This is the chemical structure for urushiol. It's the oily organic allergen found in Poison ivy and other plants of the Anacardiacease family. While photographing leaf hoppers last week Thursday, I used my right knee to brace myself, resting it on the ground in a small patch of Virginia creeper. To my shock and alarm, when I stood up I saw a few poison ivy leaves mixed in with the creeper. Crap!
For some people, it only takes a trace of urushiol no more than a few micrograms on the skin to initiate an allergic reaction. For decades I believed I was virtually immune to poison ivy. I was positive I had come into contact with the plant with little to no reaction, but that can change over time or abruptly with repeated contact, even if they're years apart.
Prothonotary Warbler at Arena boat landing.
I experienced my first severe reaction after brushing against poison ivy during the spring of 2010 while photographing a Prothonotary Warbler at the Arena boat landing. Using calamine lotion and prescription strength hydrocortisone cream, it took over a month for it to heal, but slight scarring remained for many months. Lesson learned? I guess not!
Time is of the essence once contact is made. It only takes urushiol a few minutes to bond to skin cells and I was too late by the time I got home. I made a vain attempt to wash the contact area with soap and water, but by Friday afternoon a small rash formed on the left side of my right knee where it came to rest in the plants. Recalling what happened in 2010, I immediately contacted my doctor's office for prescription hydrocortisone and began treatment later that day.
At first I thought it wasn't going to be a big deal, but I couldn't have been more wrong. By Monday morning both my legs were developing a nasty red rash that was spreading with intensity and globs of fluid filled blisters. It was then I realized I must have rested my right leg against my left in the minutes after the initial contact with the plant.
Eventually the blisters began to weep yellowish fluid which some falsely believe spreads the rash. It's actually blood serum. Once urushiol bonds with the skin, it's no longer contagious to yourself or other people. It also does not carry into the bloodstream and spread. But you can keep spreading urushiol if there are trace amounts of it on your clothes, shoes, gear, etc. The reason the rash spreads is simply because some skin areas take longer to react.
This time the hydrocortisone cream only helped relieve the agonizing itch, but when applying it I felt like I wanted to dig my fingernails deep into my skin and scratch off all the blisters. By Monday night the rash had spread almost to my feet and several inches above my knees. Then on Tuesday morning my right leg had become so swollen and inflamed I experienced difficulty standing and walking. Clearly, it was time for an alternative medical strategy. Hello Prednisone!
I got a “blast” prescription of Prednisone yesterday and already the itching and swelling has significantly subsided. The rash is retreating and the blisters are drying up. After not being able to go birding for the past few days, I returned to Pheasant Branch Conservancy this morning and found nine warbler species. Thus far, a slight headache and feeling a little jittery are the only side effects of the Prednisone.
As a lesson from this second severe reaction, I intend to procure and keep an urushiol cleaning field kit in my backpack at all times. There are several kinds to choose from and friends of mine who have had severe reactions have provided me with great recommendations. Having not tested any of these, I'll only pass on advice should I ever have to put one of them to use. For now, I'm just grateful the Prednisone is knocking out the reaction.
Bring on the warblers!
GRAPHIC CONTENT: If you really want to see how bad the rash got, click here.
© 2013 Mike McDowell