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Stopping the Scratching Before It Starts

Stopping the Scratching before It Starts

You tuck your tired kids into bed, all worn out from an afternoon's play in the park. The next morning you hear plaintive cries from their bedrooms, and when you investigate, you discover unhappy children with red itchy patches on their hands and legs.

Looks like poison ivy--or poison oak or poison sumac. Regardless of which of the three your children encountered, the cause of the trouble is the same: an oil called urushiol. 'It oozes out when any part of the plant--the roots, leaves or flowers--is crushed,' explains William Epstein, M.D., professor of dermatology at the University of California, San Francisco, School of Medicine.

If one child escaped the wrath of the plant, that doesn't imply lifelong immunity. Children under seven are rarely sensitive to this oil, say experts, and it takes at least one exposure to develop a sensitivity. ( Some people don't become sensitive until after several exposures--and about 30 percent of the population never does.)

You'll know if your child is sensitive within 12 to 48 hours after he comes in contact with the plant's leaves, roots or stems. 'The area first becomes red and itchy, and blisters appear a few days later, then oozing and crusting,' explains Dr. Epstein. You can expect a week to ten days of uncomfortable itching, he says.

What can a parent do? Here are some things to help soothe the misery-and ways to avoid exposure to these plants in the future.

Treatment

Try some ice. Applying an ice cube wrapped in a plastic bag to the itchy area for one minute can help cool the itch, says Bill Halmi, M.D., clinical assistant professor of dermatology at the Thomas Jefferson University Hospital in Philadelphia. If an ice cube isn't available, use cold running water.

Coat with calamine. Yes, the same stuff you likely used as a kid. 'This old over-the-counter lotion is still a good choice,' says Dr. Epstein. 'It helps the itch and it helps dry up the blisters.' Be sure to check the expiration date on any calamine bottle that you may have in your cabinet, since after the expiration date it's no longer effective.

Take a soothing bath. A warm--but not hot--bath with either baking soda or oatmeal can provide relief for an itchy child. Fill the bathtub with warm water and stir in about ½ cup of baking soda. Then let your child lie down and soak for a while, says Dr. Epstein. For an oatmeal bath, use ground colloidal oatmeal, such as Aveeno, advises Robert Rietschel, M.D., chairman of the Department of Dermatology at the Ochsner Clinic and clinical associate professor of dermatology at Louisiana State University and Tulane University School of Medicine, all in New Orleans. This product is available at most drugstores. Directions for use are on the package.

Cool the flame with a fan. Seat your child in front of a fan, lay a dampened washcloth across the itchy area and switch on the fan, suggests It takes longer to react to a small amount of poison than a large amount, Dr. Rietschel explains. ' Where the poison was most concentrated is where the skin erupts first,' he says. 'Places where only a little bit of oil touched the skin erupt days later.' Dr. Rietschel. 'This tends to dry up the ooze by causing evaporative cooling,' he explains. 'As the skin cools, the blood vessels compress, which in turn helps cut down on the ooze.' Try this four times a day during the two to three days the blisters are at their worst.

Reach for OTC antihistamines. An over-the-counter antihistamine such as Benadryl can help cut down on the itch, says Dr. Rietschel. ' What's more, since it tends to make kids drowsy, it can be particularly helpful if your main problem is getting the child to sleep through the night,' he says. Be sure to read package directions to make certain the product is recommended for your child's age. For the correct dosage, follow package directions or consult your physician. Some doctors don't advise Benadryl cream or spray because it could cause a reaction.

Smear on the hydrocortisone. 'This topical cream may tone down the itch a bit,' says Dr. Reitschel. You'll find hydrocortisone cream at your drugstore, and Dr. Reitschel recommends the 1 percent dosage.

Avoid these two topicals. You shouldn't use a topical antihistamine such as Caladryl or a topical anesthetic containing benzocaine, such as Solarcaine Medicated First Aid Spray, according to Dedee Murrell, M.D., dermatologist and junior faculty member at New York University School of Medicine in New York City. Your child could become sensitized to these drugs, causing a completely different rash to develop.

Preventive Care

Learn the enemy. An ounce of prevention is worth a pound of cure when it comes to itch-producing plants like poison ivy, oak and sumac. Point out these poisonous plants to your children so everyone can identify them, suggests Dr. Murrell. Libraries, nature centers and schools have books and pamphlets to help children identify poisonous plants of the region.

Try a barrier cream. Before setting out on a hike or other excursion where you might come in contact with poisonous plants, coat the exposed areas of your child's skin with a barrier cream. Three good choices are Stoko Gard, Hydropel or Hollister Moisture Barrier Skin Ointment, which were found to be more effective than other barrier preparations in studies at Duke University Medical Center in Durham, North Carolina.

'The difficulty is that all exposed parts of the body need to be covered,' says Dr. Murrell. 'If one square inch is left unprotected, your child can break out there.' She recommends applying the cream an hour before your child goes out. If you live in an area with a lot of poisonous plants, it's advisable to reapply the cream every hour or so.

Limit Rover's romping. You may be carefully steering your children clear of all poisonous plants, but in the meantime your pooch is running gleefully through the woods--and if he romps through a patch of poisonous plants, he'll likely come back with oil-coated fur, says Dr. Epstein. The dog won't be affected by that oil, but it will transfer to you or your children when you pet the dog or he rubs up against one of you. If your dog does get away from you--and you suspect he's been near such plants--hose him down to help remove the oil.

Wash the skin. If your child has just leapt into a patch of poison ivy to retrieve a Frisbee, quick intervention may prevent a reaction. ' You have about ten minutes to wash it off before it's too late,' says Dr. Rietschel.

Plain water will do the job, but it's better to use soap, says Dr. Halmi. Any kind of soap will do, but don't use a washcloth. The cloth might spread the offending oil around.

Wash everything. The oil from poison plants can stick to anything, and it can remain active for months. If your child has been exposed, promptly wash his clothes and towel in hot water, says Dr. Epstein. Also wash hiking boots, toys and tools. Rubber and cotton gloves offer some protection, but only for a short time. After you've hosed down or washed the contaminated articles, drop the gloves in the washer and immediately wash your hands, says Dr. Halmi.

Break out the alcohol. While soap and water are best at eliminating the oil, in a pinch you can use rubbing alcohol. 'If you use it immediately, rubbing alcohol will dissolve the poison plant oils,' says Dr. Epstein. This can be harsh on sensitive skin, but it's still better than living with an itchy outbreak.

Never, ever burn it. If you burn your yard debris, make sure you never get any of these poisonous plants mixed in. Getting near the smoke or fire from burning plants can have disastrous effects, says Dr. Epstein. 'Not only does the oil splatter like grease in a hot pan, it can even become airborne,' he says. The result can be an outbreak that looks like you rolled in a patch of poison ivy. Worst of all, if you inhale the smoke, you can get an outbreak in your nose or throat.