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It’s a Jungle Out There When it Comes to Plants and Bugs

WINSTON-SALEM, N.C. – The onset of summer can also mean the onset of life threatening illnesses for millions of people via plants or insects.

For many, navigating the outdoors to enjoy life can be a hazardous undertaking – there are dangers lurking in the form of poisonous plants, like poison ivy, flying insects that sting like wasps and bees, and airborne allergens from grass and trees.

Mark Dykewicz, M.D., a professor of Internal Medicine and director of Allergy and Immunology at Wake Forest University Baptist Medical Center, is just the man to help. He is a past chair of the FDA’s Pulmonary Allergy Drug Advisory Committee and has been chief editor or co-editor of many national practice guidelines for asthma, rhinitis, sinusitis, food allergy, stinging insect allergy, and anaphylaxis and allergen immunotherapy.

His number one piece of advice when it comes to these bugs and plants is simple – avoidance. If you know what your triggers are, avoid them. If you still come in contact with them, be prepared and seek treatment.

Plants like poison ivy, oak or sumac can cause a skin rash or contact dermatitis by coming into contact with it. Being able to recognize these plants and avoid them is best. Even if you’ve never had an allergic reaction, it doesn’t mean you won’t develop one at some point. You can also have an allergic reaction from indirect contact.

“Indirect contact can happen in a lot of ways,” Dykewicz said. “You can have contact with plant sap if you’ve got a dog that’s brushed up against the plant and then you pet the dog or from your clothes if you brush up against a plant and get sap on them. Also, smoke from a burning brush pile that includes some of the poisonous plants can blow on to your skin and cause a rash.”

For people who are sensitive and prone to break out in rash, Dykewicz recommends trying ivy barrier creams available at drug stores that can be applied before going outdoors. They can reduce absorption of the sap into the skin, giving you a chance to wash it off which will protect against or at least minimize the rash. While over-the-counter products might help ease the itch, Dykewicz said they don’t work well in treating the rash itself and many people need prescription oral steroids.

“I often get asked if there are allergy shots that can prevent rash breakout for poison ivy,” Dykewicz said, “but extracts for that were removed from the market years ago because they were not particularly effective.”

When it comes to stinging insects, Dykewicz cautions that even though you might have been previously stung with no adverse affects, an allergic reaction could still happen. “As with allergy causing substances in general, sometimes it takes several or even many exposures to insect venom before the body decides to turn on and create a reaction,” he said.

Avoidance is still the key. If you’re allergic, he recommends wearing long pants and shoes when outside and avoiding perfumes, lotions or other products that leave you “smelling like a flower” and attracting insects to begin with. Those who are severely allergic should carry a self-injecting epinephrine pen for emergencies because rapid treatment is essential. They should also undergo allergy evaluation for treatment with insect venom shots that are highly effective at preventing life-threatening reactions.

Environmental allergens cause problems for people through spring, summer and fall. In the Piedmont Triad area, people tend to suffer more in spring and fall, Dykewicz said, because of certain tree, grass and weeds pollens, as well as molds that are in the air in high concentrations at those times. Some people have reactions after mowing the grass, but he points out that it’s less often the grass they are allergic to, but rather the mold at the base of the grass that becomes airborne when it’s cut. Minimizing outdoor exposure, using air conditioning instead of opening windows and wearing masks when doing yard work will all help, but those who suffer severely might need more than a prescription.

When it comes allergies, no matter what type, Dykewicz wants people to know they can find relief, especially if they have severe reactions.

“By getting evaluated by an allergist, you can know exactly what you’re allergic to avoid it, choose the best available medications, and if needed, try allergen immunotherapy which will raise your tolerance over time and minimize reactions,” Dykewicz said.

For more information about allergies, Dykewicz recommends the American Academy of Allergy, Asthma and Immunology at www.aaaai.org or the American College of Allergy, Asthma and Immunology at www.allergyandasthmarelief.org.

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