4 Poison Ivy, Oak, and Sumac Counseling Points

JULY 27, 2017
Many individuals develop a rash from poison ivy, oak, or sumac from the oil found in the sap of these poisonous plants. Pharmacists, especially those in the community setting, can play an important role in education and prevention strategies. Check out 4 counseling points for these poisonous plants:

The rash does not appear immediately.
Educate patients that the rash generally develops within hours up to a week after contact with the urushiol oil found in poison ivy, oak, and sumac. Symptoms include the following:1
  • Itchy skin
  • Redness or red streaks
  • Hives
  • Swelling
  • Small or large blisters
  • Crusting skin
The plant rash is not contagious.
Individuals cannot spread the plant rash from person to person.  However, the urushiol oil can spread to the skin from clothing, pets, garden tools, and other items that have come in contact with these poisonous plants.2

Treatment usually consists of over-the-counter (OTC) medications.
Educate patients that the rash usually lasts for approximately 1 to 3 weeks and can generally be treated with OTC products.  The following can be used to relieve itching and treat the rash:1,2
  • Rinse the skin with lukewarm, soapy water if you know you have come in contact with poisonous plants.
  • Wash all clothing and other objects that came in contact with the poison ivy, oak, or sumac.
  • Use wet compresses and take short lukewarm baths in a colloidal oatmeal preparation (e.g. Aveeno Soothing Bath Treatment).  Patients can also add one cup of baking soda to relieve itching.
  • Calamine lotion can also be applied to the skin to relieve itching.
  • Hydrocortisone 1% cream can help weeping lesions and reduce inflammation for mild cases
  • Prescription corticosteroids may be necessary for severe cases.
  • Oral and topical antihistamines should generally be avoided since they are not usually effective.  Topical antihistamines may also exacerbate the rash.
  • It is important to avoid scratching the rash as this may cause an infection.
Patients should be seen by a dermatologist if the following occurs:2
  • Fever over 100 °F
  • Rash contains pus or soft yellow scabs
  • Itching worsens
  • Rash spreads to the eyes, mouth, genitals, or covers more than one-fourth of the skin area
  • Difficulty breathing
Know how to recognize these poisonous plants to prevent exposure.
Poison ivy can be found throughout the United States except Alaska, Hawaii, and parts of the West Coast and grows as a vine or small shrub.2  Each leaf contains 3 glossy leaflets with smooth or toothed edges and may have greenish-white flowers and whitish-yellow berries.

Poison oak grows as a shrub in the Eastern and Southern United States and in tall clumps or long vines on the Pacific Coast.2 The plant consists of fuzzy green leaves in clusters of 3 and may have yellow-white berries.

Poison sumac consists of a woody shrub that grows in the Northeast, Midwest, and parts of the Southeast. Each leaf has clusters of 7 to 13 leaflets arranged in pairs and may contain yellow-greenish flowers and whitish-green fruits.2
Educate patients to wash garden tools and gloves regularly and to wear long sleeves and pants tucked into boots if they may be working around poison ivy, oak, or sumac. 

References
  1. Poison ivy, oak, and sumac.  AAD website.  https://www.aad.org/public/diseases/itchy-skin/poison-ivy-oak-and-sumac.  Accessed July 25, 2017.
  2. Outsmarting poison ivy and other poisonous plants.  FDA website.  https://www.fda.gov/forconsumers/consumerupdates/ucm049342.htm.  Accessed July 25, 2017.


Jennifer Gershman, PharmD, CPh
Jennifer Gershman, PharmD, CPh
Jennifer Gershman, PharmD, CPh, received her PharmD degree from Nova Southeastern University (NSU) College of Pharmacy in 2006 and completed a 2-year drug information residency. She served as a pharmacy professor at NSU’s College of Pharmacy for 6 years, managed the drug information center, and conducted medication therapy management reviews. Dr. Gershman has published research on prescription drug abuse, regulatory issues, and drug information in various scholarly journals. Additionally, she received the Sheriff’s Special Recognition Award for her collaboration with the Broward, Florida Sheriff’s Office to prevent prescription drug abuse through a drug disposal program. She has also presented at pharmacist and physician continuing education programs on topics that include medication errors, prescription drug abuse, and legal and regulatory issues. Dr. Gershman can be followed on Twitter @jgershman2
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