An innocent afternoon spent picking fruit and making juice in the backyard left friends, Cassie and Max, with painful burns. The cause? Limes mixed with sunlight.

Eight-year-old Cassie was on a ride at the Easter Show when her mum, Felicity, noticed tears glistening in her eyes. It was then Cassie told her mum of a burning sensation in her fingers. Over the course of the afternoon, this progressed, and Cassie developed a painful, burning rash down her legs.

Suspecting an allergic reaction, Felicity gave Cassie an antihistamine before calling Max’s mum, who confirmed Max was suffering from the same rash.

When the rash continued to worsen and develop into blisters, Felicity knew something wasn’t right and sought medical attention.

Cassie and Max had both developed a rare condition known as phytophotodermatitis. The condition is more colloquially referred to as margarita burn and occurs when the chemical furocoumarin found in citrus fruits reacts with sunlight.  

The juice from the limes Cassie and Max had been playing with the day before had caused the severe inflammation on their skin.  

The symptoms of phytophotodermatitis range from mild to severe, and can include skin inflammation, redness, itching and blistering. They generally begin 24 hours after exposure, and peak after 48 to 72 hours.

Treatment will generally include a cold compress to help the pain, antibiotic creams and dressings to keep the area covered. It is important to keep the burns out of the sun and to seek medical treatment.

Cassie and Max were both referred by their local hospital to the Burns Unit at The Children’s Hospital at Westmead, where their burns were carefully treated and dressed. Thankfully, the pair have now made a full recovery.  

Felicity hopes by sharing their experience, it will help another family go through the same situation.

“This experience was a wake-up call for me. Something as simple as playing with limes in the backyard led to such a terrifying ordeal,” Felicity said.  

“I hope sharing this story can help prevent a similar situation for other parents, by educating others about the hidden dangers that can turn an innocent day into a nightmare.”

While phytophotodermatitis is rare, it can be serious and very painful, especially for children. The best way to prevent it is to ensure citrus juice is washed off the skin as soon as possible, particularly if outdoors.

For more information on burns prevention and first aid, visit the burns injuries factsheet on the Sydney Children’s Hospitals Network Kids Health Hub.