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Leaves of three, let it be
Poison oak, poison ivy, and poison sumac infections can leave you with days and nights of pain, itch, and swelling. Fortunately, over-the-counter medications can ease the discomfort. The best remedy, of course, is prevention, so familiarize yourself with the looks of these plants and try to avoid blazing new trails through the undergrowth when you're out for a hike.
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If You've Been Exposed
Upon exposure, follow these steps:
- Wash the affected area with soap and water. Some people swear by Fels-Naptha soap as a means of removing the resins from these poison plants, but the best thing to do is scrub your skin as soon after exposure as possible, ideally within 10 minutes.
- Soak the affected area in cool water or in a nonprescription aluminum acetate solution.
- Cover with hydrocortisone cream, spray, or ointment.
- Administer oral antihistamines.
- See your doctor if the rash doesn't subside or becomes worse.
Poison Ivy Does Not Go Away Easily
- Learn what poison ivy, oak, and sumac plants look like and avoid them in the future.
- The urushiol oil of these plants is incredibly resilient. It can reside on the coats of dogs that run through the woods, equipment that has been brushed through the poisonous plants, and even the soles of shoes after stepping off the trail. Be very, very careful.
- Use itch or pain relievers to mitigate the effects of a rash, or a skin protectant like an oatmeal soak.
- You may become sensitive to dyes, perfumes, or preservatives as a result of being exposed to urushiol oil. If one of the creams or ointments you are using creates an unusual response, wash it off and don't use the product again.
- If you have come in contact with poison ivy, oak, and sumac plants and have a particularly bad response, see a dermatologist. You may need powerful drugs such as steroids to relieve the effects of the rash.
- The smoke from burning poison ivy, oak, and sumac plants can be extremely dangerous. See your doctor immediately.
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Antihistamines
Reduces symptoms of itching by preventing the histamine from binding to its receptor, and through an anesthetic action. It is not recommended that the topical form be used for longer than seven days. Only three antihistamines are approved by the FDA for topical use.
Hydrocortisone
A topical corticosteroid useful for reducing inflammation and itch. Works by reducing your body's inflammatory response. Should not be used on broken skin or for extended periods of time, since it can thin the skin and slow wound healing. Prolonged use can also lead to tolerance and reduced effectiveness.
Topical anesthetics
Extremely common components of anti-itch preparations, since pain and itch sensations are carried over the same nerves. They work by suppressing sensory nerve transmission to lessen the perception of pain and itch. Higher concentrations are appropriate for use on intact skin, but lower concentrations are recommended for broken skin. Should not be used for serious burns or burns that cover large portions of the body. Use no more than four times daily. Be aware that some people are allergic to these products. Use over broken skin may lead to toxic effects.
Counterirritants
Commonly used in ointments because they reduce pain sensations by stimulating alternate nerve sensations. In other words, they take your mind off the pain by causing a distracting cooling or heating sensation. Unfortunately, they also stimulate blood flow to the area, which can cause swelling, and they may irritate the already sensitive skin.
Astringents
Agents that dry tissues. May be helpful in relieving itching and pain because they also bind proteins and bacteria, preventing them from irritating the skin.
Skin protectants
Agents that prevent skin irritation by forming a physical barrier between the skin and the irritating agent. They also soothe and soften the skin, keeping it moisturized and reducing friction against the skin. In this way, they may offer some relief from itching and pain.
| Antihistamines | Ingredient | Description |
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| Diphenhydramine | ? | A popular and effective antihistamine, it has a strong sedating effect. One of the three antihistamines available in topical form for nonprescription use. | | Pyrilamine | ? | Highly effective. Even at high doses, this drug is not likely to produce fatal toxic efffects. Not commonly found in nonprescription products. | | Tripelennamine | ? | Available as a topical antihistamine in nonprescription products to help relieve itchiness. | | Hydrocortisone | Ingredient | Description |
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| Hydrocortisone | ? | An effective anti-inflammatory agent, it should be used with caution if the skin is broken because it may allow infections to develop. | | Topical Anesthetics | Ingredient | Description |
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| Benzocaine | ? | One of the more popular topical anesthetics for the treatment of itching. It produces allergy in 1% of those who use it. But it's less toxic than lidocaine. | | Butamben picrate | ? | Less toxic than other anesthetics; however, it is less effective in relieving pain. | | Dibucaine | ? | An effective anesthetic that should not be used over large surfaces, to reduce the risk of toxicity. | | Dimethisoquine | ? | Related to the other "-caine" anesthetics, it helps dull pain. Not commonly used in OTC products. | | Dyclonine | ? | One of the safer anesthetics because it has fewer side effects. | | Lidocaine | ? | The other most popular topical anesthetic for itching. It has a lower incidence of allergy, but produces more systemic toxic effects. | | Pramoxine | ? | Used as a local anesthetic, pramoxine hydrochloride has a low incidence of adverse side effects and exhibits less cross-sensitivity than most other local anesthetics (because it is not derived from lidocaine or procaine). | | Tetracaine | ? | A potent "-caine" type of anesthetic, tetracaine relieves itching and pain on both damaged and undamaged skin. In large doses, it could interfere with heart and nervous system functions. This drug provides long-lasting relief. | | Counterirritants | Ingredient | Description |
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| Camphor | ? | At concentrations of 0.1% to 3.0%, camphor is used as a topical pain reliever and anesthetic. In concentrations over 3%, camphor induces relief of pain and discomfort by stimulating nerve endings. High doses are not recommended, as camphor is toxic. | | Phenol | ? | Phenol has a strong ability to kill or inhibit disease-causing bacteria and other microorganisms, and it is widely used as a disinfectant. It also has anesthetic properties that relieve pain and itching, and is used as an acne remedy and an antifungal agent acting against athlete's foot. However, it is extremely toxic; concentrations over 2% can cause skin to peel and die and may even cause systemic poisoning when applied externally. It is especially dangerous when used to treat diaper rash. Recent studies suggest phenol may be carcinogenic. | | Benzyl alcohol | ? | A local anesthetic, benzyl alcohol is effective in concentrations of 5% to 20% and may applied up to six times a day. | | Menthol | ? | Usually combined with other ingredients with antipruritic or analgesic properties, such as camphor. At low concentrations (0.1% to 1.0%) menthol is used as an antipruritic, but there are no controlled studies to attest to its efficacy. In higher concentrations it is used as a counterirritant. Menthol causes sensitization in certain individuals, although the sensitization index is low. Symptoms include urticaria, erythemia, and other cutaneous lesions, such as contact dermititis. | | Astringents | Ingredient | Description |
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| Hamamelis Water | ? | Also known as witch hazel, this ingredient possesses astringent properties and may act as a hemostatic for small superficial wounds. | | Aluminum Acetate | ? | When applied to the skin (as it should be) complications are rare or nonexistent. It is safe and effective in relieving poison ivy and other irritating skin conditions. It can be used as a soak or applied to a larger skin area as a wet dressing. | | Aluminum Sulfate | ? | This ingredient stings when applied to cuts, but does not cause skin irritation. Aluminum sulfate is used to make stypic pencils, and there is little or no incidence of side effects. | | Skin Protectants | Ingredient | Description |
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| Allantoin | ? | Appears to be nontoxic, nonallergenic, and nonirritating when applied to the skin. Allantoin is considered safe and effective at concentrations of 0.5% to 2%. | | Aluminum Hydroxide Gel | ? | Aluminum hydroxide gel works as an astringent and keeps bacteria and other noxious substances from reattaching to the skin. | | Calamine | ? | Calamine protects the skin by absorbing moisture and chemical irritants. It also has soothing properties. It is widely used and considered trouble-free. | | Cocoa Butter | ? | Soothing compund used to protect the skin. When applied, it prevents evaporation and keeps skin soft and pliable, which leads to less pain and irritation. Cocoa butter is safe and effective in concentrations of 50% to 100%. Use as often as needed. | | Dimethicone | ? | Dimethicone is judged to be remarkably free of toxicity. It repels water and forms an effective seal against irritants. It can also be used to treat diaper rash, but should not be used on puncture wounds or infected wounds. Not commonly found innonprescription products. | | Glycerin | ? | In a 20% to 45% concentration (as recommended), glycerin will hold water to the skin so it stays moist and is not irritated by wind, air, and other drying forces. | | Petrolatum | ? | Petroleum-derived product used to help protect irritated tissues. It should not be used on puncture wounds, lacerated skin, or wounds that have become infected, as it can retard healing. Use as often as needed. | | White Petrolatum | ? | Petroleum-derived product used to help protect irritated tissues. It should not be used on puncture wounds, lacerated skin, or wounds that have become infected, as it can retard healing. Use as often as needed. | | Zinc Acetate | ? | Zinc acetate precipitates bacteria and other proteins out of solution, neutralizing their harmful effects. It is considered a safe skin protectant. | | Zinc Carbonate | ? | It has been widely used -- without reported toxicity -- to cover and protect the skin. It appears to absorb noxious and irritating substances. It hasn't been proven effective but its wide acceptance attests to its effectiveness. Not commonly found in nonprescription products. | | Zinc Oxide | ? | Zinc oxide is used to cover the skin and protect it from dryness and other harmful environmental stimuli. It also absorbs toxic substances and serves as a lubricant. This substance is extremely safe. |
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Accurate
Pain & Itch Relievers
- For the temporary relief of pain associated with minor burns, sunburn, minor cuts, scrapes, insect bites, minor skin irritations, and rashes due to poison ivy, poison oak, or poison sumac.
Skin Protectants
- Provides temporary skin protection and relieves minor irritation and itching due to poison ivy, poison oak, poison sumac, and insect bites.
Preventing Exposure- Preventing exposure is the best way to avoid a painful and itchy rash.
- Learn what poison ivy, oak, and sumac look like and avoid them.
- If you cannot avoid them, wear protective clothing to cover any exposed areas of your body.
- If your clothing or equipment has come into contact with poisonous plants, wash your clothing as soon as possible and wipe your equipment with an organic solvent like turpentine or alcohol.
- If the plants are in your yard or lawn, kill them with herbicide or uproot them. Be sure to wear protective gear while you do this. Do not burn the plants because the smoke can cause allergic reactions as well.
Prophylactic Measures- Bentoquatum can be applied at least 15 minutes prior to exposure to allergen to prevent an allergic reaction.
- Apply liberally to all exposed surfaces and reapply every four hours for maximum protection.
Don't Scratch- Scratching can damage skin and lead to secondary infection.
- For parents with children suffering from poison ivy, oak, or sumac: you might want to trim their nails to reduce the likelihood of developing a secondary bacterial infection from excessive scratching.
- Topical antibiotics are often used concurrently with other treatments to prevent secondary bacterial infections.
Relieving Irritation- For itching and minor skin inflammation on unbroken skin, many nonprescription products are available to relieve discomfort.
- Wash the affected area to remove any possible irritants producing itching or rash.
- Skin protectants: often incorporated into anti-itch ointments; also available alone. If they are the only ingredient you may apply to the affected area as needed. If they are in combination, follow the dosaging of the other ingredients.
- Astringents: often incorportated into anti-itch oitments; also available alone. If they are the only ingredient you may apply to the affected area as needed. If they are in combination, follow the dosaging of the other ingredients.
- Topical anesthetics: are nontoxic when applied over intact skin. Can be applied over the skin three to four times per day. Some are known to cause allergies. Consult a physician if using on children under age 12.
- Hydrocortisone: used to reduce the swelling if there is skin inflammation. It takes longer to work than topical anesthetics. May be used up to four times per day. Consult a physician if you intend to use hydrocortisone on a child under age 2.
- Counterirritants: may be used up to four times per day to relieve itching and irritation on unbroken skin. Consult a physician if you intend to use on a child under age 2.
- Antihistamines: can be applied to the skin up to four times per day for up to seven days. Taken orally, they are more effective at reducing itching. Known to cause allergies if used topically for prolonged periods. Consult a physician if you intend to use on children under age 2.
Mild Allergic Reaction- Though irritating, the symptoms of a mild reaction are relatively less severe.
- Symptoms usually include blisters and swelling along with pain and itching.
- Barring secondary infection, can be managed effectively without a physician.
Moderate Allergic Reaction- All the symptoms of a mild reaction are present along with additional symptons.
- New symptoms include swelling of affected body parts and larger blisters.
- These larger blisters may need to be drained by a health professional using a sterile needle.
Major/Severe Allergic Reaction- Most of the body responds the the allergen.
- Often, large areas of swelling and eye disorders develop.
- See a physician to have medications prescribed to reduce the allergic reaction.
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Warnings
Antihistamines (topical)
Consult a physician before using or do not use if you have:- A pre-existing skin infection
- Allergy to any antihistamines
- Open wounds or sores
- Skin conditions such as psoriasis or eczema
Or if you:- Plan on using over large wounds or blistered areas
Astringents
Consult a physician before using or do not use if you have:- Allergy to any astringents
Or if you:- Plan to apply to wounds, lesions, broken, damaged, or sensitive skin
- Plan to apply near eyes or other mucous membranes
Bentoquatum
Consult a physician before using or do not use if you have:- Allergy to bentoquatum, alcohol, or any other ingredients in the product
- Preexisting rash due to poison ivy, oak, or sumac
Or if you:- Plan to apply to wounds, lesions, broken, damaged, or sensitive skin
- Plan to apply near eyes or other mucous membranes
Counterirritants
Consult a physician before using or do not use if you have:- Allergy to any counterirritants
- Open sores or wounds
Or if you:- Plan to apply to wounds, lesions, broken, damaged, or sensitive skin
- Plan to apply near eyes or other mucous membranes
- Plan to apply over large wounds or blistered areas
Hydrocortisone
Consult a physician before using or do not use if you have:- Allergy to hydrocortisone products
- Open wounds or sores
- Skin infection
Or if you:- Develop rash or other skin irritation after use
- Plan to apply near eyes and mucous membranes
- Plan to apply to wounds, lesions, broken, damaged, or sensitive skin
- Plan to use for more than three days
Skin protectants
Consult a physician before using or do not use if you have:- Allergy to any skin protectants (cocoa butter, allantoin, white petrolatum)
Topical anesthetics
Consult a physician before using or do not use if you have:- Allergy to any topical anesthetics or any component in burn and sunburn products
- Open wounds or sores
- A preexisting skin infection
Or if you:- Have symptoms that do not improve within seven days or worsen, consult a physician
- Plan to use more than three or four times daily
- Plan on using over raw surfaces or blistered areas
- Plan to use on serious or large burns
- Plan to apply to large areas of the body or under compresses or bandages
Common Side Effects
Bentoquatam
Counterirritants
Hydrocortisone
Skin protectants
Topical anesthetics
Antihistamines (topical)
Astringents
Infrequent to Rare Side Effects
Bentoquatam
- Allergic skin rash
- Mild redness of skin
Counterirritants
- Allergic skin rash
- Skin irritation
Hydrocortisone
- Allergic skin rash
- Skin irritation
Skin protectants
Topical anesthetics
- Allergic skin rash
- Skin burning, itching, or stinging
Antihistamines (topical)
- Allergic skin rash
- Mild skin irritation
Astringents
- Allergic skin rash
- Mild skin irritation
Effects of Overdose
Bentoquatam
Counterirritants
Hydrocortisone
Skin protectants
Topical anesthetics
Antihistamines (topical)
Astringents
What to Do in Case of Overdose
Bentoquatam
- For external use only. If swallowed, seek medical attention.
Counterirritants
- For external use only. If swallowed, immediately seek medical attention.
Hydrocortisone
- For external use only. If swallowed, immediately seek medical attention.
Skin protectants
- For external use only. If swallowed, immediately seek medical attention.
Topical anesthetics
- For external use only. If swallowed, immediately seek medical attention.
Antihistamines (topical)
- For external use only. If swallowed, immediately seek medical attention.
Astringents
- For external use only. If swallowed, seek medical attention.
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Websites, Organizations & Manufacturers
Sources & Further Reading
Government Sources
- 1. Food & Drug Administration. Federal Register 10/3/89.
Books
- 1. Covington, TR et al. Handbook of Nonprescription Drugs, Eleventh Ed. American Pharmaceutical Assoc. Washington, DC 1996.
- 2. Kastrup EK et al. Drug Facts and Comparisons. Facts and Comparisons.
- 3. Inlander, CB and Slamans, S. The Over-the-Counter Doctor. Cader Books. New York, NY 1997.
- 4. Zimmerman, DR. Zimmerman's Complete Guide to Nonprescription Drugs, Second Ed. Gale Research, Inc. 1983.
Find more books on health and wellness at  barnesandnoble.com.
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