Don’t let “margarita burn” interrupt your summer fun
Patient: “I have this weird finger-like rash on my side.”
Dr. Molly Malone: “Any chance you were doing shots of tequila and wearing a bathing suit in the sun?”
Patient: “Absolutely!”
Emergency Medicine Physician Molly Malone, MD diagnoses “margarita burn” at least twice a year during her work at the Cape Cod Hospital Emergency Department and Cape Cod Healthcare’s Urgent Care centers. While it’s seldom serious enough to require treatment, it can be alarming and most come in for a diagnosis, she said.
Margarita burn is actually phytophotodermatitis, a little-known skin condition. It can happen to some people who get citrus drinks on their skin, and then expose themselves to the sun. Phytophotodermatitis is quite the tongue-twister, so the easier and more memorable term “margarita burn” was born. Margaritas contain highly acidic lime juice—a prime instigator of the rash.
Whether you call it phytophotodermatitis or margarita burn, the most important thing to remember is that citrus, your skin and sunshine can be a painful mix for children and adults.
“Margarita burn is one of my favorite rashes to diagnose! I remember getting it myself after making guacamole,” said Dr. Malone. “I was outside on a sunny day, and I must have squeezed the lime, then wiped my hand on my thigh because that’s where the burn showed up the next day. It happened a few summers ago.”
She sees margarita burns anywhere patients have wiped their hands after squeezing a lime or lemon—thighs, arms, legs, tummies.
In addition to citrus fruits, peppers, celery, carrots, dill, fennel, figs, mustard, parsley and parsnips can cause margarita burn, according to the National Institutes of Health (NIH). These foods contain furanocoumarins, a class of chemicals. The active substance within the furanocoumarins is psoralen, which reacts with ultraviolet A (UVA) light to cause skin irritations.
One case report on the NIH website documented a leg rash in the shape of the patient’s palm and fingertips—exactly where a lemon-soaked hand had touched while exposed to sunshine.
Dr. Malone has never seen a serious case of margarita burn, but the burns can last a significant amount of time, she said. They are not usually painful and appear as a mild discoloration of the skin.
“Sometimes margarita burns can be itchy or mildly painful at first, but that is rare,” she said.
The good news is that these “burns” resolve on their own.
Preventing Margarita Burn
Awareness is helpful.
Parents should be aware of the potential for certain fruits and vegetables to interact with sunshine, and carefully wash their children’s tender skin—faces, arms, legs that may be exposed—with soap and water before going outside after eating.
“Adults simply should wash their hands with soap and water, making sure the juice is off,” Dr. Malone said. “If you don’t have lemon or lime on your hands, you should be fine.”
Remember to apply sunblock before exposing your skin to the sun, so you can safely enjoy all the fun and relaxation of the outdoors.
