Blistery Margarita Burn Isn’t A Drink; It’s a Disease

August 02, 2017

The names for this disease are plentiful. Officially, and by officially we mean in medical textbooks, the condition is called phytophotodermatitis.

But it’s also called lime disease, lemonitis and margarita rash – or margarita burn or margarita dermatitis or margarita-itis.

All of the names boil down to this basic fact: There are plant juices out there – most often of the citrus variety, such as lime and lemon – that don’t react well when they hit the skin and then are exposed to sunlight.

Burns and blisters, severe blisters, can emerge. Entire hands can swell up. Pain and inflammation will wreak havoc. And people will have no idea what in the world happened to their skin.

In the dermatology community, phytophotodermatitis is well known. But among everyday users of citrus fruits, it most definitely is not.

“And so this condition is under diagnosed,” says Sahand Rahnama, M.D., a dermatologist with IU Health. “It can be from tiny blisters to a severe amount of blisters. But most of the time, it’s not very dramatic and people just think they have a sunburn.”

There are several ways this disease can pop up. The most common coincides with the popular beach drink the margarita. Sit on the beach relaxing in a chair. Squeeze a lime into your margarita. Juice inadvertently drips down your hand and forearm and then you sunbathe.

But what is often self diagnosed, after that, as everyday sunburn isn’t.

Certain plants cause phytophotodermatitis because they contain chemicals that are activated by the sun. When those plant’s juices hit the skin and are exposed to the sun, the skin cells get irritated.

The blistery rash that results will often be followed by hyperpigmentation – dark streaks or spots on the skin.

The good news: Phytophotodermatitis almost always goes away on its own, says Melanie M. Kingsley, M.D., dermatologist with IU Health. But it can take several weeks to months, she says.

Topical steroids may be used or some anti-inflammatory treatment but, for the most part, patients just have to wait for the rash to dissipate.

“Typically, we just say, ‘Let it be. It will continue to get better. It will take time,’” Dr. Kingsley says.

The best way to avoid the condition, of course, is prevention, she says. If you notice lime or lemon juice dropping on your skin, rinse it off before sun exposure.

Of course, lemon and limes shouldn’t get all the bad press, Dr. Kingsley says. There is a whole list of plants that cause phytophotodermatitis.

Among them: Parsley, parsnips, celery, carrots, figs, limes, lemons, Bergamot oranges, the herb common rue and several species of wildflowers, including hogweed.

-- By Dana Benbow, Senior Journalist at IU Health.

Reach Benbow via email or on Twitter @danabenbow.

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