Poison Ivy

A huge part of summertime fun is playing outside. Naturally curious, most children love to explore overgrown areas of the yard or park. Unfortunately, poison ivy thrives in these areas. The rash that develops after exposure to poison ivy is a contact dermatitis to the chemical urushiol and can usually be treated symptomatically with home remedies.

Prior to summertime excursions, look at pictures of poison ivy and teach children to avoid it. Tell your children to count the leaves on plants and look for the "three, almond shaped, sharp-teeth leaves" that are classic for poison ivy. Dress your child in protective clothing - long pants, shirts, and shoes with socks for outdoor adventures.

If  your child comes into contact with the plant and you notice prior to the rash appearing, wash the area well with soap and water. Remove the clothing that your child was wearing and wash it in hot water.

If the urushiol absorbs into the skin, a red, itchy, blistering rash may appear. It usually appears in straight lines because of the way the plant comes into contact with the skin, but may be diffuse and appear spreading. The rash does not spread with itching or breaking the blisters, but if your child's skin comes into contact with urushiol again (from clothes/pets/repeat exposure), it will continue to spread. Urushiol will continue to occupy any surface if it is not washed off, including dead poison ivy plants.

Home remedies to try if your child develops a rash:
1) Cool oatmeal baths
2) Calamine lotion
3) Vaseline
4) Cool compresses

If itching is severe and keeping your child from sleeping you may try diphenhydramine (Benadryl) or 1% hydrocortisone cream to the red areas.

The rash typically lasts 1-2 weeks, but may last as long as 8 weeks, depending on how your child's skin absorbs the urushiol and reacts to it.            
                                                                                                       
The rash may become infected with bacteria if you child is itching it, so seek medical care if they develop fever, yellow or white drainage, yellow crusting, severe swelling or warmth to the area. Also, your child may require strong antihistamines or oral steroids if the rash spreads to the face, mouth, eyes, genitals or involves the entire body.

Heather Joyce, MD

Bike Safety

Did you know that more children are seen in emergency departments for injuries related to biking than any other sport?  On average, over 500 kids a day are injured due to cycling related crashes!  Bike safety is something the whole family needs to learn about to avoid potentially serious injuries.

This first and cardinal rule of bike safety is obvious.  Every time you and your child ride a bike, wear a helmet.  It's that simple.  Younger kids are more apt to make this a habit, while older kids tend to steer away from helmets because of the "cool factor."  But don't let this rule slide ... it is clearly shown to save lives.

Helmet fit is crucial.  A helmet should sit on top of the head in a level position, and shouldn't be loose enough to rock side to side or forward and backward.  It must always be buckled, but not to the point where your child can't breath or feels like her or she is going to choke.  Don't forget - helmets aren't just for biking.  It is just as effective for preventing injuries in activities like riding a scooter, roller blading, skateboarding, and riding an ATV.

I like the "eyes, ears, and mouth test."  This is a good test for helmet fit:

Eyes:  Look up and you should see the bottom rim of the helmet.  It should be 1-2 finger widths above the eyebrows.

Ears:  The straps of the helmet should form a "V" under your ears when buckled.  Remember, it should be snug and comfortable.

Mouth:  When you open your mouth as wee as you can, the helmet should hug your head.  If not, tighten the straps.

Click here for a video of a demonstration showing proper helmet fit.

Just like for adults, making sure the bike actually fits the child helps avoid injury.  When sitting on the seat, the child's feet should be able to touch the ground.  Of course, it's helpful if the gears, brakes, and bike components work properly.

Adult supervision and modeling bike safety will help your child learn to ride safely from an early age.  Riding as a family can be very fun and enjoyable - obey the rules of the road (ride on the right side of the road, use hand signals when applicable, and stop before entering an intersection, etc), and your child will understand how to ride a bike safely!

Rachel Brewer, MD

Hives

Hives are very common in children. The rash is itchy, red, raised welts that often move from one location to the next within minutes. If you are like most parents, your first thought is an allergic reaction and you rack your brain trying to figure out what your child may have eaten or touched. However, hives have many different causes, the most common in children being illness, either viral or bacteria. Allergen exposure is second on the list. Allergens may be food, medications, lotions, insect bites, soaps, detergents, fabric softener, clothing ...just to name a few. In many cases, it is difficult to figure out the exact cause.

Hives may last for hours to weeks, but most often 1-2 days. If they are due to an allergen exposure and the substance is taken away, the hives usually resolved within 24 hours with treatment. However, with illness, you may have to wait until the illness resolves for the hives to fully go away.

Most often, symptomatic treatment for hives is the best course of action. Antihistamines, like diphenhydramine  (Benadryl) are very effective at treating hives, however this medications may make your child drowsy or hyperactive. Your doctor may recommend a long acting antihistamine like loratadine (Claritin), fexofenadin (Allegra), certirizine (Zyrtec), or desloratadine (Clarinex) if the hives last longer than 2-3 days.

Home remedies to make your child more comfortable include placing your child in a cool bath (with or without oatmeal to sooth the skin) and dressing your child in light, airy clothing. Do your best to try and keep them from itching!

If your child develops swelling of the face, tongue, lips, or joints they need to be seen by a physician. If they develop difficulty swallowing or breathing, vomiting, abdominal pain, or pass out with hives - it is a medical emergency and can be a sign of a severe allergic reaction.

*Above is a picture of my son with hives due to a viral illness

Heather Joyce, MD