Contact Dermatitis

 (Poison Ivy, Oak, Sumac, and Certain Chemicals or Metals)

CONTACT DERMATITIS is a condition in which the skin reacts to an irritant from the environment. The sap from the leaf of poison ivy, certain chemicals found in cosmetics or metals are examples of such irritants. The rash occurs at the site of the contact and may react as early as six hours after exposure, or as late as two to three weeks of exposure and may last a total of three weeks.

The rash is usually red and elevated and there may be multiple blisters with intensive itching. Different areas of the body react differently to the same irritant. For example, the skin of the face (especially around the eyes) and genitals is very thin and may react more intensely than the thicker skin of the palms and soles. Sap from the plant leaf may come in direct contact with skin by handling the plant, or by handling clothing that has been in contact with plants. It can even be spread by handling pets that have rubbed against the plant. Sap on one area of the body may be transferred to other areas of the body and cause further outbreak. It becomes important, therefore, to wash skin and clothing immediately after contact. The fluid within the blisters presents no threat and will not spread the rash. An over-the-counter cream such as "Ivy Off" may help prevent poison ivy if applied prior to anticipated exposure.

Prevention is the mainstay of our treatment program. You must be able to identify the source of irritation and eliminate exposure. If the reaction is severe, we do have medication that will shorten the course of the reaction. This requires an office visit for the physician to evaluate your child.

GENERAL MEASURES TO CONTROL ITCHING:

  • Cool baths or cool compresses especially to blistered areas. Tap water is fine; however, the use of Burrows solution may offer even more relief. This preparation may be obtained without a prescription, and can be used four times a day with cool compresses.
  • Cooling topical lotions that contain a menthol preparation are often effective. Calamine lotion is an example of this, and if applied lightly may offer some benefit for itching.
  • Topical corticosteroids may also offer relief and 1% hydrocortisone cream may be obtained at pharmacies without a prescription. These may be applied four times a day or even more frequently, if required.
  • Antihistamines are medications that are taken by mouth to help relieve itching. Benadryl can be obtained over-the-counter and, at an appropriate dose, may be given as noted:

                    6 mos-1 yr . . . . . . . . . ½ tsp . . . . . . . . . 4 x daily

                    1-3 years . . . . . . . . . . 1 tsp . . . . . . . . . . 4 x daily

                    3-5 years . . . . . . . . . . 1-1/2 tsps . . . . . 4 x daily

                    5 yrs and older . . . . . 2 tsps . . . . . . . . . 4 x daily

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