Poison Oak/Ivy

Poison Oak and Poison Ivy Dermatitis

If you develop an itchy, red rash after spending time outdoors you may have brushed against a poison ivy or poison oak plant. What should you do? According to research or other evidence, the following self-care steps may be helpful:

Cleanse exposed skin
Wash the affected area with dish soap as soon as possible to limit the reaction; wash clothing, pets, and anything else that comes in contact to prevent re-exposure

Apply plantain
Reduce skin inflammation by covering the affected area with fresh crushed plantain leaves or using a 10% ointment

Steer clear next time
Learn what poison ivy and its relatives look like so you can avoid future contact

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or chemist. Continue reading the full Poison oak dermatitis article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.

About Poison Oak and Poison Ivy

Certain plants in the Toxicodendron (formerly Rhus) genus contain a potent resin called urushiol that, when it comes in contact with skin, can cause a severe allergic reaction in people who are sensitive to it—approximately 85% of the population, according to the American Academy of Dermatology.

Plants in this group include Western poison oak (Toxicodendron diversilobum), Atlantic poison oak (T. pubescens), poison ivy (T. radicans), and poison sumac (T. vernix).

Product ratings for Poison Oak and Poison Ivy

Science Ratings

Nutritional Supplements

Herbs

Plantain

Blood root

Calendula

Chickweed

Gumweed

Holy basil

Jewelweed

Menthol (topical)

Peppermint (topical)

Virginia snakeroot

Reliable and relatively consistent scientific data showing a substantial health benefit.
2Stars

Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1Star

For a herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

What are the symptoms?

The skin rash caused by the plant resin urushiol is a form of “contact dermatitis.” It is a red, swollen, blistering rash that is both painful and itchy. The blisters can become weepy, but the fluid from them does not spread the rash. Once developed, the rash is not contagious or spread by scratching. Scratching should nevertheless be discouraged to prevent the blisters from becoming infected. The rash can be severe but it is self-limiting, which means it will eventually resolve with no treatment. Most people seek treatment anyway for relief from the symptoms.

Medical options

Prescription strength topical corticosteroid drugs, such as triamcinolone (Aristocort) and betamethasone (Valisone, Diprolene, Diprosone), are often used to treat severe reactions to poison oak or ivy, as are oral forms, such as prednisone (Deltasone) and methylprednisolone (Medrol). Antihistamines, such as hydroxyzine (Atarax), desloratadine (Clarinex), fexofenadine (Allegra), and cetirizine (Zyrtec), might help relieve itching.

A combination product containing deodorized mineral spirits (Tecnu Outdoor Skin Cleanser) removes plant oils and prevents the spread of poison oak and ivy when used within eight hours. Other over-the-counter drugs used to treat poison oak or ivy include hydrocortisone (Cortaid), calamine/pramoxine (Caladryl), and polyethylene/nonoxynol-9 (Zanfel). Oral antihistamines, such as diphenhydramine (Benadryl) and loratadine (Claritin, Alavert), might reduce itching.

The contact dermatitis caused by exposure to poison oak or ivy may be prevented if the exposed area is thoroughly washed within the first five minutes following contact. Individuals with a rash can soothe inflamed skin with cool compresses made from gauze or thin cloths dipped in water. Clothing, pets, and other objects that have been exposed to plant oil should be washed to prevent re-exposure.

Lifestyle changes that may be helpful

When it comes to poison oak and ivy, prevention is truly the best cure. An easy rhyme helps one avoid touching these plants when venturing into the forests and meadows where they grow: “Leaves of three, let them be.”

Contact with poison oak, poison ivy, and poison sumac can be avoided by staying out of dense brush, wearing long clothes, and changing clothes after coming in contact with the plants. Dogs should be prevented from roaming freely through such areas, because they can pick up the resin on their fur and transmit it to people by direct contact or via furniture. Toxicodendron plants must never be burned because the oil can severely damage the lungs or be fatal if inhaled as smoke. The plant resin, urushiol, remains potent for years, even when the plant itself has died.

Herbs that may be helpful

Jewelweed (Impatiens capensis) is the most popular herbal treatment for poison oak/poison ivy dermatitis.¹ ² It is widely believed that rubbing jewelweed on the exposed area within 15 minutes of exposure may prevent the rash by binding the resin. Custom advises crushing a few of the succulent leaves and stems and rubbing them on affected skin, or crushing and soaking the leaves in water and then bathing the area with the leaf-soaked water. However, most scientific studies have found jewelweed to be ineffective in treating poison oak/ivy dermatitis.³ ⁴ ⁵ ⁶ Nevertheless, the efficacy of the plant continues to be supported by numerous testimonials and anecdotal reports, and is recommended in several classic botanical reference guides.⁷ ⁸ ⁹ ¹⁰

Gumweed (Grindelia spp.)is another plant popularly used to treat poison oak/ivy dermatitis. It has a long history of use, including by Native Americans, and in early-20th-century pharmaceutical preparations. ¹¹ ¹² ¹³ ¹⁴ There are case reports of gumweed’s efficacy for poison oak dermatitis, but no published, controlled clinical trials.¹⁵ Apply gumweed tincture directly to the rash. It may also be mixed into marigold (Calendula officinalis) cream and applied several times a day.

Plantain (Plantago spp.) is another popular remedy for skin inflammation, and topical use of this plant may help soothe the rash caused by poison oak and ivy. In one preliminary clinical trial, all ten people given plantain for poison ivy dermatitis improved.¹⁶ There have been no controlled clinical studies to date.

A great many plants have been used historically to treat skin inflammations like poison oak and poison ivy dermatitis. Examples include calendula (Calendula officinalis), blood root (Sanguinaria canadensis), Virginia snakeroot (Aristolachia serpentaria), holy basil (Ocimum tenuifolium), and chickweed (Stellaria media). None of these remedies has been subjected to controlled clinical studies to determine if they are safe and effective for this use. Cooling essential oils, such as peppermint and menthol, have also been used topically to relieve burning pain and itch. Such oils should not be applied full-strength, but should rather be diluted (for example in lotion or gel) to avoid further skin irritation.

Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.

Integrated approaches that may be helpful

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References
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1. Moerman DE. Native American Ethnobotany. Portland, OR: Timber Press, 1998.

2. Kavasch EB, Baar K. American Indian Healing Arts: Herbs, Rituals, and Remedies for Every Season of Life. New York, NY: Bantam Books, 1999.

3. Gibson MR, Maher FT. Activity of jewelweed and its enzymes in the treatment of Rhus dermatitis. J Am Pharm Assoc 1950;39:294–6.

4. Guin JD, Reynolds R. Jewelweed treatment of poison ivy dermatitis. Contact Dermatitis 1980;6:287–8.

5. Long D, Ballentine NH, Marks JG Jr. Treatment of poison ivy/oak allergic contact dermatitis with an extract of jewelweed. Am J Contact Dermat 1997;8:150–3.

6. Zink BJ, Otten EJ, Rosenthal M, Singal B. The effect of jewel weed in preventing poison ivy dermatitis. J Wilderness Med 1991;2:178–82.

7. Sanders J. The Secrets of Wildflowers: A Delightful Feast of Little-Known Facts, Folklore, and History. Guilford, CT: Lyons Press, 2003.

8. Gibbons E. Stalking the Healthful Herbs. Putney, VT: Alan C. Hood & Company, Inc., 1989.

9. Duke JA. The Green Pharmacy: New Discoveries in Herbal Remedies for Common Diseases and Conditions from the World’s Foremost Authority on Healing Herbs. Emmaus, PA: Rodale Press, 1997.

10. Robbers JE, Tyler VE. Tyler’s Herbs of Choice: The Therapeutic Use of Phytomedicinals. Binghamton, NY: Haworth Press, Inc., 1999.

11. Moerman DE. Native American Ethnobotany. Portland, OR: Timber Press, 1998.

12. Kindscher K. Medicinal Wild Plants of the Prairie: An Ethnobotanical Guide. Lawrence, KS: University Press of Kansas, 1992.

13. Sollmann TH. A Text-Book of Pharmacology and Some Allied Sciences. Philadelphia, PA: W. B. Saunders & Company, 1906.

14. American Pharmaceutical Association. The Pharmaceutical Recipe Book. 2nd ed. Washington, DC: American Pharmaceutical Association, 1936.

15. Caranvan D, Yarnell E. Successful treatment of poison oak dermatitis treated with Gindelia spp. (Gumweed). J Altern Complement Med 2005;11:709–10).

16. Duckett S. Plantain leaf for poison ivy. N Engl J Med 1980;303:583.

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or chemist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires March 2007.