What is the treatment for wild parsnip exposure?

Treatment for Wild Parsnip Exposure

Immediate washing with soap and water is the most effective treatment for wild parsnip exposure and should be performed as soon as possible after contact to remove the phototoxic compounds before they can cause skin damage.

Understanding Wild Parsnip Exposure

Wild parsnip (Pastinaca sativa) contains furocoumarins, which are phototoxic compounds that cause phytophotodermatitis when skin is exposed to ultraviolet light after contact with the plant 1. This reaction is not an allergic response but a direct phototoxic effect that can result in:

• Painful burning rash
• Blistering
• Subsequent hyperpigmentation
• In severe cases, tissue damage

Treatment Protocol

Immediate Actions (Within Minutes of Exposure)

1. Wash the exposed area thoroughly with soap and water

   • Most effective if done immediately after contact
   • Effectiveness decreases rapidly with time:
     • 100% removal if done immediately
     • 50% removal at 10 minutes
     • 25% removal at 15 minutes
     • Only 10% removal at 30 minutes 2

2. Commercial decontamination products

   • Can be used as an alternative to soap and water
   • May reduce symptoms by 55-70% even when used up to 2 hours after exposure 2

Secondary Management (After Washing)

For established symptoms:

1. Cool compresses

   • Apply to affected areas to relieve local symptoms 2

2. Oatmeal baths

   • May provide symptomatic relief 2

3. Sun protection

   • Keep affected areas covered and protected from sunlight
   • UV exposure will worsen the reaction if furocoumarins remain on the skin 3

Medication Options

1. Topical steroids

   • Over-the-counter options (low-potency) have uncertain effectiveness 2
   • Prescription-strength (high-potency) topical steroids may be more effective for severe cases

2. Pain management

   • Non-steroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation
   • Analgesics as needed for discomfort

3. Antihistamines

   • Effectiveness for symptom relief is uncertain 2
   • May help with sleep if itching is severe

Special Considerations

Severe Reactions

• Seek medical attention for:
  • Extensive blistering
  • Signs of infection
  • Involvement of sensitive areas (face, eyes)
  • Systemic symptoms

Ocular Exposure

• Immediate and thorough irrigation with water
• Urgent ophthalmological evaluation if symptoms develop
• Wild parsnip exposure can cause keratoconjunctivitis and uveitis 4

Prevention Strategies

1. Learn to identify wild parsnip

   • Tall plant with yellow flowers in an umbrella-like cluster
   • Often found along roadsides and in prairies

2. Protective clothing

   • Long sleeves, pants, and gloves when in areas where wild parsnip grows

3. Immediate washing

   • Wash skin thoroughly with soap and water after potential exposure
   • Wash clothing that may have contacted the plant

Pitfalls and Caveats

1. Delayed onset of symptoms

   • Symptoms may not appear until 24-48 hours after exposure, leading to missed connection between exposure and symptoms

2. Misdiagnosis

   • Often confused with poison ivy/oak, allergic contact dermatitis, or chemical burns

3. Sunscreen ineffectiveness

   • Sunscreen applied after exposure will not prevent the phototoxic reaction

4. Seasonal variation

   • Risk is highest when plants are flowering and producing seeds, typically in summer months

Remember that wild parsnip-induced phytophotodermatitis is a phototoxic reaction, not an allergic response, so treatment focuses on removing the offending compounds and managing symptoms rather than suppressing an immune response.