Dr. Lipson - Allergy and Asthma Consultants

Brian S. Lipson, M.D. treats Poison Oak Dermatitis

It’s all over California, especially the Bay Area! It is insidious, creeping up on you when you least suspect it. And it’s miserable to deal with. The diabolical skin rash we call poison oak can affect anyone at anytime of the year. In California, the rash is caused by poison oak, in the Midwest and East coast it’s caused by poison ivy, and in the South it’s caused by poison sumac. But whatever the cause, the reaction is generally the same. It is triggered by an oil on the plant we call Rhus. And the reaction of this oil to your skin will lead to the typical rash we see. This rash can occur on any skin that has contact with the oil. The rash can occur within two days of exposure to the oil, or as long as two weeks if this is your first exposure.

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Initial symptoms are skin irritation followed by itching and blister formation. The rash can be pretty extensive and may be spread by touching the initial exposure site and spreading the oil to other parts of the skin. Often the rash is seen in a linear deposition due to the patient scratching the skin in a line.

The best thing to do if you know you have been exposed to poison oak is to immediately wash all exposed skin with rubbing alcohol in which the resin in soluble. Soap works also but not as well. And rinse with cold water that will not open the skin pores to the oil.

Once the rash appears, the horse is out of the barn and no washing will help. However, contrary to popular belief, the fluid from the blisters and skin vesicles cannot spread the rash. But you must be careful not to touch any clothes that may still have the oil and be ure to wash the clothes thoroughly to get rid of the oil

Treatment of poison oak consists of cool compresses to sooth the rash. Antihistamines like Claritin or Zyrtec can be helpful to minimize the itching. And these antihistamines should not cause drowsiness like the older ones do such as Benadryl

However if the poison ivy or poison oak is moderate, severe or more extensive, a visit to your doctor may be warranted. They can prescribe potent topical steroids to the affected areas or if the rash is extensive enough than oral steroids. These medications will suppress the allergic reaction caused by the oil on the skin. In two or three days, the itching should subside and the rash should start to recede. However it is crucial to take these meds in tapering doses over two to three weeks to prevent a recurrence of the rash.

Some researchers have tried to desensitize patients to poison ivy and poison oak by giving them increasing dosing of the oil over a period of time. This has been less than successful and complicated with intolerable side effects such as outbreaks in the GI tract. They are usually reserved for those highly sensitive or people who cannot avoid contact such as forest rangers.

A better approach would be learning to recognize the plant and avoiding contact with it. Staying on a well marked trail wearing long pants and shoes have helped. If accidental contact occurs then wiping the oil with alcohol or alcohol based beverages can help. Using barrier creams such as Ivy Shield or Ivy Block may help prevent outbreaks of the rash. But old fashion vigilance in identifying the plants and avoiding it is the best approach to preventing contracting this annoying and intolerable skin rash.

Contact our office now and see what we can do to help you rid yourself of Poison Oak Dermatitis.

Call us today: 650-216-6111

Brian S. Lipson, M.D. treats Eczema or Atopic Dermatitis

Eczema or Atopic Dermatitis is a common allergic reaction often affecting the face, neck, front of the elbows and back of the knees, the so called flexure surfaces. It is estimated to affect 15 million people in the US. About 10-20% of infants have eczema.

Although it can look different from person to person, it typically is dry, red, extremely itchy patches on the skin. It has been described as an “itch that rashes” because it first manifest as an itch, with appearance of the rash when the itch is scratched. Chronic scratching causes the skin to take on a thickened texture and appear like leather.

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Many triggers have been identified with atopic eczema. It is most commonly associated with dry skin and will get worse with agents that dry out the skin, such as soap, detergents and disinfectants.

Foods allergies are a common trigger to atopic eczema. Approximately 30% of patients with eczema have one or more foods that can trigger their symptoms. That is why it is crucial to skin test patients with eczema with food allergens to identify potential triggers.
Then avoidance of that food can help improve the symptoms.

One of the most important components of eczema treatment is to prevent itching. This can be done with moisturizers on the skin, topical cortisone creams and antihistamine pills. If the itch can be stopped then scratching will stop and the rash should clear up.
Because eczema is characterized by dry skin, then moisturizers become crucial in relieving the symptoms. A good moisturizers needs to be applied daily, especially right after bathing .This combined with a good steroid cream as well as Elidel or Protopic ointment can clear up most cases of atopic dermatitis.

An allergist/immunologist is the best qualified medical professional to diagnose and treat eczema/atopic dermatitis. Please contact our office for an appointment to evaluate and treat your eczema.

Call us today: 650-216-6111