Sweet lovers may love the spring, as William Shakespeare wrote about 400 years ago, but they still need to watch where they are going in the green hills and vales of Sonoma County lest something other than romance gets under their skin.
Lurking in the lush green landscape is poison oak, the all-natural nemesis of hikers, bikers, yard workers, pet owners and just about anyone who ventures outside in California.
Accompanying the annual outbreak of warm weather this time of year, physicians and pharmacists say, are outbreaks of the itchy, blistering rash imparted to humans by the native weed that thrives throughout most of the Golden State.
"If it were a cash crop we'd all be millionaires here," said Eric Hoffmann, a California Department of Forestry battalion chief.
Wildland firefighters invariably wade through poison oak and combat the rash by washing their skin and clothing, he said.
In the worst cases, firefighters go in for steroid therapy to stem the inflammation.
Most folks treat poison oak without seeing a doctor, said Jeffrey Sugarman, a Santa Rosa dermatologist, but the prevalent plant exacts a toll.
"It can be horrible, actually," he said.
There are over-the-counter and prescription remedies that offer relief from the itching, he said, but none works immediately and people typically must tolerate the rash for a week or two.
About 2 million cases of dermatitis attributed to poison oak and its kin -- poison ivy and poison sumac -- are reported each year in the United States, according to experts at UC Davis.
In California, the number of work hours lost to poison oak makes it "the most hazardous plant in the state," they say.
Despite the three-leaf cluster familiar to many, poison oak has a stealth quality, especially in the spring when the leaves are green -- not the telltale orange, red and brown colors they wear later on.
"You'd be surprised," Sugarman said, by the number of people who have close, unwitting encounters with poison oak.
Spring is also when many people get back outdoors and when local residents begin clearing their land, a prime opportunity for tearing into the toxic plant.
Sugarman said he sees about one poison oak case a week in spring, and Windsor pharmacist Mark Burger said the troubles typically run from May to summer's end.
Here are some poison oak facts and fiction:
Fact: Poison oak is potent all year round, with the super-irritant urushiol in its leaves, stems and roots, even when the plant is dead.
Fact: Pets can transmit poison oak from their fur to your skin.
Fiction: Contrary to popular belief, the fluid that seeps from poison oak blisters is not contagious.
The rash can spread, however, as areas of the body that absorbed less urushiol take longer to react.
Fiction: Some people are immune to poison oak. Everyone is allergic to it, Sugarman said, but some have such a high threshold of sensitivity they experience no symptoms.
Fact: There is no cure, but there are products that can prevent, minimize and ease the aggravating itch.
Firefighters and physicians recommend Tecnu and Zanfel, two solvents that neutralize urushiol on and underneath the skin.
Both are best used within two to eight hours of exposure to poison oak and are also effective at washing the poison oak oil out of clothing, an important step.
"The earlier you decontaminate, the better," Sugarman said.
Failing all else, experts recommend washing the affected skin with cold water to dilute the poison.
Once the rash develops, calamine and Sarna lotions and Benadryl, an antihistamine, will ease the discomfort.
The camphor and menthol in Sarna are "what you want when your skin is on fire," Sugarman said.
Alternative therapies include Manzanita Magic, an herbal remedy made from manzanita bark, and Rhus Toxicodendron, a homeopathic remedy Burger recommends for children.
The best defense against poison oak is Ivy Block, endorsed by both the Food and Drug Administration and Consumer Reports, which prevents urushiol from penetrating the skin.
You can reach Staff Writer Guy Kovner at 521-5457 or guy.kovner@pressdemocrat.com.