What and Where...

In California, the shrub or vine is everywhere except the "inner city", the hotter deserts, and above 4,000 feet elevation. Shrubs are usually 12" to 30" high, or a tree-climbing vine, with triple leaflets and short, smooth hair underneath. Early berries are fuzzy and white; later, dun-colored. Plants are red and dark green in Spring and Summer, with yellowing leaves anytime especially in dry areas. Leaves may achieve bright reds in Fall, but the plant loses its (yellowed, then brown) leaves in Winter, leaving toxic stems. All parts of the plant remain toxic throughout the seasons. In California, western poison oak is an important food source for wildlife.

Primary contamination results from contact with bruised or broken plant parts that release "toxicodendrol", an oily resin containing the toxic chemical "urushiol".

Most people on the trail tend to get the nearly invisible oil on their hands when gathering firewood for camp. After walking through the shrub, however, their problems really begin when they brush their hands on their pants and rub their face and especially when they crawl into their tent (getting the oil on their sleeping bag), changing clothes (spread that oil around), and finally retire for the night after contaminating everything in their tent, including that jacket used for a pillow.

Return to Top

  What to do on the trail...

1. If you think you walked through poison oak, carefully remove your clothes OUTSIDE YOUR TENT, place them in a plastic bag, then wash yourself "quickly" with soap & water; launder the clothes thoroughly later at home. REMEMBER: Your BOOTS are coated with oil !!! Leave them outside your tent.

    

2. Wash yourself as soon as possible as the acuity of the rash depends somewhat on the time available for the oil to penetrate the skin. Apply water immediately if possible as (some say) the water breaks down the oil; the soap just makes the oil easier to wash off. Use Tecnu^® Oak-and-Ivy Skin Cleaner if immediately available (for me it really works and contains a chemical to quickly break down the toxic oil); However water immediately after contact is most important. Don't forget under your fingernails!!

    

3. If being sleepy is not a problem, I personally start taking antihistamine (Benadryl^®) right away. Some say it is useless, but I avoid the rash.

    

4. Because Tecnu^® includes a glycol*, some folks wash with rubbing alcohol/alcohol swabs to break down the oil. Haven't tried it.

    

5. Nothing else you can do on the trail, so enjoy the rest of your campout. Any leftover Tecnu^® put in your radiator*.

Return to Top

The Rash Arrives... Contact with one of these plants results in a red, bumpy skin rash, usually on areas of the body where the skin is thinnest, like the wrists, shins, neck, and face. The tough palms of your hands may be unaffected. There may be swelling near the rash, which usually progresses to itchy blisters that ooze, harden and then crack. The rash may appear as early as 30 minutes or as late as 2 weeks after exposure. What determines how soon a person reacts after exposure is the degree of allergic sensitivety to the plant and the number of previous exposures. The rash reaches its peak about 4-5 days after it begins. The blisters break open, releasing a watery liquid. The rash, the blisters, or fluid from the blisters is not contagious for the poison oak rash. The oil from the plants, stems, and trunk readily penetrates the skin. Healing usually takes 1 to 2 weeks. The rash, which is a type of allergic reaction, is actually caused by the body's reaction to the oil rather than damage by the oil itself.

Return to Top

Treatment, mild case   Treatment consists mainly of protecting the damaged skin, preventing infection, avoiding exposure again, and relieving the itching. If any of the following treatments are not effective, or if the case is severe and disabling, the patient should see a physician for more extensive treatment with stronger medications.   As above on the trail, as soon as possible after an exposure, thoroughly wash the affected areas with soap and water. Change clothing as soon as possible after exposure and handle contaminated clothing carefully to avoid spreading poison oak. Launder clothing several times before reuse. When the rash appears, I continue to take non-prescription Benadryl® antihistamine 25-50 mg. every 4 hours if drowsiness is not a problem. Prescription antihistamines are available that do not cause drowsiness, but are expensive.   On the rash (two days after contact), I initially use a calamine lotion (Caladryl® to help dry up the rash and blisters, and ease the itching. Later, the rash is dry, red, bumpy, very itchy, and looks terrible.   Then I quit the Caladryl and begin applying Benadryl cream® which helps the itch and soothes the skin caused by the dryness and cracking. The skin is now itchy partly because of the dryness, about seven days after exposure. Hydrocortisone cream can be applied in very small amounts to the affected areas three times a day. Use sparingly, if at all, on young children. Hydrocortisone cream can be bought over the counter at any pharmacy. All brands are equally (in my experience) NOT effective.   Apply cool soaks or compresses to reduce itching and decrease heat from inflamed areas. Exposure to hot water only increases itching; hot water causes histamine release and itching even if you don't have a rash. Aveeno® baths?? I have received many emails saying avoid a bath as it spreads the oil; take a shower instead...   For those victims who have written me about sitting or squatting in Poison Oak with a bare bottom, I suggest washing as as above and going home (and seeing your Doctor) right away. To continue a wilderness hike with such a rash may result in such misery that you cannot walk your way out.

Return to Top

Physician Treatment, more severe case   In severe cases, or cases involving a significant amount of the face, see your doctor who may prescribe oral corticosteroids, such as Prednisone®. Can have nasty side effects if used in heavier doses or longer than a week; careful! If the rash becomes extremely severe and painful, interfering with normal activity, or if any of the following symptoms appear, you should also consult a doctor: the blisters continue to ooze longer than two weeks a fever, headaches, nausea, difficulty breathing lymph nodes in your neck, under your arms or in your groin area become swollen and sore Some people are highly allergic. If you break out in a rash within a few hours of exposure, blisters form, and your eyes swell shut, seek medical attention immediately.   "Triamcinalone" corticosteroid topical cream (some say) works well on the rash; by prescription. Same category of drug as Prednisone®; oral tablets plus a topical cream dose can have additive effects. The reason why these drugs should be used sparingly if at all as studies have indicated "growth suppression" with extended or high dosage use. This product is basically a stronger Rx version of the over-the-counter Hydrocortisone creams.

Return to Top

Remedies to Avoid Theses remedies are or have been recommended at one time: Colloidal silver (like from processing x-rays) Bleach (sodium hypochlorite)     Read "Feedback" below... Extremely hot showers Oatmeal Scratching the rash & affected skin off Fels Naptha Witch Hazel Aloe Vera Jewelweed Goldenseal (Some folks swear by it) Comfrey Plantain Baking soda Tabasco Sauce

Return to Top

Facts and Fiction   Y2K UPDATE: I have received numerous and sometimes vehement emails advocating one or more of the above home remedies. Nonetheless, I neither recommend nor use any of the listed "avoid" remedies personally. For example, a member of my family years ago grew Aloe plants in our home for personal medical use. Result: useless medically but one of the few plants that grew well on my book shelf and looked nice. Highly over-rated.   Scratching the rash only spreads the rash if oil still remains on the skin. No oil is in the blisters or in the rash. By scratching, you cause bacterial secondary infection which can get wider and cause the situation to become much more severe. In this case, you need a doctor and an antiobitic prescription.   The rash is not contagious. Only the oil itself can be transmitted to others.   Once you get a reaction to poison oak, you always will, although the effects might be diminished as you get older or if considerable time has passed since your last contact.   Poison Oak can have five leaves, grow to twelve feet tall, and looks a little different from the plants in southern California.   Immunization is available, but requires continuing maintenance and can have unpleasant side effects.   Burning poison oak results in an extremely dangerous smoke that can cause severe symptoms to the eyes, nose, throat and lungs. A severe allergic reaction from inhaling the smoke, "anaphylaxis", is life-threatening. Do Not burn the plant!   My "Thanks" to all those who have sent emails concerning this site. Some are fascinating, demonstrating the extemes to which people will go in order to get rid of the effects of Poison Oak or the unusual situations in which they found themselves Nature's victim.

  Feedback... responses sent by readers...

• Kathy says: "Read an old remedy (of which I know you don't think much), and decided to try, as I could not keep up with the dressing changes. The thin transparent layer of skin between the layers on an onion applied over the extensive areas of raw oozing skin worked as a transparent "bandage". Then secured in place with gauze. The area was dry through the night, and sealed over by morning. No oozing since, 3 days. Swelling went down quickly, and the skin, though rough and red, is regaining elasticity. Possibly effective earlier on in the proceedings as well. Will remember, though hope there is no next time. ... economic."
• Stuart reports: "An employee was advised to soak in bleach, and scratch the blisters until the blisters wept. Following this advice landed him in hospital!"
• Jeremy: Avoid First Aid Creme with Lidocaine!
• Dog owners really enjoy running their pets along the California wet-side lower mountain trails; usually only once.
• Simple Green^® to clean your boots.
• Zanfel^® (resin-oil remover) worked, sort of.
• Fence in your dogs.
• Mugwort tea, (do not drink), used on external affected areas? Usually grows near the poison oak.
• Plantain Tincture: "Plantain, alone or crushed will have little effect on poison oak rash.For plantain to be effective it must be prepared using grain alcohol, making a tincture. The plantain, thin or broad leaf must be washed in cool, clear water and then broken, not cut, into small pieces. Each piece should be no larger than 1/2 inch. Place these pieces in a bowl, pour grain alcohol (vodka 100 proof minimum) over the leaf pieces. This should be allowed to soak for at least 48 hours before using. The alcohol will draw out the chemicals in the leaves. After 48 hours the tincture is ready for use. If possible, the tincture should be prepared beforehand and left standing in a dark, cool place for a week or longer for the most potent tincture. Dip a soft cloth in the mixture and gently wash the affected area carefully. The mixture does not have to rinsed off. Only the liquid should be used. As the mixture is used, replace the alcohol as needed, keeping the level above the leaves. This preparation can be stored for up to 5 months." (wm response: see Y2K Update above)
• Beware those wood chips given away at parks or recycle centers!
• Louisiana poison ivy really nasty!
• "Hi, my name is Mikey xxxxxx. I'm using my dad's e-mail account to write you this note. I am a 3rd grader at St.Mary's catholic school in Laurel, M.D. I had to do a reaport on poison oak I found your web site very helpful. It gave me good facts and good pictures."
• "Wonderful site", "impractical site", "very helpful", "You know nothing!", "never get it", "always get it", "We just moved to..."

  NOTES from the author ...

Over the years, my emails have tended to express the same problems repetitively; so here are a few of the "must do" tips...

• Do not run your dog in poison oak country until the dog needs a shampoo. Use disposable gloves!   Do you return in a car?   Where's your gloves?
• When camping, there are "Trail clothes & boots" and "Camp clothes & boots"; never the twain shall meet or serve dual purpose!   What do you do with those old wornout pairs of levis anyway?
• Do you really still sleep in your trail clothes?
• Do you learn about the country into which you're headed BEFORE you go?
• Come on!!   If your a hunter or a fisherman, you should know this stuff; teach!!
• For years now due to government cutbacks, "officials" in wilderness areas are volunteers. Ask them! That is why they are there: to help you.
• If you are miserable once, why make the same mistake twice?
• Now that you have read several web sites, go out into the woods and find (and study) a real live plant...   maybe even in different seasons!
• Know what you are sitting on.

Medical Disclaimer
The information on this page is displayed for the education and hopeful benefit of the members of Troop 5. Under no circumstance is it meant to replace the expert care and advice of a qualified physician. Information contained here may be outdated, invalid or subject to debate. Troop 5, the webmaster, or BSA assumes no responsibility for how information presented is used by any viewer or the public.

Sources: The photos were taken from an uncopyrighted pamphlet titled "Do you know this plant?", and labeled "Saftey Pamphlet No. 10015 -- Poison Oak", published by the State Compensation Insurance Fund, 525 Golden Gate Avenue, San Francisco, California 94102. Thanks to others for providing photos; sources unknown.

---

 

Top

Return to First Aid Index

Palo Alto Troop 5 ... Boy Scouts of America

 

---

 

Comments? Send E-mail to Troop 5	Troop 5 E-Mail
Maintained by Dillon Oxborrow D.D.S. Copyright © 1997-2002 by D. Oxborrow All rights reserved