Phytophotodermatitis (margarita burn)

Introduction

Phytophotodermatitis is a rare type of chemical skin reaction that happens when chemicals on the skin are exposed to sunlight. The chemical that causes this reaction is called furocoumarin. 

Furocoumarin can be found in citrus fruits or plants like: 

  • limes 
  • lemons 
  • oranges 
  • mandarins 
  • grapefruit 
  • bergamot. 

When the juice or oil from these fruits gets on the skin and then is exposed to sunlight, it reacts and can cause irritation.  

The condition is more commonly known as "margarita burn" because the reaction can occur when limes are squeezed to make a margarita drink outside. 

Phytophotodermatitis can affect any part of the skin. Children with more sensitive skin are at a higher risk.  

While phytophotodermatitis is rare, it can be serious and very painful, especially for children.  

 Signs and symptoms

The symptoms of margarita burn can range from mild to severe and are similar to that of a sunburn. These can include: 

  • skin inflammation 
  • skin redness 
  • skin discolouration 
  • a burning feeling 
  • pain 
  • itching 
  • blistering 
  • skin loss. 

Symptoms generally begin 24 hours after exposure to the chemical in combination with sun. Symptoms usually peak after 2-3 days.  

Diagnosis

Your child’s doctor can diagnose phytophotodermatitis based on signs and symptoms, their recent activities, and a physical examination of the skin.  

Depending on the severity, your child may be referred to their local hospital, dermatologist or burns unit for treatment and dressing. 

Treatment

The treatment that your child will receive will depend on the severity of the injury. 

Treatment options may include: 

  • a cold compress to help the pain 
  • pain relief 
  • dressing the blistered area. 

It is important to keep the injured area out of the sun and to seek medical treatment.  

 Management

Preventing phytophotodermatitis

The best way to prevent phytophotodermatitis is to: 

  • ensure citrus juice or oil is washed off the skin as soon as possible 
  • avoid touching other people after handling citrus fruits 
  • avoid prolonged sun exposure after handling citrus juice 
  • take sun protection measures such as applying sunscreen or covering areas with protective clothing to protect the skin. 

These actions are particularly important when outdoors. 

Protecting healing skin

Skin that is healing after this type of injury is sensitive and needs to be protected. 

You can protect your child’s newly healed skin by following any instructions given by the doctor, along with: 

  • using sunscreen 
  • covering the affected area with sun protective clothing when outside 
  • keeping your child out of direct sun as much as possible 
  • using a moisturiser like sorbelene cream at least twice a day. 

When to see your doctor

See your local doctor or go to the nearest emergency department if your child: 

  • develops significant blistering or skin loss 
  • is refusing to eat or drink 
  • has a high fever 
  • has a bad smell coming from the injury 
  • has redness and warmth around the injury 
  • has an increase in fluid coming out of their injury 
  • starts to feel more pain than usual. 

If there are any concerns, contact your treating health professional. 

Last updated Tuesday 2nd July 2024

Disclaimer

This factsheet is provided for general information only. It does not constitute health advice and should not be used to diagnose or treat any health condition.

Please consult with your doctor or other health professional to make sure this information is right for you and/or your child.

The Sydney Children’s Hospitals Network does not accept responsibility for inaccuracies or omissions, the interpretation of the information, or for success or appropriateness of any treatment described in the factsheet.

© Sydney Children’s Hospitals Network 2024


This factsheet was produced with support from John Hunter Children's Hospital.