Brain Candy #98 - Things Not to Touch in the Backyard

The mistake I made this summer is a common one to residents of the Midwest. I hadn't tangled with this particular issue in at least thirty years. I was speaking to a coworker who is a native of Vietnam a few weeks before it happened - she was unaware of this natural American hazard. The reason I told her, besides wishing to spare her - a new home owner - from a really nasty surprise, is that I knew the potential existed for me to get contaminated myself.

You've probably guessed that I'm talking about poison ivy. I'd seen some in my yard, and I brought up in conversation that I was going to have to do something about it. Not long after that, I was able to show her the results of a really minor touch of the plant. It was just the slightest of grazes on a couple of different spots on my unprotected arms. I had nitrile rubber gloves on, but as I pulled out the first few plants, one of the roots whipped up and touched my arm. This contact left a visible smear on my arm - which it turns out amounted to a huge dosage of the active agent, urushiol. I hurriedly pulled a few more plants - sadly not all - before running to wash off.

I didn't get the oil off soon enough. The place with the smear wound up badly affected. Corroded is a bit too strong of a word, but irritated is not sufficient to describe it either. From maybe an original contact of 1/32 square inches, I would up with an area of about 5 square inches of my left arm badly irritated.

This would have been troublesome enough, but I had absorbed enough of the irritant to have a systemic reaction. This is another way of saying that the agent got into my blood stream. It turns out that except for your joints, which get inflamed and somewhat sore, the urushiol doesn't do any internal damage, but it does migrate back to the skin and you wind up with a prolonged bout of poison ivy. I found this out after buying some of the fairly new agent called Zanfel (www.zanfel.com). This is a soap, combined with polymer beads and chelating agents, which can actually bind to and remove the urushiol from affected skin. It is expensive stuff at almost $40 an ounce, over-the-counter, but if it works, I think most folks would consider it money well spent. It can't offer permanent relief in the case of a systemic reaction, however. It will pull the urushiol out of the skin, but more will diffuse out of the blood and into the skin in a few hours. It also doesn't seem to work for some people, and the vendor offers no money-back guarantee.

The next treatment was steroids. I know a fair number of other sufferers who have gone this route and I had to when I was a kid. It involves six days of hormones, tapering off in dosage to let the body gradually resume its own production, which gets suppressed by the early large dosages. It seems to greatly reduce the migration of the urushiol to the skin and the joint pain.

At the end of the regimen, the poison ivy came back! Not as bad, granted, but my joint pain resumed and I had some breakouts in a few new areas. At this point, my doctor wanted to see me. We discussed the treatment - he wasn't willing to repeat the steroid dosage, as it is a rather serious medication. I was worried about a more serious systemic reaction, which he said wouldn't occur. He gave me some treatment options. I chose rather minimal treatment, just aspirin for the joint pain, since I know some tricks that work well to reduce the itching. I found that for me, very hot water on the breakouts relieved the urge to scratch for quite some time. This makes the itching worse for some people, however, and you definitely don't want to make the water hot enough to damage your skin. I also found that Claritin helped me with the itching. Neither of these actually speed healing, however, and oral antihistamines aren't thought to help most poison ivy sufferers.

Maybe the most interesting thing about this whole episode is that I came away from the impression that we really don't know very much, at a layperson level, about poison ivy. There was much advice on the web, much of it conflicting. Washing contaminated materials was generally considered a good thing, but it wasn't often noted that, for a really sensitive person like me, this might lead to a contaminated washing machine that seems to spread a low, but still effective dosage of urushiol. Or it might not. Disagreement over the effectiveness of the soap used also was common, with opinions varying from "any will do" to "anything other than special soap is worthless." I know I washed off within 15 minutes of exposure, which according to some sources should have been enough. Others say the initial binding to the skin is even faster than this.

A really good, if somewhat technical, web resource is the Professional Education Services Group short course on Toxicodendron Dermatitis: Identification, Immunologic Mechanisms, Diagnosis, and Treatment, which you can find at www.pesgce.com/toxicodendrondermatitis/derm.asp. It has a few ugly pictures of ivy dermatitis, so be warned. One interesting thing to note from this article is that any clothing that receives enough sap to develop a black spot is permanently ruined. The spot is polymerized urushiol - it cannot be removed by washing and remains capable of promoting a skin reaction permanently.

We still have some in the back yard. I think my next attempt will be on a cool day with a disposable coated Tyvek suit, and duct-taped nitrile gloves (latex rubber and leather gloves aren't completely protective!) I may also try sun tan lotion as skin barrier, which seemed to help on one occasion in the past. I'll pull everything I can see, including trespassing a bit into a neighbor's yard, since, if I don't get his batch, it will be back next season. Everything but me will get pitched once I'm done. Wish me luck, please!