In the heat of summer, a walk in the shade shouldn't make my blood pressure rise or my heart pound. But I'm afraid to stray off any woodsy path. Even then I feel like a trapped animal, my senses on alert. I look up, down, right, left. I squint in search of the cause of my anxiety. I rush past the masquerading Virginia creeper, only to stop next to my herbaceous enemy: a vicious three-leafed plant.
If this sounds a bit overblown to you, it's a good bet you don't share my hypersensitivity to poison ivy. If I accidentally brush against it -- or sometimes even if I just stand near it -- my skin tingles. Bumps appear. The rash reddens and grows into blisters that itch incessantly. And even though dermatologists claim the oozing blisters don't spread the rash, I don't believe them.
No matter how careful I am, I get another new bump anywhere I touch. Scratching too hard causes an infection that makes my symptoms worse. Eventually I avoid contact with others; I begin to look like a mummy with gauzy bandages covering the gore. My skin feels so prickly that I can't sleep at night until the blisters scab over. Months later, scars remind me of my ordeal.
How sensitive am I? I can't go outdoors when my neighbors cut their grass; even a cultivated lawn may contain some poison ivy, its seed dropped there by birds and other animals. Once it's mowed, the oil from the plant becomes airborne, and I'm as exposed as if I'd touched it directly.
While my reactions are unusually acute, many are affected by poison ivy. Up to 50 million others in the United States -- 85 percent of those exposed -- get the rash each year, according to the American Academy of Dermatology. (A lucky few don't react, either because their immune systems are otherwise occupied or because their systems don't recognize the alien invader.)
That translates into tens of millions of lost workdays (three days per person is the median), according to the U.S. Bureau of Labor Statistics. Because over-the-counter preparations provide only modest -- and temporary -- relief, poison ivy triggers an estimated 1 million emergency room visits a year, according to one expert. In severe cases, such as those involving firefighters, landscapers, linemen and others who inhale or otherwise contract poison ivy on the job, the problem can be life-threatening; steroid injections must be administered to disable the immune response.
No wonder, then, that research claiming to show better results for a lesser-known treatment has generated some excitement. A study, presented last fall to the American College of Emergency Physicians Research Forum in Boston, showed dramatic symptom relief from a wash called Zanfel. Sold on the Web since 1998 but not approved as a medicine by the Food and Drug Administration, Zanfel has achieved widespread distribution largely on the strength of Internet advertising and word-of-mouth reports, despite its cost of nearly $40 an ounce.
Could a better treatment really be at hand? Alas, experts have their doubts.
What makes poison ivy so fearsome is urushiol, the oily sap it exudes. The stuff is so potent that a tiny quantity of it -- no more than can fit on a pinhead -- can be enough to trigger a severe reaction in as many as 50 people who happen to come in contact with it.
"Poison ivy is not really a poison," at least not in the same sense that we define other substances as toxic, explained Michael Heller, director of the emergency medicine residency program at St. Luke's Hospital in Bethlehem, Pa., and senior author of the study. "The resin isn't really toxic; it just causes an allergic reaction."