, taken orally or applied topically in the form of a cream, and hydrocortisone creams are the primary itch relievers. Calamine (the pink lotion), Aveeno® oatmeal bath, and products like Ivy Dry® helps to aid in "drying" the blisters, and soothe the itch, after the blisters have formed.

In addition to identifying the poison ivy plant and, of course, avoiding it, there are some over-the-counter lotions that can be applied before potential exposure. This is ideal when adventuring out into areas that are unfamiliar to you, when camping or hiking, for example. These lotions (IvyBlock®, Stokoguard®) contain an ingredient called bentoquatam. Bentoquantam absorbs urushiol and prevents or lessens the skin's reaction to the poisonous oil. Again, these have to be applied to the skin before exposure, and then reapplied every few hours, just like sunscreen.

While most encounters with poison ivy are mild and can be treated at home, some are more severe and need to be attended to by a medical doctor. You should see your physician if you have swelling of the face, mouth, neck, eyelids or genitals, if you have a new rash that reappears or worsens, if the rash covers 30 percent or more of your body, or if you suspect an infection. Do not hesitate to call 911 if you have trouble breathing especially if the oil may have been inhaled from burning poison ivy plants. Your physician can prescribe oral steroids such as Prednisone or give you an injected steroid if necessary.

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"Leaves of three...let it be!"
   authored by:
Tamara Dulin, R.Ph., is a registered pharmacist with Nightingale Home Health Care in Carmel, Indiana. A 1991 graduate of Butler University College of Pharmacy, she has spent the majority of her career in consulting. She is a past president of the Ind...

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