Summer and fall are the seasons when many people go hiking and camping to enjoy the outdoors. Inevitably, some of those people are going to come down with cases of poison oak dermatitis. Typically, a day or two after contact, they will notice raised red spots and intense itching at the places where the poison oak scratched them. If left untreated, those areas can get quite swollen and even painful (they will be painful AND itchy, not just painful), and the raised bumps may crack and ooze. The offending chemical in the plant's oil, urushiol, can also rub off the points of initial contact and cause itching at secondary sites. All in all, it's a very unpleasant affair that lasts a couple of weeks. Fortunately, there is a lot you can do to avoid it, and failing that, to treat it very effectively. I will outline here my basic approach, perfected over years of suffering and experimentation. I just got back from backpacking with buddies Dave and Andy, and Dave ended up with some real bad poison oak, thus inspiring this post.
1. DON"T GET IT IN THE FIRST PLACE.
This doesn't have to involve avoiding wild areas. Educate yourself as to what poison oak looks like in every season. Google "poison oak" (or, on the East Coast, "poison ivy") and take a look at photos of the plant. Better yet, go on a hike with someone who is familiar with poison oak and have him point the plant out to you. Then, when you are hiking and exploring in the woods, be careful and respectful. Poison Oak is one of the great teachers of the forest, and its lessons are awareness and humility. We left the forests a couple of million years ago, and when we return to them now, we are visitors. If we break the rules of care and appreciation, if we stumble through like bulls in the china shop, we are bound to pay in some way, and a couple weeks of itching is one of the less subtle ways that we can pay.
2. ONCE YOU'RE HOME, ACT AS IF YOU HAVE BRUSHED AGAINST IT.
Do this even if you are quite positive that you were very careful and attentive and avoided all the poison oak that you saw. I cannot tell you how many times I skipped this step and then started itching a couple days later. The main thing you want to do is go to the drugstore and buy a bottle of a product called TEKNU. TEKNU, as far as I can tell, is a kind of body lotion made out of mineral spirits. You rub it on your arms, legs, neck, face, any body part that might possibly have been exposed. You leave it on for a few minutes, then you rub the excess off with a paper towel. This serves to dissolve the offending urushiol, which you then remove with the paper towel. Finally, take a shower to wash off the remaining TEKNU plus urushiol.
3. IF YOU GET ITCHY DESPITE FOLLOWING THE STEPS ABOVE, USE A SEVEN-STAR HAMMER.
This is the single most effective natural poison oak treatment option available. The seven-star hammer, also known as the plum-blossom needle, is an acupuncture tool consisting of a flexible plastic handle and a small hammerhead with a number of sharp needles sticking out. If you are an acupuncturist, the best thing to do for your patients who are suffering from poison oak dermatitis is to send them home with a seven-star hammer of their own, to self-treat at home. If you are not an acupuncturist, go to your acupuncturist and ask her to give you one of these miracle-working implements. This is what you do: the minute you notice an itchy area, get out your seven-star hammer and pound the heck out of the itchy area. Actually, all you have to do is tap lightly all around, preferably until you draw a little blood. Then, wipe the area with a cotton ball soaked with rubbing alcohol. The itching will go away, usually for a whole day. If it starts itching again, pound and disinfect again. Repeat for all new areas that begin to itch. Following this procedure will usually keep your dermatitis from getting to the nasty, inflamed, oozing, crusty phase. And you will be virtually itch-free for the two weeks or so that it takes for the poison oak reaction to completely subside. I'm not sure why this method works so well when regular scratching with the fingernails usually makes the itching worse, but it does work!
4. IF YOU ARE STILL ITCHY EVEN AFTER THE SEVEN-STAR HAMMER, USE TOPICAL MEDICATIONS.
You can try calamine lotion, calendula gel, the Chinese burn ointment called Ching Wan Hung (a.k.a. Jing Wan Hong), thinned down yerba santa/grindelia tincture, witch hazel, tea tree oil, aloe vera gel, hydrocortisone creme, or any of the pharmaceutical or herbal treatments that are available commercially. In my experience, the seven-star hammer is vastly superior to any topical preparation, as a primary treatment. But if you are still itching, try whatever is available.
5. AS A FINAL RESORT, OR IN CONJUNCTION WITH TOPICAL TREATMENT, USE INTERNAL MEDICATIONS.
If you are still itching after all of the above, treat the problem from the inside. If you are in really bad shape, with a thigh that is as thick as a tree trunk, or a face that looks like the Elephant Man, you should probably go to the doctor and get a cortisone shot (but beware - long ago, before I knew anything of the Healing Secrets of the East, I got a cortisone shot after my first bad poison oak attack, and it got even worse because it turned out I was allergic to something in the preparation! Oral cortisone did the trick). Less extreme options include homeopathic Rhus toxicodendron 200C ("potentized" poison oak extract); Chinese herbs to clear heat and toxin and cool blood heat such as rhubarb root, phellodendron, honeysuckle, and coptis; and cooling, detoxifying foods such as watermelon and mung bean. My experience with internal treatments for poison oak is that they are hit or miss - they seem to work sometimes, and other times not at all.
I will end with a few words about poison oak "vaccinations." There is this idea out there that you can immunize yourself against poison oak by ingesting small amounts of it early in the season. Being of an experimental bent, I have tried this out on several occasions. The first time, I made an alchohol extract of fresh poison oak, thinking I would take a daily dose of a few drops in water, increasing the dose each day. But I was not disciplined enough, and ended up forgetting to take my dose a lot of the time. Another time, I ate a few fresh poison oak flowers when they were in bloom, thinking the flowers might not be as oily and hence as toxic as the leaves or stems. That particular year I didn't experience any bad rashes, but I don't know whether it was because of the flowers or because by that time I had learned to be more careful in the woods. Last year I ate a couple of poison oak berries and ended up with an itchy butt for a week or so. I was not scientific to the point of purposely scratching myself with poison oak after these attempts at vaccination, and my results are overall inconclusive. If you are thinking of trying to immunize yourself against poison oak, I can only say: proceed at your own risk.
Whatever else you may have gotten out of this post, if you do nothing else, get yourself a seven-star hammer if you're going to be spending any time out in nature.