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Leaves of Three – Know the Perils of Poison Ivy

June 22, 2015

Ware – Warm summer weather means more time outside. As you start your summertime activities and take those walks in the woods, or even play in the tall grass, remember the potential to come in contact with the dreaded three-leafed plant, poison ivy.

“It’s important to know how to avoid poison ivy and sumac which are quite common in this region,” said Dr. Richard Gerstein, Chair of Emergency Medicine at Baystate Mary Lane Hospital. “Found in the backyard gardens and woods all over this area, people who are allergic to these plants develop an extremely itchy, red skin rash with bumps and blisters wherever the oils from the leaves have touched their skin. An allergic reaction to the oil in these plants, called urushiol (you-ROO-shee-all) produces the rash,” said Dr. Gerstein. “Once you’re exposed to urushiol, a rash can occur from several hours to three days after contact with the plant. While direct skin-to-plant contact with poison ivy, oak, or sumac is probably the most frequent cause of the rash, the irritants from the plants can also be passed on indirectly by pets, garden tools, shoes, or virtually anything that touches a plant.”

“Rinsing your skin immediately after touching the poison ivy, oak, or sumac, with lukewarm water, may help to rinse off some of the oil and lessen or avoid the rash,” said Dr. Gerstein. “Beware that the oil can stick to clothing and other surfaces as well, so be sure to also wash the clothes you were wearing when you came into contact with the poisonous plant, as well as gardening tools, golf clubs, leashes, and even a pet’s fur.”

According to the American College of Dermatology, only urushiol oil can cause the rash.

Most people (85%) develop a rash when they get urushiol on their skin. The first time you get this oil on your skin, you may not get a rash. The next time, this oil gets on your skin you can become sensitive to it. Once you are sensitive to it, a rash appears. About 15% of people do not become sensitive to this oil and never develop a rash. The rash caused by these plants is not contagious and does not spread. Scratching the rash or the leaking fluid from the blisters does not spread the rash although it can cause scarring and potential infection.

Urushiol can remain active for years. For that reason, even dead poison ivy, oak, or sumac plants must be handled with care. Plants should never be burned or shredded, as airborne particles can spread the oil to sensitive areas like the face and eyes and may potentially cause damage to lungs.

According to Dr. Gerstein, “Prevention is the best approach, know what the plant looks like and teach your family to avoid it. If you do have contact with one of the poison plants and the rash has set in, the three main goals of treatment are to stop the itching, decrease inflammation, and prevent infection.”

“The rash from poison ivy, oak, or sumac usually lasts 1 to 3 weeks,” said Dr. Gerstein. “Most rashes go away without treatment and while your skin heals, it more than likely will continue to itch. If the eruption is mild, applying calamine lotion three or four times a day can help with the itchiness. If the rash covers a large area of the body, an oatmeal or baking soda bath may help reduce itching and discomfort. Avoid those preparations containing anesthetics or antihistamines, as often they can cause allergic eruptions themselves,” said Dr. Gerstein. “Infections can occur if blisters break and bacteria enters the open wound. Keep the rash clean and any open blisters bandaged to help lessen the chance of infection.”

If you have any of the following symptoms, or if you have a serious reaction, seek immediate medical care by going to the emergency room including:

• Trouble breathing or swallowing

• A rash that covers most of your body

• You have many rashes or blisters

• Swelling, especially if an eyelid swells shut

• The rash develops anywhere on your face or genitals

• Much of your skin itches and nothing seems to ease the itch.

• Signs of a bacterial infection, such as pain, increased redness, or pus

“A rash from poison ivy, poison oak, or poison sumac, can usually be treated at home,” said Dr. Gerstein. “If the rash is severe, on your face, on extensive parts of your body, seeing a doctor is important, you may need a prescribed steroid ointment that you can apply to the skin, or to be place on an oral steroid like prednisone. Also beware if you are exposed to smoke from the burning of these plants, you may have itchy, watery eyes, and even shortness of breath. These symptoms require immediate medical attention,” said Dr. Gerstein.

Before you go in your yard or in the woods, learn about which plants to avoid for more visit the Center for Disease Control and Prevention at and follow the popular saying, “leaves of three, let it be,” meaning plants that have three leaves on a single stem.

The mission of the Baystate Mary Lane Hospital Emergency Department is to provide timely and exceptional care. With our 30-minute pledge, our goal is for a provider to see every patient within 30 minutes of their arrival at our facility. Check out iTriage, a smartphone-based application for Android and iPhone to see our actual ER wait times. For more information visit or find us on facebook.