Picture this: You’re outside with your friends, playing mixologist and squeezing lemons and limes into drinks, only to discover pain, redness and swelling on your hands the next day. It’s not just you: It’s the margarita sunburn, or phytophotodermatitis, a type of sunburn that’s different from the usual case of post-sun redness.
“The textbook story is spring break at a beach making margaritas,” says Tucson, AZ board-certified dermatologist Sheila Farhang, MD, who says her patients are “stunned” when they find out that their poolside cocktails contributed to their symptoms—which can include long-lasting changes in pigmentation.
And it’s not just citrus fruits. “Celery and parsnips are also culprits, but less common,” says Dr. Farhang, With that, here’s what to watch out for—and what you can do if you’re already feeling (and seeing) the burn.
Featured Experts
- Jody A. Levine, MD is a board-certified dermatologist in New York
- Julie Russak MD is a board-certified dermatologist in New York
- Sheila Farhang, MD is a board-certified dermatologist in Tucson, AZ
What is a “margarita sunburn,” otherwise known as phytophotodermatitis?
Phytophotodermatitis, happens when oil or dander from some plants (celery and parsley are top offenders) and citrus fruits (most commonly, lime) gets on your skin and then is exposed to UV light. The combination causes a chemical burn reaction (usually one to two days after exposure) that can get quite severe, leading to burning, stinging and even blisters. It also usually results in hyperpigmentation, which can take months to fade.
Typically, “sunburns occur when skin is exposed to UV radiation from the sun,” says New York dermatologist Jody Levine, MD. “Phytophotodermatitis, on the other hand, occurs when a person comes into contact with a light-sensitizing plant, such as celery or parsley, or to citrus—and then is exposed to the sun’s UV rays.”
“Phytophotodermatitis occurs anytime the skin is in direct contact with furanocoumarins, organic chemical compounds found in plants, and then exposed to UV light. Common foods containing these compounds are limes, grapefruit and Valencia oranges,” explains New York dermatologist Julie Russak MD. “All skin types are vulnerable and affected. The severity of the burn is determined by the amount of juice sap that was deposited on skin and the amount of UV exposure.”
They can look different, too: While sunburns tend to be uniform and look red, “phytophotodermatitis can appear red, blistered and hyperpigmented with streaks or spots,” says Dr. Levine, who notes that sunburns, when severe, can also lead to blistering.
What causes phytophotodermatitis?
While it might seem like the acid in citrus fruits is responsible for sensitizing skin—which is true to some extent—this phototoxic rash also results from the “interaction of furocoumarins, a certain chemical in plants, and UVA rays,” Dr. Farhang says. On a microscopic level, this chemical can disrupt the skin cells in a way that causes damage to the epidermis, the top layer of the skin.
As a result, when you get phytophotodermatitis, “the skin barrier is compromised due to cellular damage—cell death—from the UV activation of the plant chemical,” says Dr. Farhang. “This cell injury triggers an inflammatory response.” That response can in turn lead to redness and blistering in the short term and lingering post-inflammatory hyperpigmentation even once the actual burn has resolved. In some cases, it can lead to long-lasting red patches (among fair patients) and brown areas (among patients with medium to dark skin tones), she says.
How long does it last?
The immediate phase of phytophotodermatitis usually arises within 24 hours of exposure and can stick around for one to two weeks, according to Dr. Farhang. “The lingering redness or hyperpigmentation can last weeks,” she says. “I’ve had patients where it has lasted up to two to three months.”
How do you treat phytophotodermatitis?
Start the same way you would with a typical sunburn, and cool the area with a chilled compress. “Improving and repairing that skin barrier is the next priority—moisturizing with a fragrance-free, dermatologist-recommended cream is a must,” says Dr. Farhang
Then, depending on the level of inflammation, both she and Dr. Levine recommend applying a topical steroid cream, which helps decrease inflammation. Once the area has healed, your derm can address any lingering hyperpigmentation.
How can you avoid it?
The good news is that it’s far easier to prevent PPD than to treat it. “If you think you’ve come into contact with any of the foods or plants that can cause a reaction, you should wash your skin thoroughly before going in the sun,” says Dr. Levine.
“The best way to reduce your risk is to wash the skin with gentle soap that was in contact with the furanocoumarins. If that is not an option, avoid significant UV exposure and sweating,” Dr. Russak advises.
Sun protection is also, as always, essential. If you’ve gotten it before and can’t avoid contact with the usual culprits while in the sun—maybe you work at an outdoor restaurant—then you can also use gloves, says Dr. Farhang. “I personally try to avoid squeezing lemons while outside,” she says. “You can use other methods to juice a lemon that avoids the juice getting on your hands and arms.”
