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A Canadian mom is warning others about the dangers of "margarita burn" after her seven-month-old daughter was left with burns and blisters from chewing on a celery stalk.
Reanna Bendzak, from Kamloops, B.C., recently shared photos of her infant daughter with painful-looking burns around her mouth on social media. In the now-viral post, Bendzak aimed to "raise awareness" of a burn-like skin reaction called phytophotodermatitis — also known as margarita burn, margarita dermatitis or lime disease.
"Our 7-month-old was chewing on celery while enjoying the sunshine to help soothe her teething gums," Bendzak wrote.
In the post, the B.C. mom shared eight photos of her daughter's mouth over a seven-day period, each with varying degrees of blisters and red, rashy skin.
Celery, which contains naturally-occurring compounds called furanocoumarins, can trigger intense skin reactions when combined with UVA ultraviolet rays.
"It's not an allergy, but an accidental contamination of the skin with the juice or sap from a list of plants," explains Toronto dermatologist Dr. Julia Carroll.
Celery, carrots, citrus fruit, including limes, grapefruits and lemons, figs, peppers, dill, parsley and parsnip all contain furanocoumarins.
Skin reactions typically become visible 24-48 hours after exposure to UVA rays. Bendzak's daughter developed burns and blisters within 30 hours.
"It was second-degree burns all around her mouth — it had intense swelling, as well, which, of course, makes it difficult [for her] to eat or nurse," she told CBC's Daybreak Kamloops.
What is phytophotodermatitis — 'margarita burn?'
Phytophotodermatitis is a skin reaction that occurs when natural photosensitizing chemicals — furanocoumarins — linger on the skin and become exposed to ultraviolet light.
Skin can become itchy and red, and experience painful blisters, burns, inflammation, and tenderness.
It's a "super sunburn," Carroll explains.
Once the acute reaction subsides, the leftover hyperpigmentation may take weeks or months to heal.
"She is healing well, but we now have a long road of hyperpigmentation and scarring to treat," Bendzak wrote.
Why is it called margarita burn?
Phytophotodermatitis is commonly referred to as a margarita burn or any similar play on words because, as Carroll explains, it's often people who enjoy a margarita on a sunny day who learn the hard way that its consequences may go beyond a hangover.
"The very common scenario is that the lime from the margarita gets dripped on your legs, or you get it on your hands," Carroll says. If the juice is left to linger in the sun, it may turn into a "very, very dark tan, or sometimes it looks like a rash" that can peel and blister.
How can you prevent margarita burn?
While scary, Carroll says the threat of margarita burn is no reason for someone to give up their summer cocktails.
"If you get lime juice and you're going to be out in the sun, just make sure you wash your hands and wash anywhere the lime juice got onto the skin and then reapply your sunscreen," she says. "You should be fine."
How is margarita burn treated?
Depending on the severity of the burn, treatment of phytophotodermatitis will vary.
Someone experiencing a minor reaction may opt for a cold compress and anti-inflammatory medication, like Advil, to relieve the pain.
If someone is experiencing severe phytophotodermatitis, they may require medical attention to reduce the risk of secondary infection.
"If it's in the red blistery inflamed stage, I'll often give [patients] a prescription cortisone cream just to calm it down and reduce the risk of hyperpigmentation," Carroll explains.
"If it's been a few weeks and it's just at that hyperpigmentation phase, it just takes time to fade away."
At this stage, "the only thing to do is wait," avoid further sun exposure, and use sunscreen on the area," she says.