When avoiding these plants is not possible, it is recommended to wear personal protective clothing, e.g., disposable or washable, as a common solution for outdoor occupations. However, caution is needed to avoid urushiol secondary exposure (until clothes are laundered) or from clothing material that does not stop urushiol penetration to skin, e.g., sweaty, thin clothing. Use woven fabric, such as wool. If necessary, consider a waterproof coverall suit. Use heavy duty leather, not cotton gloves, for good protection from urushiol. Depending on protection needs, consider heavy duty vinyl (PVC) gloves since they prevent urushiol penetration, but latex or rubber gloves do not.
Although controversial, the evaluation of skin barrier creams, as protective agents prior to exposure to toxic plants, has been investigated for a 20+ years in effort to decrease the extensive hazard in the U.S. Forestry Services and other occupations. In the mid 1990s, it was reported that up to 150 barrier preparations had been evaluated. In 1992, several barrier creams were evaluated in clinical studies
and reported to be effective to prevent or reduce TD severity, but they are not commercially available today. Of these barrier creams, only one, topical 5% quaternium-18 bentonite lotion
, has been evaluated to prevent or minimize allergic reaction from urushiol exposure. This preparation was approved by the FDA in 1996 as Ivy Block
, and was the preferred barrier cream, but unfortunately it was discontinued in ~2018. Currently, there is another purported barrier cream, e.g., Ivy-X
, available commercially that claims to be effective, but there is no published randomized clinical trials reporting effectiveness at this time.
It is paramount to lessen the amount of time and concentration of urushiol on skin in effort to decrease symptom severity, but many lack awareness of when they were exposed. Urushiol is known to be degraded with water. If you are aware, immediately wash exposed skin within 60 minutes. (See Table 1). However, it is still recommended by expert consensus
to wash exposed skin up to two hours after urushiol exposure by using repetitive high-pressure, single direction gentle washing with soap (e.g., Dial Ultra or Dawn) and under hot running water. However, this recommendation is not applicable in the outdoors with limited resources. (Note: it is still controversial to use cool, warm or hot water with dish soap to remove urushiol from skin). Based on the evidence, we recommend to use water and dish soap, or wash exposed skin with rubbing (isopropyl) alcohol as a common household product reported for many decades to be effective. The use of rubbing alcohol should be followed by a water rinse, if available. Other recommended household solutions for cleaning urushiol off skin or tools is either mineral spirits, or hypochlorite (dilute 1:9 bleach/water).