Rashes and Insect Bites

Summer months bring on fun activities such as camping and hiking, but unfortunately this time of year also brings on skin conditions like rashes and insect bites. Every day in my office a patient brings to my attention something on their skin that causes them concern. Most often, it is not a serious condition, but it is important to be able to identify some of the more common skin problems. Generally, with prevention, home remedies and time, the condition resolves.

Poison Ivy - is always a dreaded word that can ruin anyone's summer fun. Poison ivy, along with poison oak and poison sumac, is responsible for more contact skin reactions than any other plant group. When skin comes in contact with the oil on these plants, an allergic reaction takes place that can cause intense itching and blisters. The adage, "Leaves of three, let them be" usually holds true. Poison ivy and oak have 3 leaflets per leaf and may appear shiny due to the oil. The rash can occur at anytime from 4 hours to 4 days after contact. The rash itself doesn't spread, but can be picked up from gardening equipment or a pet that has come in contact with the plant. Generally, the rash appears as small blisters that form a line. This finding along with itching usually confirms the diagnosis of poison ivy.

Home treatments for poison ivy focus on relieving the itch until the rash resolves which may take 1-3 weeks. I recommend patients try an oatmeal bath as the first line treatment, especially if the rash is wide spread.

Often antihistamines are recommended to treat poison ivy, but the medicine doesn't help with the actually itching. Instead, certain antihistamines, such as diphenylhydramine (Benadryl) cause drowsiness which can prevent the itching interfere with your sleep.

If the rash is localized to a small area on the body, creams and lotions can be useful. Calamine lotion is often effective as is steroid creams, such as hydrocortisone. For any stronger steroid creams or pills, a prescription is necessary.

Mosquito Bites

Growing up, mosquito bites seemed like just a part of summer. Playing out in the woods or at dusk was a guarantee that you would get bit. However, with the onset of the West Nile virus along with malaria, mosquito bites are no longer so innocent. The development of a red, itchy bump is the typical presentation of a bite. Generally, the worst possible scenario is excessive swelling due to an allergic reaction or superimposed bacterial infection due to scratching. In these cases, antihistamine medication and topical steroid creams will help the itching and swelling. If the area starts to drain or become painful, an infection may be developing and topical antibiotic ointments are usually effective.

In 1999, West Nile virus first appeared in the United States. The milder symptoms of infection are fever, abdominal pain and muscle aches. Usually the symptoms last 5 days and can be controlled with rest and fluids. In more serious cases, the virus infects the brain and can cause confusion, stiff neck and loss of consciousness. There is no current drug treatment or vaccine against the West Nile virus, so avoidance of mosquito bites is the only way to protect against the disease.

Mosquito repellents come in a variety of formulations ranging from plant-based products to electrical devices. These repellents can be sprayed on the skin, impregnated into clothing or worn as a bracelet. The one chemical that seems to consistently be the most effective is DEET. DEET (short for N,N-diethyl-3-methylbenzamide) has been around for almost 50 years and remains the most effective repellent on the market. Safety concerns with children do exist, with recommendations not to apply to infants under 2 months. Older children should use products that have a lower percentage of DEET.


Instead of repelling mosquitos, another option available is to eliminate them. There are various traps on the market designed to attract mosquitos with a scent which lures them in. I have had a trap in my yard for several years and find it effective. It runs on electricity, although some have battery power, and requires propane which needs to be refilled every 2-3 weeks.