P O I S O N   O A K !

Respiratory emergencies resulting from inhalation of dust or smoke from burning plants are extremely rare among the general population, but common with firefighters. Immediate attention is required, and treatment should include maintaining a patent airway and administering intravenous corticosteroids. "We have the problem of getting poison oak stands on fire," says Jeffries."Then firefighters inhale the smoke and get it in their lungs. It causes blisters, which break and run. The heavy particles of the smoke contain the poisonous resin; it falls down in soot form. When it's inhaled, the lungs swell, causing coughing and extreme irritation and swelling in the throat. It makes breathing near impossible, and can be life-threatening."

Firefighters who know or suspect that poison oak is being spread by smoke in the air should seek medical attention at the first sign of breathing problems. "It will be apparent if it's in the air," says Jeffries. "People will break out and encounter other problems. If it's a fire of any size, the medical unit leaders will be aware of it. They can detect symptoms of internal poison oak, and decide whether to treat or transport. Some people think they're immune, but poison oak should not be taken lightly."

The genus Rhus includes poison oak, poison ivy, and poison sumac, all of which may cause severe skin reaction on contact. Poison oak (Rhus diversiloba), is a common perennial that grows as a dense leafy shrub in the open or in filtered sun. In shaded areas it becomes a tall-climbing vine. Its leaves are divided into 3 leaflets, 1 - 4 inches long with scalloped, toothed, or lobed edges. New plants can sprout from seeds as well as from creeping underground stems. The foliage turns bright orange or scarlet in the fall. Poison ivy grows as either a shrub or a trailing vine, and can be identified by the clusters of three lobe-shaped leaflets and (in autumn) the round white berries. The only places in the U.S. where poison ivy is not found are above 4,000 feet elevation, Alaska, Hawaii, and some of the desert areas of California and Nevada.

The poisonous oil can remain potent on clothing and tools (or bus seats) for up to two years. Smoke from burning plants may cause severe injury to skin or lungs. Toxicodendrol is an oily resin found in the plants; it contains urushiol, and is present in all parts of the plant except the flowers, pollen, and the epidermis, or outer surface of the plant. Because neither toxicodendrol nor urushiol is volatile, the dermatitis cannot be contracted through the air unless the plants are burned. Smoke from burning plants carries a substantial amount of the irritating oleoresin and may cause serious external and systemic reactions. Inhalation may produce severe trauma to the oral and nasal mucosa and lung tissue. The time between contact and the first sign of reaction can be as short as 12 hours, but is usually two or three days. A poison oak rash may take up to four weeks to completely go away, and generally worsens 7 - 10 days after exposure.

Three other common plants are often mistaken for poison ivy and poison oak. Hog peanut, Virginia creeper, and the seedlings of Manitoba maple are similar and easily confused. Poison ivy has three leaflets with pointed tips; the stalks of the leaves do not grow from the same point on the stem; the stem is woody, and the plant may have creamy yellow-green flowers or clustered waxy berries that are green to yellow. Poison oak is similar, but has rounded tips, and the center leaves resemble oak leaves.

Hog peanut has three leaflets, but the stem is not woody. Flowers are white to lilac-colored. Virginia creeper has five leaflets, and produces blush-colored berries. Manitoba maple seedlings have three leaflets, but the leaves grow in pairs, with the stalks opposite each other on the stem.

TREATMENT

If you think you've been in contact with poison oak, you should wash immediately with soap and water, or with rubbing alcohol. The resin is soluble in alcohol, and some say that beer or other alcoholic beverages will help remove the resin from the skin. A solution of baking soda and water may also be helpful. If the oil has been on the skin for less than six hours, thorough cleansing with cold water and strong soap, repeated three times, will usually prevent reaction.

The palms of the hands rarely break out in a rash because of the thickness of the skin. Hands can still be contaminated with the plant's oil, though, so it's a good idea to wear gloves when handling contaminated clothing or tools. The problem with getting the oil on your hands is that you touch yourself anywhere and the rash spreads. You rub your cheek, scratch your ear or your back, go to the bathroom, or pull off your socks -- and you've spread the oil to all those spots.

The oil can also ride around on your clothes, and contaminated clothing should be washed separately. Once you've showered and washed all contaminated items free from the poison oak oil, the rash can no longer spread to other parts of your body or to anyone else. Even if your rash is draining, it will not spread. The fluid that drains from the poison rash blisters is not the poison oil and will not spread the rash -- it's a fluid produced by your body in reaction to the poison.

Once you have a rash, be prepared for insanity-level itching. Over-the-counter itching remedies worth trying are lotions containing menthol or phenol, and antihistamines such as chlorpheniramine or diphenhydramine. Lotions such as calamine or zinc oxide can provide some relief, and a combination of menthol with and calamine, zinc oxide, and rubbing alcohol can be soothing. Astringents such as witch hazel and zinc oxides will help reduce inflammation and promote healing. Hydrocortisone creams can provide a little relief, but aren't very effective. The big gun -- available by prescription from a dermatologist -- is halobetasol propionate cream.

A tepid bath with oatmeal or colloidal Aveeno can help. If your skin's too sore to go to the store, run some uncooked rolled oats through the blender till you have a fine flour. Sprinkle that in the bath and get in it -- it substantially reduces the itching crazies.

A short-term but effective fix is a really hot bath or shower. Heat releases histamine, which is the substance in the skin that causes itching. Extremely hot water will cause intense itching as the histamine is released, but if you gradually increase the water temperature to as hot as you can stand it, the itching subsides as the skin becomes depleted of histamine.

Treatment for severe cases often includes a prescription for topical corticosteroids such as Valisone, Diprosone, Synalar, Aristocort, or Kenalog. Steroids can suppress the immune response to contaminated cells, but topical steroid creams are less effective than oral systemic treatment.

Naturopathic remedies include jewelweed juice, which is contained in "Oak-Away." This product also contains mugwort, goldenseal, comfrey, and chickweed -- a good healing blend. Both "Oak-Away" and the homeopathic formula "Hyland's PoisonIvy/Oak" are available at health food stores. A homeopathic blend worth trying as a preventative contains Rhus toxicodendron 6X (poison ivy/poison oak) Croton tiglium 6X (croton oil) Xerophyllum 6X (basketgrass flower).

Most so-called "barrier creams" or pre-exposure treatments are not effective; most will not actually prevent dermatitis. Zirconium oxide is generally ineffective, and some people experience allergic hypersensitivity to it. "Ivy Shield," however, has shown some limited success, and a Swedish product called "Stokogard" claims to offer protection for up to 10 hours.

"Pre-exposure" products were mostly a disappointment for many years, but Jeffries says there are finally two products on the market that are good as preventive measures: Ivy Block and Work Shield. "We worked with the people who developed Ivy Block," says Jeffries, "and they've been tested. They are reported to be effective." He says Ivy Block was developed as a result of a project through MTDC initiated because of the numbers of people affected on the West Coast. "We tested the developing form of it, and it's excellent," he says.

One of the most highly-regarded products for dealing with the rash once you've got it is a product called Tecnu Poison Oak-n-Ivy Cleansing Treatment. It was originally designed to remove radioactive dust from the skin in the event of a nuclear catastrophe, and is regarded as one of the best sources of relief for the agony caused by poison oak.

Barry Drake, a network systems engineer, and his brother Todd have some history with poison oak. "My brother is a Forest Service Technician at the Happy Camp ranger station (USFS) in northern California," says Barry. "Of the two of us, he was the more susceptible to poison oak when we were young. In the course of working on fire lines (since '89), he has contracted poison oak several times, but he is now virtually immune to it." Barry had a nasty encounter with poison oak when he spent six hours removing a jungle of it from a tree. "I thought I was immune," he remembers. "I contracted poison oak on my forearms and stomach (solidly), and had scattered patches on the rest of my body. Interestingly, there was none on my face, part of which was uncovered. A friend gave me a bottle of Tecnu. It's terrific! I followed the directions on the bottle the first couple of times (rub for two minutes, rinse with cold water; repeat process with warm water if itching persists), but I discovered that the best treatment was to rub the Tecnu on and then spray hot water on it in the shower (we have a detachable shower head). That felt GREAT!!! If I were a dog, my foot would thump up and down."

He said this treatment warded off the itching for six or eight hours, and that the Tecnu dried up blisters immediately, with no scarring of the skin.

There are quite a few sources of poison oak information online, but the real motherlode is the website maintained by Manuel Davis at www.knoledge.org/oak.

His pages include submissions from those who visit the site looking for relief from rashes. "I am not an expert," he says, "merely someone stupid enough to get poison oak on several occasions. Poison oak can be a bush, vine, root, tree, whatever. My theory is that it is sentient and has a collective, malevolent intelligence. I also believe it is capable of reaching out and grabbing one's ankles when hiking on a trail."

His site includes a lot of solid information with a humor bonus, and liberal doses of sympathy in case you've got the stuff on your body. Davis provides authoritative answers to poison questions. Here are a few excerpts, printed with permission:

Q: Can Poison Oak be spread by scratching?

The rash doesn't appear until after the oil is absorbed into your skin, because it is caused by your body's immune system. So the answer is no, once you get the rash, you can't spread it around by scratching. The oil that seeps from your wounded body isn't urushiol, it's secreted by your body. The reason most people think it will spread is because of secondary infection. You touch a poison oak plant, the oil is on your hands. You rub your face, it gets there. The oil is spread. Now after a while, there isn't as much oil to spread around, so some parts get hit more heavily. What this means is, the rash appears soon in some spots, but takes a couple of days in other spots. This gives the illusion that you've spread the rash by scratching or whatever. Just make sure you aren't getting brand-new infection from your clothing. Whenever I go hiking, as soon as I get home I put all my clothes, shoes, everything in a bag, and wash it all. Only through extreme paranoia can you avoid poison oak. The alternative is to never go anywhere fun.

Q: Weren't the American Indians immune to Poison Oak? Did they smoke it to develop an immunity?

I don't actually know whether as a general rule they were immune. Immunity does wear off, so even if they were immune, they probably didn't just go bounding around in the stuff. Smoking poison oak does NOT develop immunity! Here's how I think this rumor got started: The Indians had been decimated by diseases brought from Europe, their land was taken, and they were forced to live on tiny plots of land called reservations. One day someone noticed that the Indians never got poison oak. This was because they weren't morons; they avoided it! But some white man asked the Indians, "Say, how come you people don't get poison oak?" And they thought, "Stupid white man, take our land, will you?" So they said, "We smoked it! That's why!" And then big laughs as the moronic whites go kill themselves inhaling a noxious plant.

Davis is at his best, though, when he lists his rules for poison oak. If you've had the stuff, you'll fully appreciate his sense of humor. If you're immune, or if you've never had it, you just wait.

The Manuel Davis Rules of Poison Oak

WHY YOU SHOULD NOT TAKE A HOT BATH WHEN YOU GET HOME

This is an excerpt from the submissions Davis has had. He posts them anonymously to protect the stupid.

"When Mike was a lad, he and his cub scout troop went out into the boonies on a trip. They went up a mountain. They crawled down right through the bushes and brush, 90 percent of which was poison oak. When Mike got home, he took a nice hot bath. All the poison oak oil rose to the surface, and when he got up it coated him. As a result, he got poison oak on every inch of his body except the soles of the feet and the calloused parts of the hand. All his hair fell out, and he had to wear a bedsheet for the next six months while he recovered."

Do not underestimate the evil of poison oak. If you get a bad case of it and it doesn't kill you, you might wish it would.

PRODUCT INFO:

Work Shield (508)521-7600

Ivy Block: (800)991-3376

Tecnu: (800)ITCHING

Moonrise Herbs, 826 "G" Street, Arcata, CA 95521 (800)603-8364
www.moonrise.botanical.com/ailment/ailaller.html

Poison Oak and Poison Ivy on the Internet:

Manuel Davis Poison Oak Page

Wayne College of Pharmacy

Identifying Poison Ivy

Poison Ivy, Poison Oak, Poison Sumac

NOTE: This story is © 1997 Kelly Andersson and may not be reproduced or distributed without written permission. For information on reprint rights email Kelly Andersson.

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