Leaves of three, let them be…

…but if your child doesn’t, here’s what to do about it

By Jason Zurawick, MD

As the weather gets warmer and your children head into the great outdoors, it’s important to educate them about poison ivy. One way of doing this is the simple rhyme: “Leaves of three, let them be.”
There are three types of the plant commonly called poison ivy: poison oak, poison ivy and poison sumac. Poison ivy leaves are shiny clusters of three leaves, typically found in shrubs, vines and trees. Sometimes the leaves appear waxy and curled.
An allergic reaction occurs when the oily substance from the plant, called urushiol, comes in contact with the skin. The oil can also come in contact with the skin when something has touched the plant—like your dog, sports equipment or clothing—and can remain active for more than a year.
If you suspect your child has come into contact with poison ivy, remove the oil from your child’s skin by having him shower with ordinary soap as soon as possible. Do not give him a bath, as the oils will mix with the water and spread to other areas of the body. Make sure to wash under the fingernails to prevent further spreading. It’s also important to wash all clothing, shoes and pets that may have had contact with the oil.
The allergic reaction to poison ivy will usually be noticeable within a few hours, but can sometimes take as long as a week to appear. Common symptoms include an itchy rash followed by bumps, blisters and mild swelling. The blisters will then break and ooze on their own. It’s extremely important that your child does not break the blisters, as this can cause a serious infection. Many people think poison ivy is contagious, but the rash cannot be spread once the oil from the plant is washed off.
The rash typically lasts up to a month. There are several ways you can help ease your child’s discomfort and irritation, including:

• calamine lotion or hydrocortisone cream
• an oatmeal bath, making sure the bath is cool or lukewarm
• cold compresses or ice
• oral antihistamines, such as Benadryl (but avoid Benadryl cream, which can make the rash worse)

Several creams claim to prevent poison ivy rash, such as Ivy Block and Stokogard. Although some of these “barrier” creams can prevent the oil from reaching the skin, they have to be reapplied as often as every hour and are uncomfortable for many people.
If the rash becomes severe or involves areas around the eyes, or if your child develops a fever, notify your pediatrician immediately. After a physical examination and medical history, the pediatrician may prescribe a steroid cream or oral steroids to help with the itching and swelling.