Under My Skin: Falling Into Poison Ivy


"I’ve had a poison ivy website for 10 years," read the e-mail from someone I didn’t know, named Jack, "and I wondered if you might be interested in answering some questions about that skin condition."

"Sure," I sent back. "How’d you get my name?"

"I asked my internist Stan if he knew a dermatologist with a sense of humor."

We arranged to talk on the phone. Jack told me he designs websites for a living and is, like me, an expat New Yorker. "People send me anecdotes and photos for my website," he said. "I have a Poison Ivy Hall of Fame. Some of the pictures are pretty impressive."

Jack had read books on poison ivy and looked at online health information websites. "How did you get involved with this?" I asked him.

"I had a bad case myself," said Jack. "Then I talked to people and collected stories. I guess you could say I fell into poison ivy."

I knew we would get along fine.

Jack set a time to come to my office for a video session, during which I would respond to common questions he gets. His list was familiar, because patients ask us the same ones: What’s in the blisters? Can you spread it by scratching? And so forth.

I expected the session to be cordial, but in truth I had doubts. After all, here was an energetic layman who had run a health-related website for 10 years – one that gets thousands of hits a week in winter and a hundred thousand in summer – and who had never once spoken to a doctor about the subject. Why?

Some lay groups treat our profession with suspicion, even hostility. I think for instance of the Morgellons folks. They are convinced that their sufferers are afflicted by unknown fibers, perhaps originating in outer space. Doctors like us tend to suggest, however gently, that the itching and burning sensations they report have a psychiatric origin. To them, this just goes to show how insensitive and indifferent we are.

A few years ago I wrote to the Morgellons organization. Since many of their cases seem to cluster in the Boston area, I offered to examine patients, perform biopsies, and so forth, for free. My letter was neutral, expressing no skepticism. They ignored my offer.

More recently, the Morgellons lobby convinced the Centers for Disease Control and Prevention to research the condition. Some $600,000 later, their study found much picking and scratching, no infectious or environmental cause, and no alien fibers, just cellulose. This report will no doubt fail to convince anyone not already convinced.

I considered that some opinions I would be sharing with Jack might clash with beliefs that are widespread in the poison ivy community. (There is one, just as there is a ChapStick addiction community, and a rename-yourself-after-a-Mayan-deity community.) I would not agree, for instance, that oozing contact dermatitis implies infection, that blister fluid contains poison, or that poison ivy itches in a unique way that differs from all other itches. Also, I would remain politely agnostic on the efficacy of jewelweed and myriad other natural and folk remedies. Would my opinions be acceptable? Tolerable?

I needn’t have worried. Jack was pleasant and willing to listen, even when what I said surprised him. Key, of course, was Jack’s sense of humor. As anyone who deals with a lot of people knows, a parley with the humorless can be tough.

But if Jack is neither suspicious nor hostile, why didn’t he talk to a doctor for a decade? Probably for the boring but key reason that he just didn’t know anyone to talk to. And how come the 100,000 people who visited his website weren’t bothered by the absence of an authorized medical voice? Because while we may flatter ourselves that people shouldn’t get information anyway they can, they do. At times – pretty often, in fact – they give little or no extra weight to pronouncements from official authorities.

If Jack follows through and posts the edited video (he promised the camera would not make me look fat), then I will have possibly diluted a little of the copious folklore about urushiol dermatitis. But not much.

But it was fun falling into poison ivy myself. So to speak.

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