Rash Decisions: Fighting Backcountry Itches

Here's what I keep in my first-aid kit to battle the itchiest rash known to medical science.
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Here's what I keep in my first-aid kit to battle the itchiest rash known to medical science.

I'm one of the 15 percent of Americans who are exquisitely sensitive to poison ivy. So sensitive, in fact, that I often dream of those "leaves of three" and wake up itching and scratching. When I'm actually stricken with poison ivy, the itching is so intolerable that I'm in no mood to talk, hike, or carry a pack. Fortunately, years of anti-itch experimentation and my training as a physician have helped me find the most effective treatments. Here's what I keep in my first-aid kit to battle the itchiest rash known to medical science.

Barrier creams. Try IvyBlock, Stokogard Outdoor Cream, Hollister Moisture Barrier, or Hydropel Moisture Barrier. These creams work by binding to the oil in poison ivy, oak, and sumac as you're hiking. When you wash off the cream, the irritating oil goes with it. If you're a sweaty hiker, reapply the cream every 3 to 4 hours.

Drying preparations. Calamine and Burow's solution dry the irritated skin so that a crust forms, and dried blisters itch less than moist ones. Reapply these remedies several times a day if you're sweating.

Anti-inflammatory steroids. These prescription drugs are the big guns in the war against poison ivy rashes. Prednisone can be soothing and may heal the rash if taken in high doses (120 mg a day for 2 days) within a few hours of when the rash starts. Although prednisone won't cure the rash if you wait a day or 2 before you start taking it, it will ease inflammation and itching, especially if the rash affects your face or genitals. Topical fluorinated steroid gels applied before blisters appear can also be helpful for individuals with mild to moderate poison ivy sensitivity. Discuss with your doctor which steroid is right for you. Pregnant women and children should not take steriods.

Homeopathic methods. Beer, milk, baking soda paste, kaolin, oatmeal, Epsom salts, table salt (2 teaspoons in a quart of water), and ocean water are all good drying agents. Just cover the affected area and soak for 30 minutes. Jewelweed often grows near poison ivy and very effectively treats the rash. Crush a handful of the stems or leaves, then smear the juice on the affected skin.

Note: Sprays or lotions containing antihistamines, zirconium, or benzocaine don't help heal poison ivy rashes.