Plant and Sun Dermatitis (Phytophotodermatitis)
Plant and sun dermatitis (phytophotodermatitis) is an inflammatory reaction of the skin. It occurs after contact with the leaves and stems of certain plants, followed by sun exposure. It starts with a burning feeling. This is followed by a red rash. Sometimes there are blisters. This starts about 24 hours after exposure. The rash gets worse over 1 to 3 days, then symptoms start to get better. There is often no itching. The rash can't spread from person to person. If you are not able to link the skin reaction to a plant, it could be from medicines that have photoallergic reactions. These include some sunscreens, nonsteroidal anti-inflammatory drugs (NSAIDs), or antibiotics. A certain form of plant and sun dermatitis called berloque dermatitis is caused by exposure to perfumes.
As symptoms get better, the rash may look darker or lighter for weeks or months before it fully fades. Sometimes these color changes are lifelong (permanent).
This skin reaction is not an allergic or immune reaction. It is a reaction between the plant substance and the skin cells. Sunlight is needed to start the reaction. The lining of the skin cells is damaged. The cells die and flake off (like a bad sunburn).
The plants that cause this reaction are found all over the U.S. and the world. They include meadow grass, parsley, carrots, parsnip, celery, limes, fig leaves, lemon, mustard, and chrysanthemums.
Treatment includes washing the skin to remove any remaining plant oils, staying out of the sun during the acute phase of the rash, and treating symptoms.
The following guidelines can help you care for yourself at home:
On the first day, use ice packs to relieve severe pain. Some over-the-counter first-aid creams and sprays contain an anesthetic which also relieves pain. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel. Don't put ice or an ice pack directly on the skin.
If a dressing was applied, change it once a day. If the bandage sticks, soak it off in warm water.
Wash the affected area every day with soap and water. Pat dry with a clean towel. Use hydrocortisone cream to help with inflammation.
You may use acetaminophen or ibuprofen to control pain, unless another medicine was given. If you have chronic liver or kidney disease or ever had a stomach ulcer or GI (gastrointestinal) bleeding, talk with your healthcare provider before using these medicines. Don't use ibuprofen in children younger than 6 months.
If you know what plant caused your reaction, stay away from this plant in the future.
Follow up with your healthcare provider, or as advised. The skin often heals without infection. Sometimes an infection may occur even with correct treatment. Watch for the signs of infection listed below.
When to get medical advice
Call your healthcare provider right away if any of these occur:
Increasing redness, swelling, or pus coming from the wound
Fever of 100.4°F (38ºC) or higher, or as directed by your provider