writ­ten 6/9/24, updat­ed 8/19/24

Summary

From con­tact to end, my expe­ri­ence with poi­son ivy (first time!) was both typ­i­cal and atyp­i­cal with both “nor­mal” and “abnor­mal” lesions asso­ci­at­ed with it. I have his­to­ry of skeeter syn­drome and many oth­er sen­si­tiv­i­ties so it does not come as any sur­prise that I would have a stronger/complex reac­tion than most peo­ple would. This is a chron­i­cle with images and thoughts of my expe­ri­ence with the Tox­i­co­he­dron fam­i­ly of plan­t’s irri­tat­ing oil, urush­i­ol.

Timeline

CONTACT: Sun­day, May 26, 2024 — Con­tact - Small red dots with black­ish brown smear like a burn on left under­side of arm, ful­ly asymp­to­matic, flat. Imme­di­ate issue are 3 bug bites

Day 1–2; Mon­day, May 27–28 — Bug Bites Wors­en­ing — 27th was Memo­r­i­al Day. Pushed through work on 28th but suf­fered all-con­sum­ing dis­com­fort from severe­ly inflamed and spread­ing bug bites. Prob­a­ble fever. By the end of the day on 28th, notic­ing a change in pri­ma­ry poi­son ivy lesion: grow­ing more ery­themic, raised, skin stretch­ing like a burn, grow­ing more sen­si­tive to pal­pa­tion

Day 3: Wednes­day, May 29 — Man­i­fest­ed and Symp­to­matic — Absent from work. Placed on Medrol dose pack (methyl­pred­nisolone steroid), for 3 bad skeeter syn­drome welts on both fore­arms

Day 4–8: Thurs­day, May 30 — June 3 — Bites Resolve, Poi­son Ivy Pro­gress­es Rapid­ly — As the bites dimin­ish quick­ly in response to steroids, itchy, red dots and spots pop up and spread increas­ing­ly along­side taper­ing med­ica­tion. 2 new Minor blis­ter­ing Areas pop up on out­side of right arm. All oth­er lesions, while red and blis­tery seem nor­mal for poi­son ivy. All areas weep con­stant­ly. Many bandaids

Day 9: Tues­day, June 4 — Severe Reac­tion Detect­ed — As soon as the steroid stopped, the poi­son ivy was loosed and expo­nen­tial­ly spread. Blis­ter­ing is severe on pri­ma­ry lesion. Ery­the­ma spreads, turn­ing deep red and increas­ing­ly bumpy. Sus­pect entire ery­themic area will blis­ter soon. 2 Minor Areas form large blis­ters overnight. Dog starts to notice inflam­ma­tion. No inter­est before. Last Medrol pill tak­en night pri­or. Sus­pect repeat con­tact from improp­er­ly washed sur­faces and cloth­ing. Com­mence deep clean of bed­ding, blan­kets, car, tools, etc. Itch­ing is unbear­able and throw­ing hive/eczema spots all over body, espe­cial­ly around stom­ach area, that are far itch­i­er than poi­son ivy lesions. Sys­temic.

Day 10: Wednes­day, June 5 — Med­ical Help — Exact­ly 1 week lat­er returned to PCP for poi­son ivy lesions this time, specif­i­cal­ly the pri­ma­ry lesion. Doc­tor and assis­tant reel from severe Pri­ma­ry Lesion. Doc­tor thinks this is now cel­luli­tis, too. New steroids pre­scribed, Pred­nisone taper­ing for 2 weeks, and 30 count cephalex­in antibi­otics. Went to work right after, unable to pick up med­ica­tion until after­wards. By the time I left work, my left arm (Pri­ma­ry Lesion) was unus­able. Dif­fi­cult to make a fist or hold objects. Drove with one hand which was also start­ing to hurt from inflam­ma­tion. Felt like some­one had a vise on the arm tight. Wor­thy of note: apart from the local severe Pri­ma­ry Lesion infec­tion, woke up in the morn­ing feel­ing like a cor­ner had been turned as a whole.

Day 11: Thurs­day, June 6 — Relief — Imme­di­ate response to strong steroid dose. Although blis­ter­ing and ery­the­ma is worse on all lesions, every­thing feels bet­ter. Still itchy, still weep­ing, and still blis­tery. Able to bend and twist arm and make a fist. Still a lit­tle tight. Spir­its are bet­ter as co-work­ers not­ed. Steroids don’t seem to help with hive/eczema spots which con­tin­ue to crop up all over. Pho­to and heat sen­si­tiv­i­ty on skin very promi­nent

Day 12: Fri­day, June 7 — Pain and Progress — Pri­ma­ry Lesion’s blis­tered con­verged. Dur­ing the course of the day, enter intense, sear­ing, nerve-like pain every few hours. Start­ed won­der­ing if this is like shin­gles. After work and removal of ban­dages, noticed that Pri­ma­ry Lesion’s blis­ter­ing is now a crater. Real­ized that intense pain is like­ly drainage and heal­ing of the area

Day 13–15: Sat­ur­day, June 8 — Mon­day, June 10 — Intial Heal­ing — Intense pain comes and goes. Notice­able on big­ger of 2 Minor Lesions. Ery­the­ma has some­what fad­ed, though still present through­out. Blis­ter­ing has notice­ably stalled on all lesions. All eczema/hive lesions are crazy itchy while poi­son ivy lesions no longer itch or even hurt except Pri­ma­ry Lesion upon pal­pa­tion or pres­sure. Many night­time bath­room awak­en­ings. Taper­ing of pred­nisone start­ed. Hive/eczema lesions so itchy, start­ing to won­der if aller­gic to cephalex­in. Pri­ma­ry Lesion begins to hard­en, crater and exhib­it incred­i­ble, intense, sharp pains every few hours. Attrib­uted to drain­ing and inter­nal heal­ing. Most lesions’ itch­i­ness has low­ered in inten­si­ty, though hive lesions con­tin­ue to pop up as pred­nisone tapers. Scratched a small­er hive and cre­at­ed bruis­ing

Day 16–17: Tues­day, June 11–12 — Heal­ing and New Hives — Grow­ing depressed. This has been going on for a long time and start­ing to men­tal­ly feel unwell. Cra­ter­ing has increased in Pri­ma­ry Lesion while blis­ter­ing sub­sides and skin begins to peel. Minor Lesions are weep­ing blis­ters, but a hole forms in one which starts to hard­en and scab. No craters like Pri­ma­ry Lesion. “Nor­mal” lesions fade in col­or and weep minor­ly. Right Elbow Patch starts to fade in col­or, still itchy. Left bicep area grows itch­i­er and forms new patch­es. Bel­ly Lesion dark­ens, but begins to grow in size. New prob­lem: Upper Bel­ly forms new red dots that are very itchy. Very pho­to­sen­si­tive on all skin

Day 18: Thurs­day, June 13 - Scab Crack­ing — Excite­ment! Morn­ing shows a crack halfway through Pri­ma­ry Lesions’ scab. Through­out the day pieces break off. Itchy in a scab way. By the end of the day, much has fall­en off, show­ing new skin under­neath! Ery­the­ma lessens on all ini­tial poi­son ivy con­tact lesions. Left Bicep area’s ery­the­ma increas­es along with itch­i­ness. Bel­ly Lesion notice­ably grows larg­er and Upper Bel­ly patch­es increase in size and itch­i­ness. Sleep­ing is grow­ing dif­fi­cult

Day 19–21: June 14–16 — Con­tin­ued Heal­ing and Increased Hive Activ­i­ty — All Poi­son Ivy Lesions con­tin­ue to heal. Pred­nisone tapers more and final­ly rid of cephalex­in. Pri­ma­ry Lesions devel­ops red­ness with­in the new skin which is wor­ri­some as it’s raised and shaped exact­ly like the ini­tial con­tact lesion. Not over­ly symp­to­matic, how­ev­er. Minor Lesions con­tin­ue to hard­en and scan with minor cra­ter­ing. “Nor­mal” Lesions con­tin­ue to fade in col­or, have not been a prob­lem. Fri­day, June 14 is tor­ture at work because I stu­pid­ly cut pred­nisone pill in half, afraid of not hav­ing the dou­ble dose in the day result­ing in major with­draw­al symp­toms. Unable to stay awake longer than 30 min­utes at a time. It’s obvi­ous my body is addict­ed. All hive lesions con­tin­ue to wors­en except the first Right Elbow lesion. Sleep­ing is next to impos­si­ble except for a few hours at a time. Extreme­ly itchy and uncom­fort­able around the bel­ly and upper arms. Dif­fi­cult to con­cen­trate on any­thing. Decid­ed to start treat­ing hive lesions like eczema con­di­tion with heavy lotion use, and not eat­ing any­thing that could remote­ly set off aller­gic reac­tions. Haven’t slept well in many days. Eyes feel like the desert. NEW PROBLEMS: skeeter syn­drome bumps begin to inflame (they do that) and leg hive/eczema lesions flare up. Very itchy

Day 22–26: June 17–21 — Fin­ished Med­ica­tions and Less­en­ing of all Lesions — Day 24 marked the first day of zero med­ica­tions, and pro­vid­ed for anoth­er day of with­draw­al symp­toms, though not as bad. Sleep­ing grow­ing more com­fort­able. Over­all con­di­tion is bet­ter and able to com­mu­ni­cate well with cowork­ers and patients. Every day itch­i­ness lessens and skin peels all over. Quit hav­ing to use heavy duty skin treat­ments except on leg. More ener­gy and increased desire to accom­plish tasks. Less pho­to­sen­si­tiv­i­ty. Stu­pid skeeter syn­drome bumps.

Day 27–28: June 22–23 — Almost Nor­mal — Every­thing is bet­ter. Leg. Bel­ly. Arms. Even skeeter syn­drome bumps. Pri­ma­ry Lesion is heal­ing nice­ly, with a lit­tle more ways to go. Minor Lesions are almost ful­ly healed, though still peel­ing. Fore­head has grown a hard lit­tle bump, asymp­to­matic. Elbow and Bicep lesions no longer itch. Bel­ly Lesions only some­times itch. Leg lesions are get­ting bet­ter. I feel bet­ter all around! 1 month mark has been met. Lesions are all sen­si­tive to heat (heat­wave right now), but sig­nif­i­cant­ly less pho­to­sen­si­tive

Pictures!!

*WARNING* Images might be gross to some peo­ple

Primary Lesion — Left Forearm Underside

Start­ed oral methyl­pred­nisolone on Day 3 Have treat­ed with 3–4 rounds of Zan­fel at this point. Day 6 is larg­er and raised but con­tained thanks to the steroid. Note the blis­ter­ing start­ing on Day 3 under the dark streak­ing and grow­ing on Day 6

Last days of methyl­pred­nisolone. Start­ed trac­ing the out­line. Notice­ably blis­tery and raised. Not over­ly hot yet. Col­ored rings show the pro­gres­sion of size

Day 9: 12 hours apart. Grow­ing worse! Blis­ter­ing and ery­the­ma sig­nif­i­cant­ly worse. Last pill of taper­ing methyl­pred­nisolone tak­en night pri­or on Day 8. VERY uncom­fort­able. Start­ing to feel effects on fin­ger joints, much pres­sure from inflam­ma­tion on arm

Doc­tor Day! Could­n’t come fast enough! Severe inflam­ma­tion, blis­ter­ing, ery­the­ma, heat, itch­i­ness, pain. Doc­tor sus­pects pos­si­ble cel­luli­tis. Rx pred­nisone and cephalex­in. Unfor­tu­nate­ly, could not get med­ica­tion until after work. So much pres­sure and inflam­ma­tion that hand became unus­able by the end of the day. Unable to grip objects secure­ly. Notice the dark red col­or­ing, almost pur­pling

2 views in dif­fer­ent light. Looks ter­ri­ble with much more blis­ter­ing, but med­ica­tion start­ed night pri­or and it felt a ton bet­ter. No longer blaz­ing hot, less red­ness, able to twist, bend, and grip

Blis­ters have con­verged into a large one (the whitish pink is calamine lotion that got stuck in the bumps and ridges). Right image is a good view of the skin blis­ter­ing that con­tin­ues to spread but much more slow­ly around the red areas. New symp­tom: crip­pling, sharp pain that seemed to pierce the arm’s nerves. Would come on every few hours dur­ing the day

It seems that the intense sharp pain has some­thing to do with the cra­ter­ing that has appeared. Blis­ters are drain­ing and leav­ing behind a dark, hard…scab? Notice­able light­en­ing of ery­the­ma between two images

Cra­ter­ing is even larg­er and hard­er. Signs of skin peel­ing and scab shed­ding. Fad­ing blis­ter­ing

Progress! It cracked in half overnight and you can see new skin under­neath!

Very itchy owing to scab shed­ding.

Wor­ri­some pro­gres­sion of the new skin. The red, raised dots on the new skin look exact­ly like the ini­tial poi­son ivy con­tact. Itch­es to touch, but oth­er­wise not both­er­some

Looks kind of bad! How­ev­er, the red­ness is dry, not sig­nif­i­cant­ly raised and appears to be peel­ing off slow­ly. No symp­toms to pal­pa­tion aside from minor sen­si­tiv­i­ty. VERY pho­to­sen­si­tive!

Day 24 is the first day with no med­ica­tions at all. Red­ness is fad­ing and peel­ing, too, thank good­ness!

Sig­nif­i­cant improve­ment by 28-day (1 month) mark! Itchy and dry to the touch. Been apply­ing lotion. 5‑week mark shows improve­ment, but still there and still peel­ing

6 Weeks: Much less pho­to­sen­si­tive, but still peel­ing and rough. What you can’t see is that the entire area that the lesion cov­ered ini­tial­ly con­tin­ues to be dark­er in col­or than the rest of the arm, almost like a port wine stain. 3.5 Months: I actu­al­ly for­got about it (or blocked it out??). Rarely, it will itch like­ly from dry­ness. The skin on my arm is still dark­er in col­or than the rest of the skin, but feels smooth to the touch

Other Lesions

Aside from the Fore­head one, these all cropped up as soon as the ini­tial Medrol dose pack steroid (methyl­pred­nisolone) tapered and fin­ished (last pill was night of Day 8). Pred­nisone and cephalex­in admin­is­tered night of Day 10

2 Minor Lesions — Right Forearm Outside

By 3.5 months, I no longer remem­ber that I had it. Scars remain and con­tin­ue to heal. Com­plete­ly asymp­to­matic. Skin will occa­sion­al­ly itch as it sheds and heals

Forehead Lesion — Present Since Contact

Fastest to heal

3.5 months: This healed the fastest by far. This far out a faint scar remains

“Normal” Lesions

This is what I assume a “nor­mal” reac­tion to poi­son ivy would be. You can see the lines where the plants brushed up against the skin. It blis­tered, it wept, it was itchy, and got red, but it was­n’t exces­sive. Real­ly, was­n’t all that bad.

Left Fore­arm Out­side

3.5 Months: Scar­ring still present but con­tin­ue to heal. Com­plete­ly asymp­to­matic. Ignore the 2 skeeter syn­drome bites which are also heal­ing

Right Fore­arm Inside

Only ever minor­ly itchy. Did an exper­i­ment where I popped the blis­ters when they first came up. Don’t do that.

Hive/Eczema/Rash Lesions

These did­n’t act like the poi­son ivy lesions. They did not pro­duce blis­ters and they itched 100x worse. The doc­tor con­firmed that it was a sys­temic response. The big ones got leath­ery. I treat­ed them like they were eczema lesions and that approach seemed to work. What­ev­er you do, DO NOT scratch them as they seemed to spread to scratched areas!!! Start­ed won­der­ing if it’s an aller­gic reac­tion to the antibi­ot­ic…?

Arms

Right Elbow — Day 8 Symp­tom Start

I made the mis­take of scratch­ing when it first popped up. It grew rapid­ly in response and got even itch­i­er

Then it grew some more trail­ing lesions

Most­ly healed at this point. Can be itchy if irri­tat­ed by a sleeve or bend­ing the arm for too long a peri­od of time

Left Arm

This is also extreme­ly itchy and pos­si­bly a result of me scratch­ing a small red hive. At one point it even spread onto the pri­ma­ry lesion

Tor­so - Day 10 Symp­tom Start

These popped up last and has been the WORST of all the lesions for discomfort/itchiness by far!!

Bel­ly

Grow­ing sig­nif­i­cant­ly larg­er and spread­ing to areas pre­vi­ous­ly untouched. You can see the more red areas on the out­skirts of the main patch and spread­ing towards my back. VERY itchy, but grow­ing more painful/stingy too

Mid to Upper Bel­ly

Grow­ing notice­ably worse as the steroids taper. Supreme­ly itchy… more than the stom­ach patch

Day 105 (3.5 months)

Leg

Day 105 (3.5 months)

Second Contact with Prompt Treatment

I got it AGAIN! On July 4, 2024. I had bar­ri­er lotion on while doing yard­work and attempt­ing to erad­i­cate it phys­i­cal­ly but did­n’t have face pro­tec­tion and some­thing brushed up against my face. With­in 2 hours I had doused my face in 91% iso­propyl alco­hol, bathed in Dawn dish soap, and scrubbed with Zan­fel. I knew it was­n’t a mos­qui­to bite because (unlike the one on my ear) it did­n’t itch right away, just start­ed welt­ing up and inflam­ing, no oth­er symp­toms. Because of the quick action, I (think so far) have been able to con­tain the reac­tion. It itch­es and twinges, but so far noth­ing else. Here are pic­tures!

Right Cheek

The oth­ers did­n’t get bad until a week lat­er, so here’s hop­ing it does­n’t get worse! Day 1 felt the inflam­ma­tion affect abil­i­ty to move cheek. The worst itch­i­ness so far has been Day 2. Day 3 has more of an aware­ness so far

Day 43: Itch­es a few times a day, tin­gling worse than usu­al with­in the last 48 hours. Sus­pect heal­ing.

Recommended Treatment and Info

From Professionals

• Home­care for most cas­es (mild-mod­er­ate reac­tions)
• Severe cas­es (i.e. dif­fi­cul­ty breath­ing or swal­low­ing, facial swellings where eyes shut, wors­en­ing itch­i­ness, full body rash, fevers) require IMMEDIATE med­ical atten­tion
• If/when you come in con­tact with the plants, as soon as pos­si­ble, clean the affect­ed areas with soap (even laun­dry deter­gent) and warm water. You can also use rub­bing alco­hol or OTC poi­son ivy wash­es. The faster you get it off, the less chance there is of strong reac­tion
• Wash ALL affect­ed cloth­ing and gear includ­ing shoelaces in the laun­dry thor­ough­ly in longer cycles. It is rec­om­mend­ed to wear gloves to pre­vent the spread as you remove your cloth­ing.
• Use OTC prod­ucts such as poi­son ivy wash­es, calamine lotion, top­i­cal anti­his­t­a­mines, oral anti­his­t­a­mines, cool com­press­es to relieve itch­i­ness
• Do NOT scratch and leave blis­ters alone to pre­vent infec­tion
• Most rash­es take any­where from 2–3 weeks to clear up on their own and can seem to get worse before get­ting bet­ter. Reach­es peak out­break around 2 weeks

First expo­sures take longer to pro­duce lesions as the body is slow­er to sen­si­tize. Sub­se­quent expo­sures appear much more quick­ly and last for the rest of your life.

Lesions are not con­ta­gious and liq­uid from popped blis­ters will not spread the rash because the liq­uid is just the body’s flu­id, not more urush­i­ol oil.

Useful Treatments