I Didn’t Use Protection and Paid Dearly: What You Should Know About Poison Ivy

Andrew Siegel MD  8/6/2022

It’s a hazardous world out there and one needs to use protection to prevent disease transmission. Recently, I was cavalier and smug and didn’t use any protection.  Several days after my promiscuous foray, I developed itchy, blotchy, red lesions on my on my neck, behind my ear, my wrist and arm, hip, groin, and pubic area.

Lesions on my arm
Lesions on my hip region

At first, I thought that mosquitos were the culprits because the initial lesions appeared on my neck near my jugular vein where mosquitos have traditionally fancied dining — and a few days before the appearance of the lesions, I had spent considerable time outdoors painting the mailbox and gardening. 

When one of the nurses with whom I work closely with saw me scratching my neck and observed the appearance of the skin lesions she shook her head in disagreement with my working diagnosis. She was correct in her diagnosis — these were not mosquito bites — but a contact transmitted disease from the indiscriminate and unprotected plucking of weeds, unknowingly exposing myself to poison ivy.

I am somewhat neurotic about order and organization.  Our home has a paver stone driveway with sand in the gaps between the stones and nothing irks me more than a weed growing in the gaps.  Equally annoying to me are random weeds growing within our lawn’s nicely coiffed and mulched shrubbery beds.  When I walk outside to retrieve the mail or newspaper, I do reconnaissance for the random invading weed and extricate it.  Usually I don a pair of gloves, but this past time I did not. Sadly, it only takes one act of not using protection to get the disease.

Characteristic of poison ivy, a variety of different appearing skin lesions emerged over the next few days — some blotchy, some linear, some flat while some were bumpy, all itchy, uncomfortable, and annoying.  As is true with so many afflictions, the symptoms (itching) were exacerbated during sleep time.  However, during the day, the itch was also somewhat unbearable at sites where the rash contacted clothing.  I used a potent topical steroid cream and (lifesaving!) calamine spray and over the next few weeks, the lesions and symptoms ever-so-gradually resolved, but it took a full 3 weeks for complete resolution.  It was not a pleasant experience and a completely avoidable one.   Although this was not my first bout of poison ivy, hopefully I will profit from this experience, and it will be my last.  

Poison Ivy: What You Should Know

Poison ivy leaves: “Leaves of three, let it be.”
Stilfehler, CC BY-SA 3.0 <https://creativecommons.org/licenses/by-sa/3.0&gt;, via Wikimedia Commons 

Poison ivy, poison oak, and poison sumac are rampant in North America. Poison ivy and oak grow as vines or shrubs, whereas poison sumac grows as a small tree.  The plants are not poisonous but release an oil – urushiol – that even with minimal contact with skin can result in an itchy red rash with bumps and blisters within a few days of exposure.  This reaction to urushiol is an allergic reaction referred to as a contact dermatitis. The oil releases when the leaf or other plant parts are bruised, damaged, or burned. When these plants are burned, the urushiol can be inhaled, causing a serious irritation of the lungs. Aside from direct contact with the plant or inhalation of particles containing urushiol from burning, indirect contact may occur from touching tools, pets, or clothing that have the oil on them. Urushiol remains active even on dead plants.

Poison ivy has 3 broad, tear-shaped leaves and grows as a climbing or low-spreading vine. Poison oak has serrated leaves that look like typical oak tree leaves and grows as a vine or shrub and often has 3 leaves but can have as many as 7. Poison sumac trees have 7-13 leaves on a stem with smooth surfaces and pointed tips.

The skin lesions caused by poison ivy usually occur within one to three days of contact, the location dependent upon where the urushiol oil contacted the skin and the size and shape of the lesions dependent upon the amount of oil touching the skin and the pattern of contact.  Most people will develop a rash when exposed to only a 50-microgram dose of urushiol, which is less than one grain of table salt! 

Streaks or patches of red, raised blisters are characteristic.  The affected areas typically become swollen and itchy.  The blisters may weep, but the fluid contained within will not cause the rash to spread nor is contagious to others.  The rash usually peaks within one week and can last up to three weeks.

The pathophysiology underlying the rash is quite complex.  Please refer to the following brief YouTube video for a superb explanation.

If You Contact Poison Ivy

The problem is that most often there is no knowledge of the contact.  However, if one knowingly contacts the plant, there are some steps that should be taken immediately:

Wash your skin using rubbing alcohol or alcohol wipes, poison plant wash, dishwashing soap or detergent and plenty of water.  Rinse abundantly with water. Use a scrub brush to wash under your nails. Wash your clothes, clean your shoes, and hose down and use rubbing alcohol on garden tools.

Treating Poison Ivy

When and if the rashes appear, keep the areas clean, dry, and cool.  Application of cool compresses can be soothing.  Hydrocortisone cream, calamine lotion, and antihistamines can help control the itching. Try to resist the urge to scratch.  For severe cases, systemic steroids and a medical consultation are often necessary. The rash is not contagious.

Video of tips for treating poison ivy

Preventing Poison Ivy

One solution is to let someone else do your weeding!  If that is not possible, when weeding keep your skin covered by wearing a long-sleeved shirt, pants, closed shoes, and disposable gloves. Take care not to touch your face.  When finished weeding, carefully remove and wash your clothes, clean your shoes, and hose down and use rubbing alcohol on garden tools. Be careful when hiking and with any activity that brings you into wooded areas. When you slice your golf ball deep into the woods with your driver, don’t go too crazy hunting for your ball because it’s simply not worth the risk of contracting poison ivy!

Wishing you the best of health,

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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro AreaInside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community. He is a urologist at New Jersey Urology, the largest urology practice in the United States.  He is the co-founder of PelvicRx and Private Gym.  His latest book is Prostate Cancer 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families. 

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Video trailer for Prostate Cancer 20/20

Preview of Prostate Cancer 20/20

Andrew Siegel MD Amazon author page

PROSTATE CANCER 20/20 is now available at Audible, iTunes and Amazon as an audiobook read by the author (just over 6 hours). 

Dr. Siegel’s other books:

THE KEGEL FIX: Recharging Female Pelvic, Sexual, and Urinary Health

Video on THE KEGEL FIX

MALE PELVIC FITNESS: Optimizing Sexual and Urinary Health

PROMISCUOUS EATING— Understanding and Ending Our Self-Destructive Relationship with Food

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