Question:
I am a 42-year-old man married to a wonderful woman and with three children. I am sitting at work with huge blisters on my arms and on my legs below the knees. The blisters are leaking on my shirt and pants, and every doctor I called was full today. My wife told me not to come home, because I was contagious if my poison ivy was draining. Where can I go for help?
Answer:
You can go home, since the oozing blisters are not contagious. Because new blisters can keep appearing over the course of several days, people assume that touching the rash causes it to spread or that the blister fluid leaks onto the skin, causing it to spread to those areas or to others.
The fluid in the blister is one’s own serum and not the allergic oil from the poison ivy plant called urushiol. One’s individual skin sensitivity, the amount of poison ivy oil on the skin, and the amount of time the oil is on the skin prior to washing determines the speed and severity of the rash.
The parts of the body with the greatest poison ivy oil exposure break out initially, followed over the next several days on parts of the body with less exposure to the poison ivy oil. Once one has bathed and no poison ivy oil is on the skin, scratching does not make the rash spread; and the blister fluid does not cause the rash to spread nor is it contagious to others.
If a physician is not available, cool compresses help reduce the itch and begin to dry the blisters. Large blisters can be drained with a sterilized needle (the blister fluid will not spread the rash). Once the blisters are no longer draining, stop the cool compresses.
Tepid baths with oatmeal bath added can decrease itching. Avoid hot baths, as heat usually increases itching and inflammation.
During the blistering phase of the poison ivy rash, the use of calamine lotion helps relieve itching and dries up the blisters. Once the blisters have dried, use hydrocortisone cream 1 percent, which is available over-the-counter. Taking an oral antihistamine can help reduce the itchiness, and acetaminophen PM can be taken at bedtime to help reduce itching and help with sleep.
With severe cases of poison ivy, consulting a dermatologist is the treatment of choice. There are systemic therapies with oral steroids at the top of the list. Prescription oral antihistamines and prescription cortisone creams are also available.