Ahhh, you’ve finally made plans to kick back and relax with a warm aromatherapy soak, or maybe an icy pitcher of margaritas outdoors…but beware! The citrus that you use might just change your chill to a shrill (image credit).   

Essential oils and bath/skin burn 

IPC received a call from an otherwise healthy pregnant woman who wanted to take a relaxing bubble bath. She decided to use several drops of orange essential oil in the bath and within a few minutes of soaking, she started to feel a burning sensation on her legs. She called IPC shortly after she got out of the tub and said her skin was bright red, warm and irritated.

The culprit was limonene, a chemical found in the rind of citrus fruits, such as lemons, limes, and oranges (image credit). Due to its strong aroma, limonene is utilized in many soaps, shampoos, lotions, perfumes, laundry detergents and air fresheners as well as botanical insecticides, pesticide products and eco-friendly insect repellents. Limonene belongs to a group of compounds known as terpenes, whose strong aromas protect plants by deterring predators. However, when applied directly to the skin, limonene may cause irritation in some people, so caution should be used when handling essential oils that contain limonene.

Prevention tips:

• Use products specifically formulated for topical use.
• If using an essential oil that contains limonene, dilute the desired essential oil in a carrier oil (eg, coconut, olive, jojoba oils) before using.

NOTE: Some people are particularly sensitive to essential oils with limonene and may need to avoid topical use altogether.

Treatment advice:

• Shower and/or wash with mild soap and water.
• Be patient; symptoms generally improve within an hour or two.

NOTE: Similar skin reactions have also been seen with the use of cinnamon and peppermint essential oils.

Lime Juice +  Sun = Margarita Burn

Tequila, lime juice and salt with a splash of ice…a summertime favorite of many adults. But that summertime favorite had a new twist for Courtney Fallon, as reported in the Feb. 22, 2021 issue of Wide Open Eats. While enjoying a long Memorial Day weekend with her family in Florida, Courtney decided to go big and “squeezed hundreds of limes” to make a giant pitcher of margaritas for poolside refreshments.

The next morning, Courtney woke up with a burn but it wasn’t from the sun. Her hands were covered in giant red blisters and felt like they were “on fire.” Courtney was suffering from phytophotodermatitis, also known as “margarita burn,” a chemical reaction between UV light and citrus juice (image credit).

What is phytophotodermatitis? An article from Prevention.com explains:

“Certain plants, particularly citrus fruits, contain compounds called furocoumarins, which can cause a ‘severe chemical reaction in the presence of sunlight,’ explains Joshua Zeichner, MD, director of cosmetic and clinical research at Mount Sinai Hospital in New York City. When exposed to UVA light, the furocoumarins within one of these plants induces a photochemical reaction in the skin, which damages the skin cells, spurring cell death. The reaction varies from person to person, but it can result in large blisters, burning, pain, and redness.”

Celery plants or lime peel oil can also cause this condition, known as “celery picker’s itch” and “bartender’s itch,” respectively.

Prevention tips:

If you plan to be in contact with a plant or food known to cause phytophotodermatitis, make sure to:

• Wear gardening gloves or food preparation gloves.
• Use sunscreen before heading outdoors or using a sun lamp/bed.

Treatment advice:  

Care at home:

• Wash the area well using mild soap and water.
• Apply a cool compress. Wet a washcloth with cool water and put it on your rash. Do this several times a day to help decrease itching, pain, and swelling.
• Protect your skin from the sun’s ultraviolet (UVA and UVB) rays when outside. Your skin may be sensitive to the sun after phytophotodermatitis. The following can help you protect your skin:
  • Wear sunscreen when you are outside. Use sunscreen that has an SPF (sun protectant factor) of 30 or higher. Make sure it has UVA and UVB protection. Follow directions when you use sunscreen. Put on more sunscreen if you swim, sweat or are in the sun for longer than an hour. Protect your lips by using lipsticks and lip balms that contain sunscreen.
  • Stay out of the sun between 10 am and 4 pm. This is when the sun is strongest and most damaging to your skin.
  • Wear protective clothing. Long-sleeved shirts and pants will protect your arms and legs when you are out in the sun. A wide-brimmed hat can protect both your face and neck. Over-the-counter medications:
• Antihistamines found in topical anti-itch cream or pill form can be used to relieve itching and irritation. Do not use antihistamine cream on broken skin.
• Topical steroids such has hydrocortisone may be used to decrease swelling and spread of lesions.

When to seek medical care:

• If large areas of the body (20-30% or more) are affected by blisters;
• The rash area becomes more swollen, red, warm or painful; or
• If you develop a fever and the rash looks infected.

If you find yourself in one of these situations, don’t panic! Call the IPC’s free, confidential 24/7/365 expert helpline at 800-222-1222. No question or issue is too big or too small (or too embarrassing). Just call!  People living/working in Illinois can request a free Safety Packet (with sticker/magnet) and/or take advantage of the IPC’s free online Poison Prevention Education Course (and free CEC).

Cheers, Vickie and the IPC Team

P.S.: Speaking of blisters, check out these ubiquitous bugs and botanicals that can cause some real doozies:

• Giant Hog Weed
• Wild Parsnip
• Botany, Bugs and Blisters . . . Oh My!
• Poison Ivy: An Itch You Won’t Forget