Zack Morris - Story of My Life

Before I get poison ivy again next year and forget how the heck I got over it, I just want to record the best treatment:

1. The first 7-10 days: Calamine Lotion (Caladryl) is the ONLY thing that works during the first week you have poison ivy. Don’t listen to so-called experts who may question the medical efficacy of zinc oxide and iron oxide (the “inactive” ingredients of Caladryl). At this point, think of it like a nuclear blast, the best you can hope for is containment, as your body is exposed to millions of times the amount of urushiol needed to cause a reaction. Apply it liberally anywhere that it itches. It doesn’t matter at this point if you scratch it. In fact, the itching is so severe, that it’s virtually impossible not to scratch. In my experience, the people who say not to scratch have never really had a case of poison ivy. The oil has become bonded to your skin, so in other words it’s embedded in you, and scratching actually helps to slough off the infected skin and puss, which is absorbed by the calamine lotion and locked away. Wash/scratch the rash vigorously with soap in the shower and then apply the calamine immediately when you get out. Apply it after a shower and then every 3 hours and 45 minutes throughout the day. Many drugs today are programmed to work for 4 hours, so you have to preemptively take a dose 15 minutes ahead of time to avoid a flare up. Don’t bother with Benadryl at this point, since it’s more important to get the autoimmune agents out of your body, and the crusty, sap-like puss helps do that.

2. Days 7-14: At this point your body will begin to develop a secondary reaction to the calamine lotion because it’s too dry, but also suffers from a rebound affect. This is a bit confusing. The lotion makes the skin too dry, but when you try to stop taking it, the rash returns. My girlfriend Kellie suggested I try Gold Bond Medicated Lotion. This has a similar anti-itch ingredient to Caladryl, and hydrates your skin. You can take it indefinitely. Apply it after your shower and again every 3 hours and 45 minutes throughout the day. Unfortunately, it will not stop an itch once it starts, but it will prevent it. In emergencies, keep Caladryl in your pocket and apply it where it itches. Up to day 10, you’ll still periodically end up covering a whole arm or leg in Caladryl, but it’s ok because you aren’t dosing your whole body 4 times a day. You can also begin taking Benadryl, since the oil has worked out of your system and now it’s time to decrease the itching and give your body a chance to heal. I thought I was better a few days ago and went off the Benadryl, but the rash immediately flared up again in skin that looked healed, and even started showing up in new places. This can be especially frustrating, because the autoimmune agents have diffused deeper into the skin, and scratching lets them enter the bloodstream. The rash expands its borders and moves onto other places, like my belly. You’ll take the Benadryl 3-4 times a day for 7 days. Then if flare ups continue, gradually decrease your dosage to 1-2 pills a day (possibly broken into half pills, depending on body weight) till roughly day 20. It’s most important to take it right before bed to prevent flare ups in the middle of the night, and then either in the morning or early afternoon to both prevent the recurrence and try to even out the dosage. Your body will eventually renew itself with new cells and absorb the toxins at a rate below that which triggers itching (this is the key).

Notes: You can try Ivy Dry which acts like sore throat spray and provides relief for flare ups in the middle of the night. I thought this was great 2 years ago, but it turned out to cause a bad rebound (similar to nasal decongestants), and has no healing properties. A friend suggested Benadryl Spray and I will try it next time I get poison ivy. I like the idea of localized medication, but it may act similarly to hydrocortisone cream and just postpone the immune response, since the irritants are still in the skin. I’ll use it in days 7-14 just like oral Benadryl. The most important thing to remember is that you can’t rely on your own body/health/immune system to heal you, since poison ivy has had millions of years of evolution to sabotage this system. If you do nothing, and you’re in that lucky few percent of the population (like me) that has a severe reaction to even a whiff of poison ivy, your symptoms can last up to 6 weeks, cover most of your body, and eventually make it into your bloodstream and do nasty things like constrict your airway. You have to fight it militarily with every weapon in your arsenal, and understand what’s going on subdermally. There is a sort of cathartic release to scratching a poison ivy rash till it becomes a raised, bleeding plateau, but you must treat it with Caladryl or it will just spread and become infected. I have noticed though that if you really tear into it this way, it will form a crust and heal sometimes in that spot by the next day.

One last thing to note is that I didn’t even get poison ivy last year. I used Ivy Block on the crick of my elbows and knees, and then washed it off in the Bruneau river when we set up camp. Unfortunately this year, I applied it halfway into the hike, and then didn’t bother to wash it off. I think the cream may have rubbed off into my sleeping bag, which I have since washed. We tend to think that we have vanquished an enemy like this and then throw caution to the wind, but this is a life and death struggle and you can never let the enemy gain the upper hand Prevention is still the best medicine. I’d love to hear any thoughts others may have.