Margarita Dermatitis (Phytophotodermatitis)

Escape the cold winter blues and say hello to an all-inclusive resort in Mexico where the mid-summer sun beams down in December! Let your skin out of the cold, arid awfulness that comes with a Canadian winter, and swap it for some Mexican warm sun! Margarita in one hand and a relaxing book in the other, what could possibly go wrong?

The way that things go wrong is usually mundane: You get sloshed from guzzling too much free alcohol, and suffer a painful hangover the next morning. Perhaps you forget the sunscreen, forget that you’re in Mexico where the sun is far more powerful and scorch yourself to a crisp during an outdoor nap. Then there are the mysterious accidents. No, not cartel kidnappings, but a mysteriously shaped burn mark on your hands that seems oddly patterned, but makes no sense to you. You went for a quick swim, had a few cocktails while lounging around for a bit by the pool. Sure you skipped the sunscreen this time since it was only a short time and all was good, but the next morning you wake up, and now you have painful blisters on not just your hands, but on your chest as well.

So What Happened?

Margarita dermatitis, is the upgraded hip name for a well known condition in dermatology called phytophotodermatitis. Many citruses like limes (but also many other fruits and vegetables) contain substances that make the skin hypersensitive to UV light. They are called photosensitizers, and due to a chemical reaction, it can really burn the skin, usually within 24 hours, and even cause hyperpigmentation which can have a delayed onset and last for months. The exposed part of the skin will often show symptoms within a day or two. The back of the hands are the most common, as juices can spill innocuously without notice. A common sign is a line or a streak on the skin where the cocktail was spilled. Redness and irritation are often the first signs of phytophotodermatitis. Citrus fruits are known to cause sensitivity to UVA rays, but this type of dermatitis can also be caused by celery, parsley, carrots, and figs. Margarita dermatitis is a common and well known chemical interaction, but in North America where alcohol and beaches generally don’t mix as often, it is little known, and as a result, sometimes people are caught off guard when vacationing and end up burning their skin. The Corona beers and cocktails are another problem. While drink spills occur, generally we wipe ourselves if we spill. When we squeeze the lemon/lime into our drinks, we pay less attention to the splash of lime that hits our skin, which is why our chest got burned the next morning. While Margarita Dermatitis in Mexico might beat frostbite from the frigid cold, it is no laughing matter.

How to deal with it:

For minor irritations, just leave them alone. Ignoring it and waiting out the milder symptoms is perfectly acceptable. If you notice, however, that the symptoms are more severe (rashes, intense heat and redness, blistering), it’s time to see a doctor. A doctor will prescribe some stronger creams, likely a topical steroid to reduce the inflammation and itch. Hyperpigmentation, or dark streaks where you spilled the fruit drink on the skin, might also appear. These are often delayed reactions that appear after a week or more following contact with the reactive fruit. This type of hyperpigmentation usually fades over several months, but in rare cases, it may last longer. For faster recovery, visit your dermatologist for a consultation. There are skin brightening products that can help treat most cases of hyperpigmentation.

Prevention:

Phytophotodermatitis is an easily preventable skin reaction. The combination of citrus fruits and certain plants simply don’t mix well with sunlight. If you’re bringing your fruity cocktails outdoors, be extra careful that you don’t spill any on your skin. If you do, wash your skin off carefully before exposing your skin to the sun. As always, have some sunscreen on if you’re going to be under the sun. If you’re in a “bartender role” outdoors, whether you’re paid or not, you should be aware of this interaction between citruses and sunlight and take care to wash your hands often, or you may be in for a painful surprise. Finally, all the sun awareness stuff is twice as important when on vacation. The sun’s rays are not equal everywhere in the world, and as a result many North Americans who are used to a less intense sunlight can get caught off guard.

Sun protection with Dr. Shannon Humphrey