How to deal with Mother Nature's rashes and bites

Avoid and treat poison ivy, Lyme disease, and other troubles

Consumer Reports on Health: April 2012

As the temperatures heat up, the bugs come out, including some that carry dangerous illnesses such as Lyme disease and West Nile virus. The warmer weather can also lead to rashes caused by plants, like poison ivy, and fungal infections from the heat and humidity. Here’s how to protect yourself.

Poisonous plants

What to watch for: Poison ivy, oak, and sumac. Poison ivy and oak have leaves clustered in threes, with the longest stalk in the center. The leaves on poison ivy are oval-shaped, smooth-edged, or moderately notched, and shiny or dull green, sometimes tinged maroon. At the shore, the plants have waxy, droopy leaves. Poison-oak leaves are lobed, like those on an oak tree. Both grow throughout the country, poison ivy as a dwarf shrub or vine, poison oak usually as a shrub. Poison sumac grows as a tall shrub or small tree in swampy areas, especially along the East Coast and in the Midwest. The leaves have rows of leaflets with an extra leaflet at the end.

What to do: Don’t touch the plants or anything that may have touched them. Their resin contains urushiol, a chemical that triggers rashes in most people. Bag the plants, and never burn them, since the resin travels through the air on soot particles, and can enter your lungs. If you’re exposed to urushiol, wash with mild soap and cool water. Also rinse clothes and any contaminated objects. Consider IvyBlock, an over-the-counter clay-based lotion, if you have a history of reactions or if you think exposure may be unavoidable.

If the above steps fail, an itchy, blistery rash will usually develop within two to three days. Most cases run their course within 10 days. In the meantime, don’t scratch. That doesn’t spread the rash but it can lead to infection. To ease the discomfort, take cool showers or apply cool compresses, or use a nonprescription hydrocortisone cream. Remedies such as calamine, zinc oxide, and oatmeal baths can help dry the oozing blisters. If necessary, ask your doctor about a prescription corticosteroid.

Lyme disease and other tick-borne illnesses

What to watch for: The bull’s-eye rash that most of the people with Lyme disease develop, as well as the deer ticks that spread the disease.

That’s especially important if you live in the Northeast or upper Midwest, where the sesame seed-sized ticks are most common. While the rash usually expands over a few days, in some cases you see only part of the circle, or it may appear solid or blotchy.

Ticks can also cause other diseases, including ehrlichiosis (especially in southern states) and Rocky Mountain spotted fever (which, despite its name, is most common in southern Atlantic states from Delaware to Florida).

Both of those conditions are less likely to cause rashes. But all three can cause flulike symptoms, including chills and fever, fatigue, headaches, and sore muscles or joints. The symptoms of ehrlichiosis come on suddenly and hit hard, with high fever, splitting headaches, and debilitating muscle aches.

What to do: Wear long pants, long-sleeved shirts, socks, and closed-toe shoes when you’re in woodsy or grassy areas during late spring and summer. Tuck shirts into pants and pants into socks. And wear light-colored clothes to make it easier to spot the ticks.

Apply insect repellent containing deet, picaridin, or oil of lemon eucalyptus. Inspect your skin when you go indoors and remove any attached ticks, preferably with tweezers so you remove the entire tick.

Get treated if you have signs or symptoms of any of the diseases and you suspect a tick-borne illness. Prompt treatment with inexpensive antibiotics is very effective for all three infections and can prevent more serious long-term complications, including extreme fatigue and facial paralysis with Lyme disease, potentially life-threatening secondary infections such as pneumonia with ehrlichiosis, and widespread damage to the joints,heart, and kidney with Rocky Mountain spotted fever.

Bee stings and bug bites

What to watch for: Hives—a widespread rash of itchy, red skin bumps—that can indicate a potentially serious allergic reaction to bee stings and spider bites.

What to do: If you’re stung by a bee, carefully scrape away thestinger in a side-to-side motion with a straight-edged object, such as a credit card.

Cold compresses and steroid creams can help ease most bites, along with oral antihistamines. But consider seeking medical attention when inflammation and swelling extend well beyond the bite site, since you may require prescription drugs. If you’ve had severe reactions to insect stings, ask your doctor to prescribe an epinephrine injection kit (EpiPen, Twinject).

West Nile virus, malaria, and dengue fever

What to watch for: Any unexplained fever, headache, muscle pain, or weakness, especially if you live in an area infested by mosquitoes. Higher temperatures and changing rainfall patterns from global warming have caused those mosquito-borne diseases to spread northward. For example, some cases of dengue fever, a tropical disease, have now been reported in Texas.

What to do: Rid your yard of water-filled containers, where mosquitoes breed. Wear long sleeves, long pants, and socks when you’re outside between dusk and dawn. Spray clothes and exposed skin with the same repellents used for ticks. And avoid tight-fitting clothing, perfume, and aftershave. To ease itching, try cool compresses and a topical steroid cream. Seek medical attention if you experience fever, headaches or body aches, nausea, vomiting, swollen lymph glands, or a rash on your torso after possible exposure to a mosquito.

Fungal and yeast infections

What to watch for: A flat, brownish-red rash on your feet (athlete’s foot), groin (jock itch), armpits, and under the breasts in women. Summer is prime time for such infections, since the moldlike culprits flourish in warm, moist, dark places, such as the insides of just-used running shoes or a wet swimsuit.

Fungal infections usually will not go away on their own, and if left untreated they can lead to secondary infections or, in rare cases, permanent disfigurement.

What to do: Wash the affected area daily with soap and water, then dry well. Apply clotrimazole cream (Lotrimin AF and generic) or miconazole (Micatin and generic) powder or spray. Use daily for at least two weeks. If the symptoms worsen or last longer than that, see your doctor for a definitive diagnosis and possibly prescription medication.

Editor's Note:

This article first appeared in the monthly newsletter Consumer Reports on Health.

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