Study finds lettuce as effective treatment for common rash

By Stephen Beech via SWNS

Lettuce is just as good as dock leaves for treating nettle stings , according to a new study.

Rubbing a sweet gem lettuce leaf on a nettle sting may be as effective at easing discomfort as the traditional folk remedy, say doctors.

It may simply be the cooling and soothing effect of sap evaporating from a crushed leaf that brings relief, suggest the findings published by the Emergency Medicine Journal .

Doing nothing might work just as well - although possibly not if you’re a small child, according to the Scottish NHS research team.

The stems and leaves of nettles are covered in stinging hairs, or trichomes, with a brittle tip that snaps off when touched, releasing a mini jet of histamine, acetylcholine, and serotonin chemicals into the skin.

Rubbing a dock leaf on the affected area to ease the ensuing discomfort is a well-known folk remedy first mentioned 600 years ago by Geoffrey Chaucer in his epic poem Troilus and Criseyde.

It may have been prompted by the cooling and soothing effect of sap evaporating from a crushed leaf, according to the researchers.

Study author Dr. Rajendra Raman, of Victoria Hospital, Kirkcaldy, Scotland, said: “If so, any large, fresh and non-toxic leaf would do the job, and dock may have become the leaf of choice simply because it grows in similar habitats to nettle."

To find out if the remedy has any foundation in science, the researchers conducted the Nettle-induced Urticaria Treatment Study, or NUTS, involving nine A&E doctors.

As the dummy treatment needed to mimic the physiological effect of the dock leaf, and be of similar size, shape, and texture, but contain no anti-inflammatory or toxic properties, a sweet gem lettuce was chosen.

Participants brushed the inside of a demarcated area of both forearms with two stems of freshly harvested nettle stem 10 times. They were then blindfolded.

After 60 seconds - to mimic the time it might take to find a dock leaf in real life - the participants rolled a dice. If an odd number was rolled, two dock leaves were rubbed on the area for 60 seconds of their right arm and two lettuce leaves on their left for 60 seconds. For even numbers, the application arms were reversed.

After each application, the participants were asked which arm they thought had been treated with dock and which with lettuce. They rated the discomfort felt in each arm after one to five minutes, 10, 15 and 20 minutes on a scale of zero (no discomfort) to five (the most discomfort possible from a nettle sting).

The term ‘discomfort’ incorporated various sensations provoked by nettle stings including burning, itching, and tingling.

The score was tracked until the resolution of symptoms and named the Insult to Complete Healing (ITCH) score.

The total number of discrete wheels visible within the demarcated area at five, 10, 15 and 20 minutes after stinging was also recorded and given as the Observable Urticaria/Count of Hives (OUCH) score.

Participants photographed their own forearms at those time points, and OUCH scores were counted subsequently by an observer unaware of the treatment arm to determine peak OUCH and time to peak OUCH.

The results showed that three participants correctly stated which arm had been treated with dock leaves, three were incorrect, and three were completely unable to say which treatment had been applied.

The average absolute reduction in ITCH score at five minutes was three points for dock leaves compared to two points for lettuce - a not statistically significant difference, according to the research team.

And while there was a statistically significant fall in ITCH score over time for both interventions, there was no significant difference between dock and lettuce leaves.

The average peak OUCH score was 27 for the dock treatment and 20 for the lettuce treatment, while the average time to peak OUCH was five minutes for both, neither of which was statistically significant.

The observed discomfort of nettle stings eased rapidly over 15 to 20 minutes with both dock and lettuce leaf applications.

Dr. Raman said: "The effect was not significantly different between the two interventions.

“It is possible that the same relief would have occurred with no treatment at all, and our study design does not permit us to conclude that either dock or lettuce is better than simply doing nothing.

“Work from other studies suggests that children in particular do not consider doing nothing to be an acceptable option when they are in pain, and we feel this may well be applicable to nettle stings.”

The trial was primarily conducted as part of a team-building exercise and an exploration of the concepts involved in research.

Dr. Raman added: “We conclude that dock leaf may work for nettle stings, but lettuce may be just as good; relief comes quickly either way.”

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