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DITCH THE ITCH

As temperatures rise, so does the incidence of skin irritation. "We're outdoors longer and wearing less, making us more exposed and vulnerable," explains Vancouver dermatologist Dr. Alastair Carruthers. Here's how to deal with the season's common skin irritants.

Poison Plants
Contact with the oily sap on poison ivy, oak or sumach can cause a red, itchy rash. "Of all the things that make us itch in summertime, [plant-induced] rashes can be the most unpleasant," says Carruthers. "They can take a week or two to develop and last for several weeks." The rash turns into small bumps filled with clear fluid that may leak and cause extreme discomfort. In severe cases, swelling can occur.

Prevention: Learn how to identify these plants so you can avoid them (see photos). When in high-risk areas, such as a forest or swamp, wear long pants and sleeves.

Care: If you touch a poison plant, wash your skin with soap and cool running water as soon as possible. Removing the sap may not prevent a rash from occurring, but it can keep it from spreading. To relieve the itch, apply a product containing menthol, a cortisone cream or calamine lotion. Taking an over-the-counter antihistamine may also help. Keep skin clean and dry, and protect blisters with dry bandages. Do not prick or burst blisters. Severe cases may need to be treated with prescription cortisone.

Tip: Sun activates the sap in buttercups and many other common plants, producing a chemical reaction. If you touch the sap, you can get blisters or red streaks on you skin. If this happens, immediately wash the area with soap and water, and apply an anti-itch product.

Bug Bites
For many people, insect bites pose few problems beyond itchiness, mild swelling and short-lived pain at the sting site. If you're allergic, though, symptoms from wasp and bee stings can be more serious, including: difficulty breathing, vomiting, fainting, rash or hives, swelling and loss of consciousness. Some insects can also transmit serious illnesses: mosquitoes can pass on the West Nile virus and ticks, Lyme disease.

Prevention: Decrease your chances of being bitten by wearing loose-fitting clothing with long pants and sleeves, and a hat when outdoors at dusk or dawn or in a heavily wooded area. Avoid wearing bright and deep colours that attract bugs, as well as perfume, hairspray or scented lotions. If you plan to be in an infested area, try an insect repellent containing DEET. (Ask your doctor or pharmacist about Health Canada's guidelines for using products with DEET. Always opt for those with lower concentrations when possible.)

Care: If the area is itchy, avoid scratching, which causes further irritation and can lead to infection. Try an over-the-counter topical anesthetic, antihistamine or menthol-based lotion to control the itch. If it does get infected, treat it with an antibiotic cream and keep the area clean and covered. For a tick bite, carefully remove the head with a pair of tweezers. Your doctor may want you to keep the tick in a sealed jar to test for Lyme disease. If you're been stung by a bee, flick the stinger off with your fingers instead of trying to squeeze it out. Prevent infection by washing your hands and the affected area with soap and water. Apply an ice pack for 15 minutes to decrease swelling and discomfort. For further relief, try a topical lotion such as cortisone or take Aspirin, acetaminophen or an antihistamine.

Heat Rash
Also called prickly heat, discomfort occurs when your body overheats and perspires excessively. This plugs the sweat ducts, trapping perspiration beneath the skin, causing an itchy and prickly rash of tiny red bumps surrounded by a red patch. Heat rash often appears on clothes body parts, such as the back, abdomen, neck, upper chest, groin or armpits.

Prevention: Avoid excessive heat and humidity and wear loose clothing when outdoors. Tepid baths and air conditioning will keep you cool, while exfoliating regularly to remove dead skin cells may also help.

Care: Heat rash usually goes away on its own. The best treatment is to stay cool. A light dusting of powder may make you feel more comfortable, but avoid ointments that keep skin warm and moist. Occasionally, heat rash can interfere with how the body regulates heat, leading to fever, heat exhaustion and even death. Seek medical help at the first signs of fever.

Eczema
Characterized by inflames, dry, scaling and itchy skin, eczema typically appears on the neck, chest, inner elbows, ankles and backs of knees, but can also appear on the face and scalp. Its cause is unknown, but people with allergies or sensitive skin are prone to this chronic disorder, which has been linked to an overactive immune system. "Eczema can get better in summer or worse," says Carruthers. Summer flare-ups are usually due to: heat, sweat, increased allergens and pollutants, salt water and chlorine. Excessive scratching leads to cracked and scaling skin, increasing risk of infection.

Prevention: Don't wear tight clothing that irritates skin and causes sweating; choose cool, breathable fabrics instead. Avoid exposure to chemicals and strong detergents. After swimming, immediately cleanse skin with a moisturizing shower gel or bath oil. Do not scratch skin. Wear sunscreen to prevent skin from burning, which can aggravate eczema.

Care: There is no cure for eczema, but it can be controlled in most cases by moisturizing often with an emollient cream and avoiding irritants and allergens. Your doctor may prescribe a topical steroid cream, non-steroid immunomodulating cream (which inhibits the immune cells) or oral antihistamine to help reduce the itch. Phototherapy (PUVA) may also help reduce symptoms.

Scratch that
Certain ingredients can aggravate sensitive skin. PABA, although rarely found in sunscreens today, can be irritating. Itch-controlling topical anesthetics with the word "caine" in their names can also cause allergic reactions, says Carruthers.

	Poison ivy grows as a vine or shrub, usually in shady areas such as woods or meadows. Each pointed leaf has three leaflets.
	Poison oak often grows as a shrub in wet areas or in sandy soil. Each rounded, oak-like leaf has three leaflets.
	Poison sumach grows as a shrub or small tree and is usually found in swamps. It has seven to 13 staggered leaflets with one on the tip of the plant.

* The leaves of all three of these poison plants very in colour throughout the year. Generally bright green in spring, the leaves usually turn yellow in summer and red in fall. The plants produce small, green flowers in the spring and whitish berries in late summer.

Source: Glow magazine, July/August 2004, article by Alison Wood.