Tell me about poison ivy rashes
July 24, 2020 3:12 PM   Subscribe

Help me understand how my poison ivy might have spread. I had a mild case of poison ivy (or oak or sumac) with blisters on the back of both hands which then became a full blown rash across multiple parts of my body (thighs, abdomen, shoulder, arms and armpit) 6 days later. This second outbreak was bumps and red rash, no blisters. The first outbreak was only blisters.

I saw the doctor today, he said it looks like poison ivy, is definitely contact dermatitis, and not anything systemic. But I'm struggling to understand how it spread. I know you can't tell me specifically what happened to me but I'm looking for plausible explanations of what might have happened. And general information about how poison ivy spreads.

Here's the timeline. I was in a small garden shared by me and my neighbor two days before I got the blisters and the only thing I remember doing was cutting down some weeds with scissors. This made sense, since the blisters were on the backs of my hands, and I very likely brushed my hand against some leaves. 

Note: I have not identified the plant and am making an assumption it was something in the garden because of the timing. Other than that, I've only been at home and shopping, haven't contacted plants anywhere else. Also, neither my neighbor nor I got any rashes from pulling weeds several times previously without gloves. But on this particular day I was cutting weeds in the unused half of the garden.

After I got the blisters, I only went in the garden twice, briefly, to water the plants and harvest cucumbers. Both times I wore socks, long pants, long sleeved shirt, and gloves, and took off my clothes as soon as I came inside.

Six days later, as the blisters were starting to dry up, I suddenly got bumps and a red rash across many areas of my body. 

The doctor says one of two things must have happened: Either I transferred some of the oil to other parts of my body on the day I first touched the plant and there was a delayed reaction of 6 days. Or, I had a second contact with the same plant and then transferred the oil.  

This makes no sense but then again what do I know - have never had poison ivy or any kind of rash. Is there a plausible explanation for how I could have transferred oil to so many places on my body - and would there need to be a lot of the oil to affect so many different areas? And the severity of the two rashes is completely different - one was mild and the second is widespread, red, and extremely itchy. Could the same oil account for both?  Or could it be a coincidence and the two rashes are unrelated?

Sorry this is so long, I've tried to edit as best I can. Any insights on how poison ivy spreads and any similar experiences, would be so helpful. Even though the doctor said this will go away, I can't help but worry. 
posted by daikon to Health & Fitness (23 answers total) 1 user marked this as a favorite
 
From the FDA website:

"The rash will occur only where the plant oil has touched the skin, so a person with poison ivy can’t spread it on the body by scratching. It may seem like the rash is spreading if it appears over time instead of all at once. But this is either because the plant oil is absorbed at different rates on different parts of the body or because of repeated exposure to contaminated objects or plant oil trapped under the fingernails. Even if blisters break, the fluid in the blisters is not plant oil and cannot further spread the rash."
posted by tmdonahue at 3:18 PM on July 24, 2020 [6 favorites]


I have absolutely no medical expertise so please do not ascribe to much weight to my comments.

I was recently convinced that I had poison ivy. After a week of a painful and not so itchy blotches it turns out I had shingles. I would think about other possible factors if a plant based rash doesn't make the most sense... maybe something bed bug related?

Best of luck.
posted by Quack at 3:39 PM on July 24, 2020 [1 favorite]


Your first reaction to poison ivy's compound -- urushiol -- can be the mildest. Subsequent exposures can each be worse, up to and including anaphylactic shock.

What is likely is that your first contact exposure had a comparatively mild reaction but sensitized your immune system to react strongly to subsequent exposures in a systemic way.

Then, a few days later, you touched some leftover oil or a bit of a cut plant, and your immune system said OH FUCK! WE'RE DEALING WITH THIS SHIT AGAIN and went into overdrive. If you're still suffering from it, a course of steroids would knock it right down.

You should probably find a doctor who isn't an idiot, and the next time you think you've got an exposure to poison ivy, get to a clinic right away because you'll probably need the 6-5-4-3-2-1 pack of pills.

(The above is based on my ex's experience with poison ivy. If you get sensitized, it can be life-threatening.)
posted by seanmpuckett at 3:40 PM on July 24, 2020 [4 favorites]


I assume you've washed the clothes you wore that first day, but do you happen to remember what else was in that load?

I know people with sensitivities such that several washes of the originally contaminated clothes were necessary, and enough oil was transferred to other clothes in the initial wash to cause them to produce a rash when worn.
posted by jamjam at 3:41 PM on July 24, 2020 [5 favorites]


I don't have any experience with poison ivy, but plenty with poison oak and they work basically the same.

Items that have contacted the plant can be contaminated with the urishol oils that cause the itching. This can happen with your gardening tools, your clothing, your shoes. You don't need to be in contact with the oils for long, if you managed to get any inside of your clothes (or gloves, gloves are a big one), it can affect you even if you only wore the clothes a short time. Hats. Glasses. Anything.

Another vector of contact can be other people, some people aren't as affected and might unknowingly transmit the oils to others, or to furniture they sit on wearing their outdoor clothes (you don't want to sit in the favorite chair of one of these folks!). Dogs, horses, and other animals can transmit the oils to you if you pet them after they have rolled in it, or they chew on the leaves and slobber on you or things like dog toys etc. People store things over the winter and have a reaction when they get them out later, so 6 days isn't going to get rid of it.

As you might guess from all of this spreading, no you don't need much of the oil.

Wash everything! Soap helps. If I've been somewhere I may have been exposed, when I get home the clothes go straight into the washing machine or a plastic bag, then I take a shower. Don't rub your face if you suspect exposure, wash with soap, rubbing won't help. Hand sanitizer won't help either.

neither my neighbor nor I got any rashes from pulling weeds several times previously without gloves

Most people don't react the first time, it takes time to become sensitized to the allergen. Some people who are exposed all the time develop a lower/no sensitivity, but if that ceases and they get exposed again later they might not have their seeming immunity anymore. There's a stereotype of people new to areas and of cocky young men (who might have been exposed more regularly as a child) announcing that they are "immune" and plunging fearlessly into poison oak patches, only to be laid low a few days later.

I had a mild case of poison ivy (or oak or sumac)

Usually there is only one of these things common in an given area. If your doctor wasn't sure that does seem odd -- are you sure these grown in your area? Check your local gardening or hiking groups. If you live in the mountains or somewhere with microclimates you will need to ask at the very very local level.

Some people feel antiperspirants, the kind that contain aluminum compounds, can help with the itching and dry the blisters.

Whatever you do don't burn the plants where you would breathe any of the smoke at all! With the pandemic, I'd avoid burning them entirely.

(On preview, yeah you want to wash the clothes separately. I change my underwear too, because I'm showering, but I don't put the underwear in the wash with the outer clothing.)
posted by yohko at 3:49 PM on July 24, 2020


Oh and you will see guides claiming the plants have that certain "leaves of three" look -- that's not wrong, exactly -- but you'll only see that on plants that have leaves, not on dormant plants, not plant roots that are no longer attached to the leaf part, not the weird stick-like growths that don't actually have leaves on them which sometimes invade dark areas....
posted by yohko at 3:52 PM on July 24, 2020


Best answer: Tangential. I can barely look at poison-anything without getting a rash, which sucks since I work outside. I can’t tell you exactly how it spreads, but I can 10000000% recommend the TecNu treatment brand. There’s a “gel wash” to wipe down surfaces and do your laundry with, along with showering your bod. There’s a scrub that feels so effing good with cold water, and really gives relief. And there’s an on-the-go spray I keep in my bag, when I have an outbreak, that relieves and helps stop spread.
posted by functionequalsform at 4:33 PM on July 24, 2020 [2 favorites]


Best answer: Seconding seanmpuckett. Some folks are just more susceptible. I had one single, minor exposure to poison ivy that turned into severe, systemic allergic reaction. It started with a 2 inch scratch on my calf. I did everything you’re supposed to do to treat and not spread it, but only a few days later I had hives spreading throughout my core. Recovery involved several weeks of oral steroids. I found out later my dad is also severely allergic to it.

It sounds like you’ve got a systemic reaction and not multiple topical exposures. I’d recommend visiting a different doctor. Good luck, and I hope it clears up quickly!
posted by Orange Dinosaur Slide at 4:59 PM on July 24, 2020 [1 favorite]


Have you scrubbed the scissors? Your gardening gloves? Is it possible you used them again without washing them (maybe harvesting your cucumbers) and again transferred oils onto your hands, and then touched the secondary areas? That could explain the second rash. I have actually done this in the past with gardening snips. And I should know better, having had several really awful poison ivy outbreaks in the past.

One tip to mention to your doctor if this rash worsens - I once had such a severe rash with blistering on the inside of one arm that I couldn't bend my elbow. A short course of oral steroids was miraculous!
posted by citygirl at 5:59 PM on July 24, 2020


He's right about the oil.

How bad the rash is depends on lots of things. How much of the oil got on you, how long it was there until you got it off, where on your skin it landed, your body's reactiveness to the oil, etc.

The option he didn't seem to mention is when the oil gets on a blanket, or on a pair of gloves or jeans or shoelaces. You can get it over and over again as a result. I hate poison ivy.
posted by Patapsco Mike at 6:03 PM on July 24, 2020 [1 favorite]


I would also suggest that the most likely culprit is your washing machine. No blisters the second time around because there was less oil present, more widespread because it probably ended up on your clothes (hence the high contact areas not protected by underwear or the like: armpits, shoulders, arms, thighs).

If you have rly adequately wiped down your washer and drier you might be spreading the oils to more clothing. I recommend Tecni as well and hand soap with jewelweed for your rash. I’m sorry!
posted by lydhre at 6:38 PM on July 24, 2020


Best answer: Me every summer: this is the summer I don’t get poison ivy!
Also me every summer: ...shit

I have been in exactly your shoes, down to the timing, and I agree with everyone above who suggested that your second rash was due to the urushiol lingering somewhere (on your clothes or tools or washing machine) and getting on you a second time.

What has helped me? TECNU for sure, for my body, my tools, and my laundry. Remembering, too, that the oil can penetrate fabric and can linger on surfaces. A neighbor once recommended I think of it like glitter, it is as tenacious and spreadable. The grim irony is that we have a much better analog now in COVID; how we thought about the virus in the early days of the pandemic - wiping down our grocery and delivery boxes, obsessing about doorknobs and what our hands had touched - is great practice for thinking about urushiol.

Your rash will get better. Even my worst ones didn’t linger more than a couple weeks. If you haven’t already, do a good deep clean around the house and are-run all your clothes in the laundry with tecnu. You have my sympathy!
posted by minervous at 7:13 PM on July 24, 2020


Best answer: I once got a massive case of Poison Oak from a bedspread because when I got home from a hike my ritual of stripping off all my clothes and putting them in the washer included the step of tossing my clothes on the bed while I got undressed. Idiotic I know but it’s easy to underestimate how pernicious urishol can be.

First thing I thought when I read your description was that you had dried yourself off with a towel that had shared the washer with your urishol contaminated clothes. It looks like I’m not the only person who went that direction with it.
posted by Tell Me No Lies at 7:19 PM on July 24, 2020 [1 favorite]


I have been hospitalized because of a severe case of poison ivy. I can also attest to making sure everything that may have come in contact be thoroughly cleaned. This is a little embarrassing, but once, I went hiking and knew I had walked through some ivy so I was very careful to not touch anything that may have had contact. Except, when I got home after I had showered, I picked up my pants and spread out the leg to spray some Shout on the mud at the bottom of the pant leg. I did not think about the oils staying on the pants.

I put the pants and other clothes in the washer. Then, before I thought about it, I went to take a pee. Big mistake. HUGE mistake. Poison ivy on your penis is really not something you want. Trust me.
posted by AugustWest at 10:56 PM on July 24, 2020


I would take a careful tour of your weeds and see what you've got. Maybe it's all Toxicodendron, but I wonder if you might be hitting something else, like photosensitivity.
posted by away for regrooving at 1:37 AM on July 25, 2020


Some good info here.

I also recommend washing your clothes in Tecnu was products.

Now for some anecdotal info. Many years ago I moved to the southern United States and my company had a job on a small uninhabited island for about a year. Part of the job involved clearing pathways in areas of heavy brush. Management noticed the local experienced workers were getting a lot of poison ivy and sumac rashes and missing work, but the foreigners like me didn’t seem to be infected. Eventually, most of the crew were foreigners from the north. I worked this job for a few months but then had a minor injury that required light duty for 2 weeks (sprained ankle). During those 2 weeks I mainly drove an air conditioned truck to support our jobs in three states. After the first week of light duty so developed a rash of mostly silver dollar size sores all over my body consistent with poison ivy. One of my knees was especially bad and actually got blood poisoning from it. My knee swelled up to 3 times it’s normal size.
What I learned from that is that the oil sticks to your clothes for years, even with repeated washings. But also the reason we northerners were not affected was because we were not used to the heat and humidity and we were constantly sweating. Your skin usually needs to be dry for the oil to irritate it. The locals would not sweat very much as they were more accustomed to the heat and more fit, so their drier skin was effected more. Since all of my clothes had become contaminated through direct or cross contamination in the wash, all my clothes were irritants and the time I spend driving in the air conditioned car allowed the oil to do its thing.
I would recommend washing the clothes you have worn or washed in the last week a few times with Tecnu. If the rash is over your body look for signs of blood poisoning and see a doctor.
posted by Short End Of A Wishbone at 10:30 AM on July 25, 2020


citygirl is right about the steroids.

If you have a really bad case skip the topical treatment and take prednisone. Start with a relatively large dose, then taper off quickly usually down to zero within a week (drug shouldn't be taken for long periods unless a doctor says so). Within 24 hours of the start, all desperate thoughts, suicidal ideation, etc. will be replaced by calm anticipation, the oily sores crusting over, and sweet sleep.

Be sure you can recognize the plant. Leaves of three is pretty common, but you want to implant your brain with the typical notched leaves, usually asymmetric.

I'm experienced with poison oak in California and poison ivy in the midwest.
posted by lathrop at 12:29 PM on July 25, 2020


Response by poster: About Tecnu: never heard of this product, so this is great new information to know for the future. For this time, I think it’s too late since this happened two weeks ago and I don’t remember what I wore that day. Since then, I have washed all my clothes that I possibly wore and any clothes that might have touched those clothes. After reading these answers, I washed my bath towel and sheets again, this time in hot water.

From what I’ve read about Tecnu, you have to pre soak your dry clothes in a basin and then put them in a washer with normal detergent. This is why I think it’s too late. To soak all my clothes and sheets and towels seems like I’d need gallons of the stuff. If I’m misreading this, let me know.
posted by daikon at 1:16 PM on July 25, 2020


This isn't an answer to the spreading question, which is covered well already, but to say that the awful itching can be stopped for hours by an *extremely* hot shower or bath. The heat can be brief but needs to be almost unbearable; it denatures the irritant and you have relief from itching several hours.
posted by anadem at 4:59 PM on July 25, 2020 [1 favorite]


It might be an id reaction, a delayed immune response rather than re-exposure to poison ivy, that would explain why it has a different appearance.
posted by FungusCassetteBicker at 7:16 AM on July 26, 2020


I don't usually get poison ivy from just brushing against a leaf. But if I cut it down or pull it out by the roots it gets on everything it touches. So if you cut it with scissors, it got on the scissors. If you touched the scissors with your clothes or body, it got on you. If you didn't wash off the scissors, gloves, etc. and used them within a few days, you re-exposed yourself. If you have pets that were in the garden, they could have gotten it on their fur if you pet them while wearing contaminated gloves or if they were rolling around in the weeds. You can easily contaminate clean towels, bedding, doorknobs, water fixtures, light switches, etc. if you aren't careful and re-expose yourself later.

When I get a poison ivy rash that spreads and gets worse over several days It usually stops spreading if I wash my sheets/blankets and towels/washcloths. Because when I come in from working in the yard I often flop down on the bed and rest for a few minutes and I reuse my towels for a few days in between washings.

I've used the sap of the Jewelweed plant to treat poison ivy with pretty good success. It reduces the rash and stops spreading rashes in my experience. If you are lucky enough to have any growing near you, try that.
posted by Blue Genie at 1:00 PM on July 26, 2020


My husband and I run and hike in areas with a lot of poison oak, and the last time he got it, it sounded a lot like your case. We washed clothes and bedding in HOT water using Dharma Trading Co's professional textile detergent.

Remember that you can get the oils on you even in the winter when the plant has no leaves.
posted by kiripin at 12:34 AM on July 27, 2020


Response by poster: Thanks everyone for all the great answers. I’ve learned so much about poison ivy which I’ll store away for the future.

The good news is that on Saturday my rashes got 30% better in just one day. I had expected it to get better gradually, a little bit each day, so this was a nice surprise. The doctor gave me a prescription for Prednisone but I decided not to take it after the surprise recovery.

To add to the mystery, someone just came to my house to look at the garden. A plant expert. He knew the name of every weed. He said there’s no poison ivy or any other poisonous plant in the garden.

I’m going to accept that I may never know what happened. I live alone, no animals, so there’s no one else who could have brought the oils into the house.
posted by daikon at 11:12 AM on July 27, 2020 [2 favorites]


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