Mixing citrus juice and sunshine can cause ‘margarita burn’, medics warn

Mixing citrus juice and sunshine can cause ‘margarita burn’, medics warnLook at one U.S. bartender hand. It became red, swollen, and dotted with thick, bubbly, yellow, fluid-filled blisters over few days after he spent a day in the beach sunlit cafe, squeezing juice from limes. It’s phytophotodermatitis, or ‘margarita burn’ - a rare type of human skin extra-sensitiveness.

The juice and oil of limes contain chemicals called photosensitizers, which make human skin extra-sensitive to sunlight. When an affected spot is overexposed, it ... burns.

Some other fruits and plants, including wild carrots and parsnip, also contain photosensitizers. According to the Mayo Clinic, bartenders, chefs, and other people who routinely handle citrus fruits are among those most at risk of developing phytophotodermatitis. Burns mostly happen on people’s hands, but they also can pop up on arms and legs, where citrus juice has splattered or citrus-based drinks have splashed or dripped.

Margarita burn is treated just like any other burn, says Jeremy Goverman, a burn expert at Massachusetts General Hospital and professor at Harvard Medical School. “Moisturizer and sunscreen for first-degree burns, and for second-degree burns, we drain the blisters then apply bacitracin or a triple antibiotic, nonstick dressing and gauze once a day until the burns are healed.”
Mixing citrus juice and sunshine can cause ‘margarita burn’, medics warn

But treatment can only happen if phytophotodermatitis is recognized in the first place—which, according to Goverman, isn’t always likely. Goverman has only seen three cases of phytophotodermatitis in his career—all of which could have been mistaken for other skin conditions—and has heard of others where doctors initially suspected their patients’ burns were poison ivy or oak, or some other kind of skin irritation.

“In a sense, it’s a different type of ‘lime disease,’ in that phytophotodermatitis is often misdiagnosed; it’s that rare,” he says.
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