Parts of the country may be buried in snow, but the start of
spring is right around the corner.
And with warmer temperatures comes working in the yard.
Dermatologists are hoping to get a head start on warning the public
that what may start as a seemingly harmless day of gardening or
yard work can quickly take a turn for the worse when common plants
make their mark on the skin, causing a host of mild to severe skin
reactions.
Skin allergies
Last week, at the 69th Annual Meeting of the American Academy of
Dermatology (Academy), dermatologist Julian J. Trevino, MD,
FAAD, associate professor of dermatology at Wright State
University Boonshoft School of Medicine in Dayton, Ohio,
discussed common skin reactions that can occur from contact with
plants, including effective treatments and preventive
strategies.
"For example," he said, "people who are allergic to plants or have sensitive skin that is prone to eczema or atopic dermatitis may experience more severe or long-lasting effects that require medical attention."
The sources
There are many outdoor plants that can cause an adverse skin
reaction simply by brushing up against them.
One group of plants in particular that causes toxin mediated
urticaria (hives) is stinging nettle plants, which have sharp hairs
that produce irritants.
These irritants are chemicals, such as histamine or acetylcholine,
which usually cause an immediate outbreak of hives within 30 to 60
minutes upon exposure. Most people experience a mild reaction with
hives that resolve on their own in a few hours.
Trevino also explained people who handle food frequently or those
with a tendency toward eczema can develop an allergic reaction to
plants known as immunologic contact urticaria.
In this instance, a person usually experiences itching and hives within 30 minutes. In its more severe form, this reaction can involve not only hives on the skin, but also swelling in the throat, lungs or gastrointestinal tract that requires immediate medical attention.
Another common cause of skin irritation from plants stems from exposure to spines or glochids -- tiny emergences of certain cacti or prickly pear plants -- which can get caught in the skin and cause an itchy rash.
Since these tiny spines break the skin, Trevino cautioned a person could develop a staph or fungal infection if bacteria or fungus are present on the prickly spine that enters the skin, leading to a more serious situation.
"The spines from the plants should be carefully removed from the skin, usually with tweezers or a piece of tape that is placed over the area where the spine entered the skin and gently torn away with the tip of the spine attached," said Trevino.
Treatments
Minor itching, irritation or rash can be typically treated with
an oral antihistamine or over-the-counter topical steroid, but
Trevino recommends seeing a dermatologist when a rash doesn’t
respond to over-the-counter treatments.
“In cases where a rash is accompanied by more severe
reactions such as difficulty in breathing or swallowing, a person
should go to the emergency room immediately," he said.
The Big Three
Perhaps the most well-known and feared plants linked to skin
rashes and irritation are poison ivy, oak and sumac.
Trevino explained that these plants contain a resinous sap called
urushiol that can cause a rash when it comes in contact with the
skin in the estimated 50 percent of the population that is allergic
to these plants.
However, Trevino added that direct contact with poison ivy and its
variants is not the only way that people can get this bothersome
rash.
Urushiol can be released in the air and stick to nearby objects if
a poison ivy plant is injured.
"That means that you can develop poison ivy if you pet your dog
after he has come in contact with the plant, or if you touch a
gardening tool or piece of clothing that has come in contact with
poison ivy,” said Trevino.
Even airborne contact with urushiol is possible, especially in the
fall or winter when poisonous plants are burned among other brush
and particles of urushiol are released into the air.
“If these airborne particles land on your skin or you inhale
them, you can get a widespread rash and severe irritation in the
respiratory tract."
Quick treatment
When a person with poison ivy allergy contacts the plant,
Trevino said time is of the essence to prevent a rash. The area
that has been exposed should be rinsed off immediately with water.
This can remove at least some of the resin before it is absorbed in
the skin.
To treat a rash caused by poison ivy, lukewarm baths and soaks with
products containing aluminum acetate (a type of salt that dries up
the weeping and blisters), and topical preparations such as
calamine or topical steroids are helpful.
While oral antihistamines will help alleviate itching and skin
irritation, topical antihistamines should be avoided – as
some people are allergic to them and the rash could get
worse.
"In some cases when a rash is severe or covers a large area of the
body and is not getting better with over-the-counter therapies, a
dermatologist may prescribe strong topical steroids or a course of
steroids taken orally," said Trevino.
Prevention
To minimize the risk of such skin reactions, Trevino recommends the following tips:
- Wear protective clothing whenever possible -- including gloves (preferably vinyl gloves), long sleeves and long pants tucked into socks.
- Apply an over-the-counter barrier cream or lotion containing quaternium-18 bentonite to exposed skin before going outdoors. This helps prevent urushiol from poisonous plants from contacting the skin.
- Avoid poisonous plants (remember this phrase: "leaves of three, let it be").
