Once I had a severe sunburn. With the pain I had, I suspected that I would have some blistering by the next morning. So I applied a solution of Solarcaine to my skin. The pain lessened, and next morning, no blisters. Perhaps for poison ivy, along with other therapy, applying Solarcaine might help. I don’t know anyone doing so, however. This is an extrapolation from my personal (and last) sunburn experience.
— KEN PHILLIPS, MD, Providence, R.I. (204-4)

I was introduced to the product Zanfel at a conference. I have had great success with quickly clearing poison ivy, oak, and sumac by using the product on exposure or first symptons of contact for my patients and friends, as well as personally. It has prevented the severity of reaction and the need to put patients on systemic steroids. — CLAUDIA JOHNSON, WHCNP, RN-E, Dover, Del. (204-5)

I have used Tegaderm or extra-thin DuoDERM for poison ivy, burns, and abrasion. Both products work. The DuoDERM works with draining wounds, and the Tegaderm works better with nondraining wounds. I have been using them for years. They speed up healing, decrease pain, and help to prevent infections by contamination. — HELEN BARNES, FNP, Warminster, Pa. (204-6)

Never use, or recommend using, bleach to treat Rhus (poison ivy or other Rhus species) dermatitis. Chlorine bleach is NOT approved, nor is it safe for use on skin or mucous membranes, especially when that skin is potentially already damaged or sensitized.

If you develop a rhus rash after exposure, treatment with Zanfel (an OTC scrub) can be very effective.

Another very effective approach is histamine blockade with Zyrtec (cetirizine) 10 mg orally twice daily (for adults) for the 2-week course required to outlast the Rhus reaction. At a recent Essentials for Primary Care Conference, Zyrtec was the suggested recommendation for all acute allergy treatment situations as the new and better replacement for Benadryl (diphenhydramine). — THOMAS URSCHEL, PA-C, Leroy, N.Y. (204-7)

Whenever outside and a possible exposure to poison ivy or poison oak could occur, wash the area with Dawn dishwashing liquid soap. This is the soap used to remove oil from birds and animals exposed to oil spills and is the best at removing the oils of poison ivy/oak. I have friends who keep a bottle in the shower to use as a first-pass wash prior to using their regular soap and shampoo after camping or working in the yard. I also use it to wash my dogs during poison ivy season. They run through the bushes and get the oils on their coat, then I pet them and get poison ivy on my forearms and legs that they brush up against. This is inexpensive and available everywhere. — SUSAN SCOTT, PA-C, Dallas, Tx. (204-8) 


These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.