Poison Ivy: One of the most annoying and bothersome consequences of spending time in the great outdoors is the development of an extremely itchy rash. Its medical name is rhus dermatitis, but it is better known as poison ivy. The rash is caused by a reaction to urushiol, an oil that is present in plants of the genus toxicodendron. The two plants with which a person is most likely to come into contact are poison ivy and poison oak. A third, poison sumac, can also trigger the rash, but contact with this is rare because it grows primarily in boggy areas that are difficult to reach.

Poison ivy, which is found most commonly in the eastern half of the United States, has pointed leaves that are smooth or mildly toothed. A key characteristic is that the leaves occur in sets of three leaflets. The middle leaflet has a longer stem than those on the sides. The leaves have a reddish tint in the spring, turn green during the summer, and can be orange, yellow, or red in the fall.

Poison oak is more common in western and southern states. Like poison ivy, the leaves are found in sets of three leaflets. They have the lobed shape of oak leaves and are easily mistaken for small oak trees, especially when they are found growing in and around mature oaks. All parts of the plants contain urushiol. The worst case of poison ivy I have ever experienced was triggered by clipping roots to free some wire as I was clearing a piece of property. The area had been mowed so I didn’t realize that the roots belonged to poison ivy plants.

The rash itself is not contagious even if it is weeping. Any contact with the oil can trigger a reaction, however. It is not uncommon for a person to develop poison ivy in the process of doing laundry if a piece of clothing has urushiol on its surface. Persistent or recurrent episodes of poison ivy may be due to the presence of the oil on work gloves or other unwashed articles of clothing. I have known families who broke out in rashes after a family pet came in contact with poison oak or poison ivy. It is even possible to react to smoke in the air if the firewood contains traces of urushiol. Since the oil can remain active for up to five years, care must be taken to wash any items that are suspected of having come into contact with one of the toxic plants and the same precautions one would take when dealing with living plants must be taken when handling dead ones.

In addition to itching, symptoms may include swelling, blistering, oozing, and burning. Poison ivy should be suspected if the rash begins as linear streaks on a part of the body that may have brushed against the plant. If the exposure has been heavy (roots contain enough urushiol to affect 10,000 people) or if the oil has come in contact with broken skin an internal systemic reaction may occur. A systemic reaction should be considered if new areas continue to break out for longer than four days or if more than 15 percent of the skin is involved.

Treatment goals include removal of any remaining urushiol from the skin, stabilizing the reaction of the immune system, and calming inflammation. Washing with soap and water before the oil binds to the skin can prevent a reaction. Experts differ regarding how quickly binding takes place. Most suggest that washing within two to four hours will be effective, but some suggest that binding of the oil to the skin can occur in as little as ten minutes.

A significant advance in the management of poison ivy is the availability of Zanfel™ a product that removes urushiol even if it has been bound to the skin. Washing with Zanfel usually eliminates itching and pain in less than a minute and brings resolution of the rash within 24 hours.

If a systemic reaction occurs it is necessary to calm the immune system and stop inflammation. Two supports that are helpful in calming down the reaction of the immune system are colostrum and beta glucan. Examples are Imu Plus and Beta Immune Activator™. The therapeutic amount of each is two capsules three times daily.

Inflammation can be reduced by supplementing omega-3 fatty acids and systemic enzymes. A total of 1,000 to 2,000 mg of EPA and DHA should be taken daily. A systemic enzyme product such as Panzymes is also helpful in reducing inflammation. Four to six capsules should be taken on an empty stomach (at least one hour before or two hours after eating) three times daily until improvement is noted. The amount can be then be tapered by one or two capsules per serving at three day intervals as long as improvement continues.

Severe systemic reactions may require the use of steroids. Seek medical attention if symptoms persist despite the topical use of Zanfel and supplementation with immune system modulators and anti-inflammatory supports.

Heat Rash: Heat rash is also called prickly heat or miliaria. It occurs when sweat is being produced faster than it can evaporate from the skin. When this occurs sweat glands become blocked and sweat becomes trapped within the skin. Depending upon the amount of sweat being trapped a heat rash may consist of small bubbles or bumps on the skin, redness and itching, or pain. Heat rash can generally be prevented by avoiding exercise in hot, humid conditions, by wearing loose fitting clothing that allows the skin to breathe, and by using fans or air conditioning to increase the rate at which sweat evaporates. Heat rash tends to resolve as the skin cools, but it can become severe during spells of hot, humid weather if air conditioning is unavailable.

Sunburn: Sunburns are not only painful; they can damage the skin and set the stage for the appearance of skin cancers later in life. Excessive sun exposure can cause sunburn in anyone, but fair-skinned individuals are the most susceptible. The amount of sun exposure that is excessive will vary depending upon the degree of tanning that has previously taken place, the altitude, and the time of day. Untanned skin can burn in as little as fifteen or twenty minutes. Burning is more likely to occur at higher altitudes because the sun’s rays are more intense in the thinner atmosphere. The risk of burning is greatest during midday when the suns rays are most intense.

Avoiding sunburn is always preferable to treating sunburn that has occurred. Prevention is accomplished by wearing protective clothing and limiting the time spent in direct sunlight. A broad-brimmed hat can protect the ears, nose, and neck from the sun. A long-sleeved shirt can protect the arms, and long-pants and socks can protect the legs and feet. Performing outdoor activities before 10:00 a.m. or after 3:00 p.m. can lessen the risk of sunburn significantly. The need for protective clothing can be reduced by gradual tanning. Initial exposures should be for twenty minutes or less. As the tanning process progresses, the length of each exposure can be increased.

Sunscreen is best used as a “back-up” when “cover-up” is not a reasonable option. If used, sunscreen should be applied only to the areas of skin susceptible to burning. Its use should be infrequent; it should not be routinely applied on a daily basis.

I caution against the frequent and excessive use of sunscreen because it is clearly a two-edged sword. On one side it provides varying degrees of protection from sunburn and thus can potentially lower the risk of subsequent skin cancer; on the other it subjects the user to toxic chemicals, many of which are known to increase future cancer risk.

Nearly all sunscreens contain a chemical called oxybenzone. It is often added to other personal care products such as moisturizers and anti-aging creams as well. The Centers for Disease Control reported in 2008 that 97 percent of Americans tested had oxybenzone in their bodies. This included 6 – 8 year old children. The chemical has been linked to allergies, hormonal disruption, cell damage, and low birth weight in girls whose mothers were exposed to it during their pregnancy. As if its own ill effects were not bad enough, oxybenzone increases the rate at which other substances are absorbed through the skin.

Many of the other chemicals found in sunscreens are suspected carcinogens (cancer-causing agents). These include aminobenzoic acid, avobenzone, dioxybenzone, diazolidinyl urea, ecamsule, octocrylene, octyl methoxycinnamate, padimate O, phenylbenzimidazole, phenoxyethanol, and titanium dioxide. In addition, several of the chemicals interfere with hormone function, damage the skin, and adversely affect the body’s immune system.

The effectiveness of sunscreen use in preventing skin cancer is unproven. The Sun Protection Factor (SPF) is often assumed to reflect a product’s effectiveness, but the SPF does not tell the whole story. The SPF represents the product’s ability to prevent burning caused by ultraviolet B radiation. It says nothing about the product’s ability to protect against ultraviolet A radiation, which is also a contributing factor in the development of skin cancer. “Broad Spectrum” sunscreens provide some degree of protection from both types of ultraviolet radiation, but they do so at the expense of adding additional toxic chemicals to the preparation.

Melanoma is the most dangerous form of skin cancer. While melanoma risk reduction is often cited as a reason to use sunscreen, melanomas occur most frequently on the non-sun exposed areas of the body. This is referred to as the melanoma paradox. Researchers from the Karolinska Institute in Stockholm, Sweden have demonstrated that melanoma risk is actually related to exposure to television and FM radio waves rather than sunlight. The type of cancer most likely to occur as the result of sunburn damage is basal cell carcinoma, a less aggressive form that can cause a great deal of damage in a localized area, but which rarely spreads to other parts of the body.

Nutrients that provide internal protection from the sun’s rays are often overlooked. Plant substances called oligo proanthocyanidins (OPCs), which are present in the skins of dark colored grapes and berries and are also extracted from pine bark and grape seeds, act as internal sunscreens. They decrease the likelihood of burning and neutralize free radicals that are responsible for much of the damage caused by excessive sun exposure.

When sunburn occurs, early intervention can bring rapid improvement and significantly reduce the damage resulting from it. The most effective sunburn treatment is rehydration with micro-clustered water. Water as it is found in nature is made up of large clusters of H₂O molecules. Catalysts can be added to water to break up the large clusters. The resulting micro-clustered water is able to move through cell membranes much more effectively. Catalysts are sold under the names “Willard Water”, “Biowater”, or simply “Catalyst Water.” One ounce of catalyst is sufficient to convert one gallon of regular water into micro-clustered water.

The micro-clustered water can be placed in a spray mist bottle. The burned area should be sprayed liberally. Pain and burning will ease almost immediately. The area should be sprayed again each time discomfort reappears. I have treated dozens of people in this manner and even the most severe sunburn has resolved without blistering or peeling. Applying a moisturizer that is free of oxybenzone to the area once the micro-clustered water has successfully eliminated the initial pain and redness can enhance the healing process.

My forearms recently became sunburned while mowing my yard. It was the first time I had been out in the sun for a significant length of time since last fall. I was wearing a hat, long pants, and shoes, but failed to wear a long-sleeved shirt. I normally wear short sleeves during the summer months without any difficulty, but I failed to recognize that my protective tan had vanished over the winter.

When I noticed the burn that evening I began spraying it with a product containing 5 % panthenol in micro-clustered water. (Panthenol is vitamin B-5, which helps repair damaged cells.) By the next morning much of the redness had subsided. I continued to use the spray and applied a moisturizing hand and body lotion containing antioxidants in a micro-clustered water base. The sunburn resolved uneventfully with no blistering or peeling.

Eye Damage: The skin is the organ that usually comes to mind when thinking about the risks of excessive sun exposure, but the eyes are also at risk from ultraviolet radiation. Certain types of cataracts, which obscure vision due to cloudiness in the lens of the eye, are triggered by exposure to ultraviolet light. Macular degeneration is a leading cause of blindness in people over the age of sixty-five. It does not appear to be related to ultraviolet radiation, but prolonged exposure to bright sunlight does play a role. One study found that individuals who spent five or more hours in bright sunlight daily in their teens, twenties, and thirties were twice as likely to develop macular degeneration later in life.

Broad-brimmed hats and sunglasses can provide significant protection to the eyes. Sunglasses that provide UV protection are available, but it is important that they not be excessively dark. When wearing dark lenses the pupil of the eye dilates to let in more light. Light coming in from the sides can then be more damaging than if the pupil had remained small. One solution to this challenge is to wear wrap-around sunglasses. These can be particularly useful in activities such as skiing where the sunlight is intensified by the thinness of the mountain atmosphere and by reflection off the snowy landscape.

Tick-borne Diseases: Ticks can transmit several diseases to humans. The most common are Rocky Mountain spotted fever (RMSF) and Lyme disease.

RMSF is the most lethal tick-borne disease. It is so named because it was first identified in the Rocky Mountains during the late nineteenth century. It is most common, however, in a band of states that includes Maryland, Virginia, North and South Carolina, Tennessee, Arkansas, and Oklahoma. It has been reported in all states except Vermont and Hawaii. It is spread by the wood tick in the west and the dog tick in the east. The disease may be prevented if ticks are found and removed promptly as it may take up to twenty hours for the disease to be transmitted.

RMSF has a mortality rate of 25 percent. Nearly all deaths result from a delay in diagnosis and treatment. The disease must be suspected if someone develops flu-like symptoms including chills, fever, headache, and muscle aches during the summer months when influenza is uncommon. The characteristic rash, which unlike most rashes can involve the palms and soles, generally appears several days after the fever begins. The rash is not a reliable sign of the disease as it does not present in a third of those infected.

The treatment of choice is with an antibiotic called doxycycline. The drug is given twice daily until the individual has been symptom-free for three days. A typical course lasts 5 to 10 days, but it may need to be continued for up to 14 days.

Lyme disease is named for the town of Old Lyme, Massachusetts, where it was first identified in 1975. It occurs most frequently in northeastern states from Virginia to Maine, in the north-central states of Minnesota and Wisconsin, and in northern California. It is spread by the deer tick, which is much smaller than the wood and dog ticks that spread RMSF.

Since the tick must be attached for approximately 24 hours to spread the disease, a careful whole body search should be conducted each evening in high-risk areas, especially if time has been spent in areas frequented by deer.

Like RMSF, Lyme disease can cause flu-like symptoms. A telltale sign is a rash that spreads out from the original bite as the center clears. Subsequent rashes can also spread from the center creating a “bull’s eye” or “target” appearance. Many cases of Lyme disease resolve without causing any significant symptoms, as studies of forestry workers in endemic areas have found that a high percentage have antibodies to the Lyme organism even though few of them can recall having an infection.

A short course of antibiotics can cure Lyme disease in most symptomatic individuals. In some instances, untreated individuals will later develop arthritis, heart rhythm irregularities, and nervous system challenges such as difficulty concentrating, numbness, and facial paralysis. It is important not to assume that health challenges are due to Lyme disease when no history of a Lyme-like illness is present. I have seen many individuals who had been told that they were suffering from Lyme disease and placed on long-term antibiotics, but whose symptoms were due to a totally different cause.

Health challenges need not interfere with fun in the sun. Common challenges like poison ivy, sunburn, and tick-borne diseases can often be prevented by taking simple precautions and can be managed effectively if the challenge is recognized and treatment is begun in a timely manner.