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Zanfel:
Poison Ivy, Oak and Sumac Wash
Allergy to Urushiol: What is it?
 Poison ivy, oak and sumac belong to a family of
plants that produce one of the most common allergic
reactions in the United States.
 Experts estimate that up to 70 percent of the
population is allergic to urushiol, the oil found in the
sap of these plants.
 The reaction, known as “urushiol-induced allergic
contact dermatitis,” occurs when urushiol attaches
itself to the skin after a person’s direct or indirect
exposure to the oil.
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What does Poison Ivy look like?
Poison Ivy, the most
common of the three
plants, is characterized
by three or five serratededge, pointed leaflets.
These leaves assume
bright colors in the fall,
turning yellow then red.
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T. Radicans radicans demonstrating trifoliate leaves with three leaflets each. Brown aerial rootlets
can also be seen emanating from the branches. These are clinging to the bark of the tree.
Used with permission – Photo from Jere Guin, MD – University of Arkansas
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Urushiol on leaf, oxidized to black. Urushiol self-melanizes on exposure to oxygen. The 'black-spot test'
helps identify toxic Anacardiaceae, but it also increases one's likelihood of contracting a nasty dermatitis!
Use a stone to thoroughly crush plant contents, especially the leaf stalks, between the folds of white
paper. Urushiol turns dark brown within 10 minutes and black
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White fruit on poison ivy in the winter.
Used with permission – Photo from Jere Guin, MD – University of Arkansas
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Figure 1: Early shrub version of T. radicans.
Figure 2: T. radicans ssp. radicans growing at least 20 feet up an alanthus tree. Fort Detrick, MD. All
the leaves on the lower half of the tree are poison ivy. Note the rear end of a truck in the lower left hand
corner for comparison.
Western poison ivy (T. rydbergii ) growing just west of Denver in the foothills of the Rocky mountains.
Contrary to what many sources say, poison ivy can grow above an altitude of 4000 feet. The lowest elevation
in the park is 7600 feet. If you look closely, you can see black dots of self-melanizing sap on the leaflets.
This picture has been published in Cutis 61:249-250. May 1998. Used with permission.
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What does Poison Oak look like?
Poison Oak has three oaklike leaves and grows as a
low shrub in the eastern U.S.
and as both low and high
shrubs in the western U.S.,
where it is most prevalent.
Poison oak produces whitish
flowers from August to
November that dry but may
remain on the plant for
many months.
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Western poison oak (T. diversilobum)
Used with permission – Photo from Jere Guin, MD – University of Arkansas
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What does Poison Sumac look like?
Poison Sumac has seven to
13 leaflets per leaf. Mainly
found in the eastern U.S.,
poison sumac grows in peat
bogs and swamps as a shrub
or a small tree. The large
allergen-containing fruit is
white and grows between
the leaf and the branch.
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Poison sumach (T. vernix). Note flowers growing from an axillary position.
Used with permission – Photo from Jere Guin, MD – University of Arkansas
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Non-allergenic Rhus glabra (Common sumac) growing on the campus of Kansas State University in
Manhattan, KS. Note the terminal, red fruiting structure (inset).
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Other plants that contain urushiol





Brazilian Pepper Plant
Cashew Nut Tree
Japanese Laquer Tree
Mango Plant
Poisonwood Plant
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Anacardium Occidentale
Cashew Nut Tree
Cashew apples and cashew nuts. Used with permission.
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Toxicodendron Vernififlua
Japanese Lacquer Tree
Branch from Japanese lacquer tree (T. verniciflua).
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Mangifera indica
Mango Tree
The mango tree (Mangifera indica)
Used with permission. (Photo courtesy of Richard Gentry, MD)
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Symptoms of urushiol induced
contact dermatitis
Symptoms include:
 rashes
 oozing blisters
 itching
 swelling
 red leathery skin
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Figure 1: Acute reaction to poison ivy from hand transfer of allergen to face. Note significant periorbital edema.
Used with permission. Bolognia
Figure 2: Acute poison ivy dermatitis with vesicles and bullae.
Used with permission. Bolognia
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Note pattern of transfer from this photo to the next in a young women with poison ivy dermatitis.
Used with permission – Photos from Jere Guin, MD – University of Arkansas
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Hand transfer pattern of urushiol to forearm.
Used with permission – Photos from Jere Guin, MD – University of Arkansas
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Incidence of Poison Ivy
Peak poison ivy season is between
Memorial Day and Labor Day, yet
people suffer from poison ivy exposure
throughout the year. Even in winter,
the dormant plants are still toxic.
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Myths and Facts
Myth: Poison ivy rash is contagious.
Fact: Since poison ivy rash is an allergic
reaction to urushiol (the toxin found in
poison ivy, oak and sumac plants), the only
ways to contract poison ivy is through direct
contact with the plant; indirect contact by
touching something that has urushiol on it
(like a family pet or garden tool); or through
airborne exposure to burning plants.
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Myths and Facts
Myth: Scratching poison ivy blisters will
spread the rash.
Fact: The fluid in the blisters will not spread
the rash. After the first five minutes to two
hours following exposure, neither scratching
nor skin-to-skin contact can spread the
reaction. However, excessive scratching may
cause infection because it allows bacteria
from dirt on the hands to enter the skin.
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Myths and Facts
Myth: Dead poison ivy plants are no
longer toxic.
Fact: Urushiol stays active on any
surface, including dead plants, for up to
five years in wet climates and up to nine
years in dry climates.
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Myths and Facts
Myth: Once allergic, always allergic to
poison ivy.
Fact: A person’s sensitivity changes
over time, even from season to season.
Sensitivity to poison ivy tends to
decline with age, as the body’s immune
system slows down.
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Effective Date: June 13, 2005
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Exposure Sales by Region
2005
2006
2007
Region
Share of Exposure
Northeast
25.4%
25.9%
26.8
Mid South
18.4%
16.9%
16.1
Great Lakes
15.4%
16.4%
15.7
Southeast
12.7%
12.8%
12.2
California
10.6%
9.9%
9.4
South Central
9.8%
9.4%
11.0
Plains
5.0%
5.2%
5.6
West
2.7%
3.5%
3.3
Source: IRI Drug COT 52 week ending December 31st, 2007
Share of Exposure Share of Exposure
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Poison Ivy Toxin Quickly
Binds to Skin
Once urushiol touches the skin, it begins to
penetrate in minutes. It is completely bound to
the skin within 8 hours.
Source: Godfrey HP, Baer H, Watkins RC. Delayed hypersensitivity to catechols V. Absorption and
distribution of substances related to poison ivy extracts and their relation to the induction of
sensitization and tolerance. J Immunol 1971; 106:91-102.
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How to Prevent a Scratchy Situation
 Know what to look for and educate your family. Before
you head outside, make sure your family knows how to
identify these plants so they can avoid them.
 Wear protective clothing. Clothing, including long pants,
long-sleeved shirts, hats and gloves, can help protect you
from exposure.
 Wash outdoor items frequently. Be sure to wash all
clothing, shoes, tools or pets that may have been exposed.
 Do not burn any suspicious plants. Burning the
problematic plant and inhaling its smoke can cause a
systemic reaction, which can be deadly.
 Stop the symptoms before they start. If you know
you’ve been exposed to poison ivy, cleanse the area
immediately with plain soap and water to remove urushiol
before it has a chance to bind to the skin.
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Prevention of Poison Ivy Rash by
Cleaning with Soap and Water
Time of Washing
After Exposure
Extent of Removal of
Poison Ivy Oil (%)
Immediately
100
10 min
50
15 min
25
30 min
10
60 min
None
Source: Fisher AA. Poison Ivy/Oak/Sumac Dermatitis. Part 1: Prevention – Soap and water, topical
barriers, hyposensitization. Cutis 1996; 57:384-386.
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Zanfel – How It Works
Dual-action Zanfel is the only product clinically
shown to remove “urushiol,” the toxin found in
poison ivy, oak and sumac, from the skin anytime
after breakout, while relieving itching within 30
seconds.
Evidence Based – A double-blind study (presented in
2003) has clinically shown the effectiveness of
Zanfel Poison Ivy, Oak and Sumac Wash’s patented
formula.
Source: Anals of Emergency Medicine, V42 (4suppl 1), Davila A,et al, “A New Topical Agent, Zanfel, Ameliorates UrushiolInduced Toxicodendron Allergic Contact Dermatitis,” Abstract 364, © 2003, with permission from American College of
Emergency Physicians.
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Zanfel Poison Ivy, Oak &
Sumac Wash
Zanfel is a safer, more effective option than
the steroids or antihistamines commonly
prescribed for poison ivy, oak and sumac.
Hydrocortisones, prescription steroids and
antihistamines only treat the symptoms,
Zanfel goes after the cause of the allergic
reaction and completely removes urushiol
from the skin.
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Zanfel Facts
• Zanfel is effective at any stage of the outbreak.
• In many cases, one washing is adequate for each
affected area (For mild to moderate reactions).
• Zanfel is safe for the face and genitals, and can be
used by children and pregnant or nursing women.
• Zanfel is sold in 1 oz. tubes. The product has a 10year shelf life and provides approximately 12-15
applications the size of an adult hand or face.
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Zanfel Results
24 hours prior to using Zanfel
5 hours after using Zanfel
2 days after using Zanfel
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Zanfel Directions
Zanfel is easy to use: (The following directions are for an area the size of an adult hand or face.)
For best results, use Zanfel in a shower or sink where it is easy to thoroughly rinse off the product.
This tube contains enough Zanfel to wash approximately 15 patches the size of an adult hand or face.
Note: Severe reactions (that typically look like thick leathery burns) will probably require additional washings.
If symptoms persist, reread the Q&A insert and see a physician.
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Got Poison Ivy?
Get Zanfel! It Works!
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