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.

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