Dr. Engelman explains that the more juice that comes into contact with the skin, the higher the potential for a more exuberant reaction. The reaction isn’t contagious (thank the skin gods) but predicting when it’s going to happen can be a little tricky. Dr. Kourosh says that she’s seen it occur in all skin types and that it can happen anywhere where the sun is intense. Dr. Engelman agrees, noting that no specific skin type is more prone to this type of dermatitis.
How common is phytophotodermatitis?
While it’s difficult to discern exactly how many cases occur per year — it’s often mistaken for typical sunburns or allergic reactions — Dr. Engelman says she only sees about five to seven cases of phytophotodermatitis a year in her practice. While anyone is susceptible to the reaction no matter where they live, Jeanette Graf MD, a board-certified dermatologist and assistant clinical professor of dermatology at Mount Sinai School of Medicine, explains that is more common among people in wooded areas and forests where plants such as weeds containing the offending chemical are found, and at beaches with restaurants or resorts where drinks are served with plants like lime and celery. She says that it is most common during the late spring and summer months, when plants are in bloom and the sun’s UV rays are the strongest.
According to Dr. Engelman, phytophotodermatitis is only caused when these plants actually touch our skin. While people can get it by having lime juice squeezed on them on the beach or at the pool, she emphasizes that people are more at risk of getting it while hiking, gardening, or participating in outdoor activities in wooded areas that are home to those offending weeds. Those who have a history of other types of contact dermatitis, or if they work or exercise frequently outdoors, she adds, may be at a greater risk for the reaction.
But don’t worry if you enjoy snacking on celery by the pool. When you’re eating them (rather than extracting their juices) Dr. Engelman says celery, citrus fruits, parsley, and fennel are totally safe. The chemical found in these plants and fruits, a.k.a. furocoumarin, is only activated when exposed to UV rays to cause phytophotodermatitis. When we eat these plants or fruits, she says the sunlight cannot activate the chemical through our gastrointestinal (GI) tract. Dr. Kourosh adds that ingesting this family of plants just causes a more generalized sensitivity to sunlight through the skin. “[This] means that if a person is out in the sun after exposure to these plants, either by ingestion or sometimes contact with the skin, it can cause irritation and sometimes hyperpigmentation,” she explains. She adds that it is possible you might be more prone to sunburn, and it can’t be predicted who will be more sensitive to sun exposure as it is dependent on the person. So, in general, it’s always a good idea to use sun protection regardless of what you’re snacking on.
What are signs that you have phytophotodermatitis?
Signs that you might have phytophotodermatitis can include skin inflammation and irritation. Dr. Kourosh specifies that the chemical reaction of these sunlight-reactive plants can cause redness, blisters, itching, or darkening of the skin where the juice of the plant has touched the skin and reacted to the sun. Dr. Engelman says this often occurs on the legs, hands, or arms, but it can happen anywhere that the skin comes into contact with the plant. She also says that generally, you’ll find phytophotodermatitis rashes in a more geometric shape versus a diffused pattern. “It looks like something got onto the skin and caused the rash versus [it] coming from within,” she adds.
How do you treat phytophotodermatitis?
If you suspect you have phytophotodermatitis, there are a couple of easy fixes to reduce the inflammation and treat irritation. Dr. Engelman recommends using a cool compress to help with the inflamed area and to help stop the itching. She also recommends over-the-counter ointments, such as aloe and calendula, or taking a lukewarm bath to soothe and help with symptoms. Dr. Graf adds that a topical steroid (or an oral option, if the case is severe) can also help. Dr. Kourosh adds that topical steroid creams like hydrocortisone will help inflammation and emphasizes the importance of using sunscreen to protect the skin from sunlight. Over-the-counter topical steroids, Dr. Engelman says, are safe to use without consulting a dermatologist and often effective for the short term. But if symptoms aren’t improving, she says to seek a professional.