Phytophotodermatitis: The Not-So-Sweet Side of Margaritas

By: Nicole Werpachowski

As summer approaches and outdoor gatherings fill our calendars, there’s an unwelcome guest lurking amidst the festivities: phytophotodermatitis. This lesser-known and peculiar-sounding condition might not be a household name, but its effects are all too familiar to those who have encountered it. Frequently referred to as “margarita rash” or “margarita burn,” unsuspecting individuals can fall victim to this unwelcome summer guest. In this article, we will explore what exactly phytophotodermatitis is, how it presents, and most importantly, how to avoid falling victim to its presence during the sunny season.

Phytophotodermatitis: Overview

The term “phytophotodermatitis” might sound like a mouthful, but breaking it down can shed light on its origins. “Phyto” refers to plants, “photo” to light, and “dermatitis” to skin inflammation. Essentially, phytophotodermatitis is a skin reaction triggered by the plant compound “furocoumarin” upon contact with the skin, followed by exposure to UV light or sunlight. Citrus fruits like limes, lemons, grapefruits, and bergamot oranges are the primary culprits behind this reaction. However, other sources include carrots, celery, parsley, capsaicin peppers, fig, and, interestingly, pelea anisata (used in Hawaiian leis) [2-4]. Don’t worry about this happening when eating these foods poolside; phytophotodermatitis typically occurs when extracting juices outdoors into food or drink [1].

Phytophotodermatitis: How it Manifests

Phytophotodermatitis typically manifests 24 hours after exposure, characterized by redness, irritation, and sometimes blistering of the affected skin. These symptoms are often mistaken for a first- or second-degree burn, chemical irritation, contact dermatitis, or skin infection [5]. Unlike a classic allergic reaction, phytophotodermatitis typically lacks itchiness [3]. Several days after exposure, hyperpigmentation in an irregular geometric pattern (resembling streaks from citrus juice or imprints of the plant on contact) gradually develops. Notably, phytophotodermatitis doesn’t play favorites – it affects all skin types and can affect any sun-exposed area of the body.

Phytophotodermatitis: Will It Last Forever?

If you think you have phytophotodermatitis, do not panic! There are many ways you can tackle the initial symptoms head-on. To alleviate any itching or inflammation, apply a cool compress on the affected area and take an antihistamine. However, hyperpigmentation is a real concern as it may takes months or years to improve. Patience is key, as the pigmentation will clear over time. One crucial way to prevent further discoloration and darkening is by protecting your skin from the sun. Make sure to apply a broad-spectrum sunscreen with SPF 30 or higher on the affected area (as well as to the rest of your skin not covered by clothing) [1-3, 6]. Don’t forget that this rule applies to cloudy days! If these symptoms do not improve or worsen, see a board-certified dermatologist for additional management.

How Can We Protect Ourselves?

As with most skin diseases or manifestations, prevention is key. Now that you know what foods and plants can cause phytophotodermatitis, the best thing you can practice is avoidance. Otherwise, make sure to wash your hands (or any body parts that come into contact with the food or plant) thoroughly with soap and water before going out in the sun. If you are gardening or hiking, make sure you wear long-sleeve shirts and pants to protect your skin from unexpected brushes with potential offenders.

Take Away

As you prepare for sun-soaked adventures, remember to keep phytophotodermatitis off your guest list! Don’t say we didn’t warn you. Armed with this new understanding of culprits and proactive measures, you can outsmart this unwanted visitor and confidently navigate the warmer weather. So, whether you’re sipping margaritas or tending to your garden, stay vigilant and stay protected. Here’s to a summer filled with fun and flawless skin!

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