You'd expect to wake up with maybe a hangover after an afternoon of margaritas, but one woman's holiday cocktail left her with painful second-degree burns on her hands due to a reaction caused by lime juice and sunlight.
"I was just confused. I was freaking out," Ashleigh Booth, who is from NSW and detailed her story on TikTok, told Yahoo News Australia.
"[My family] thought I was having an allergic reaction. We couldn't quite figure it out."
The 23-year-old was diagnosed with phytophotodermatitis, a skin condition caused by a reaction found in several chemicals contained in some fruits and plants. The reaction left her hands in such a painful condition she was unable to even dress herself.
Ms Booth, who has worked as a bartender for five years, was making the drinks for her family on their Byron Bay property on Boxing Day, juicing the limes, making the drink, then taking them out to the pool and having a swim.
"I was in the sun for most of the day doing that back and forth," she said.
"I was washing my hands in the meantime, but obviously not thoroughly enough."
Hands swelled to the size of her face
When Ms Booth woke up the next morning, her hands were red and swollen, which got progressively worse throughout the day.
"I'm not allergic to anything that I know of, so we were just kind of wondering if I [was bitten] by a spider if I brushed against a plant," she said, adding she tried to retrace her steps in case she was bitten by something or came across a poisonous plant.
"[We] had no idea what was going on," she continued.
"Then I woke up on Tuesday morning and I was in a lot of pain and [my hands] were really swollen — almost the size of my face — so I went to the hospital."
At the hospital, she was given an antihistamine in case it was an allergic reaction and then sent home.
It wasn't until a friend of her neighbour, who is a doctor, identified the burn later that day that she realised the reaction was caused by lime juice and sun exposure.
"[I thought] that doesn't seem right," she admitted.
"Because I juice limes every day by hand in the bar around five times a week so it was crazy to me."
She returned to the hospital where they gave her antibiotics for a bacterial infection, ibuprofen and burn cream.
The burns on her hands eventually blistered which Ms Booth said was extremely painful before drying out.
"My hands looked like they were 150 years old after they dried out," she joked.
"Then it peeled off and now it's just kind of fresh skin.
"I couldn't dress myself or shower myself because I couldn't get them wet, I couldn't go in the sun, I couldn't cook; I couldn't really do anything that involves my hands for quite a few days," she explained.
Although not fully healed, Ms Booth can now do most things for herself again almost two weeks after she had the reaction.
"They're not as sore," she said. "I've got vitamin E oil... to reduce scarring and I'll have pigmentation for a while."
What is phytophotodermatitis?
Phytophotodermatitis, known colloquially as 'margarita burn', is a skin condition that occurs after exposure to certain plants in the sun.
"There are certain groups of plants [that] have chemicals within them which make us the most sensitive to the sun," Dr Deshan Seberatnam, a dermatologist and Conjoint Senior Lecturer at UNSW, explained.
"They're called furanocoumarin and there's lots of different types of them, but pretty much these chemicals make your skin more sensitive to the sun," he continued.
"Classic examples are limes or lemon.
"Pretty much... your skin becomes really, really sensitive to the sun and a little bit of sun — which would not normally even cause a sunburn — suddenly causes this massive kind of toxic reaction [on] the top layer of your skin."
Dr Seberatnam said the severity of the burns could vary, with some people experiencing an itchy red rash and other reactions leaving scars.
"[Some] get blistering on top, depending on how bad the rash and you can have scarring," Dr Seberatnam said.
"One of the other things that often happens is you can get some pigment changes.
"You can get stains to the skin and damage to the skin and that can last for months, but it's not something that normally [results in a] a lifelong problem."
Dr Seberatnam advises to wash lime or lemon juice off your skin under running water and avoid the sun.
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