Phytophotodermatitis – Plants That Cause It, How to Treat It
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I’m sharing my story here so you don’t make the same mistake I did, and end up with Phytophotodermatitis (PPD). Phytophotodermatitis is also known as plant and sun dermatitis, parsnip burn, and sometimes lime disease (not to be confused with Lyme disease) or margarita photodermatitis. You get it from exposure to plant sap or juice and sunlight, as outlined below. We’ll cover plants that cause phytophotodermatitis and how to treat it.
This was not parsnip burn from exposure to some “poison parsnip” or giant hogweed. I was working in my garden. Garden parsnips and wild parsnips are the same species, and it turns out they can cause the same problems. Several other plants can cause the problem, too.
I originally wrote this post in 2014, and unfortunately ended up with another smaller case in 2018. I thought I was being careful, but apparently not careful enough.
The pain doesn’t start until days after sap and sun exposure. By then, the damage is done, and all you can do is treat the symptoms.
What is Phytophotodermatitis?
Medscape defines Phytophotodermatitis as:
Phytophotodermatitis (PPD) is a cutaneous phototoxic inflammatory eruption resulting from contact with light-sensitizing botanical substances and long-wave ultraviolet (UV-A 320-380 nm) radiation. The eruption usually begins approximately 24 hours after exposure and peaks at 48-72 hours.[1] The phototoxic result may be intensified by wet skin, sweating, and heat.
In other words, your skin erupts with blisters and itchy, burning red areas because you were in contact with plant chemicals (in this case, parsnip and carrot sap) and exposed to sunlight.
You don’t realize you’re in trouble until several days after exposure, by which point, you’re skunked. This is one of the aspects that makes PPD different from most other contact dermatitis. If you’re working with wet plants on a hot summer day, it’s going to be worse. (That’s what happened to me.)
If you visit the Medscape website, they go into a detailed explanation of how the chemicals in the plants that cause the damage (Furocoumarins) are activated in stages under different conditions, and how they actually damage the DNA of the skin.
You cannot “wash off” phytophotodermatitis chemicals with soap and water once they are activated by UV radiation. I did shower after working in the garden, but it didn’t do any good. Washing may help limit additional damage.
Is Phytophotodermatitis contagious?
Nope. Only those directly exposed to the problem plants and conditions experience skin reactions.
The only case that might be an exception is berloque dermatitis, a special type of phytophotodermatitis caused by perfumes. There are older perfumes that used oil of bergamot. (Bergamot is one of the citrus fruits that can trigger PPD.)
If one person applied the problem perfume and was in close contact with another person, they might spread the perfume – and the skin condition. It’s unlikely, but possible.
Which Plants Cause Phytophotodermatitis?
Here’s a kicker – there are wide range of plants that can cause this condition that you might never suspect.
Plants that may cause phytophotodermatitis include (but are not limited to):
- Parsnips (Pastinaca sativa)
- Carrots (Daucus carota subsp. sativus)
- Celery (Apium graveolens)
- Gas plant (Dictamnus albus)
- Parsley (Petroselinum crispum)
- Wild Parsnip (Pastinaca sativa)
- Queen Anne’s Lace (Wild Carrot) (Daucus carota)
- Giant Hogweed (Heracleum mantegazzianum)
- Limes (Citrus × aurantiifolia)
- Figs (Ficus carica)
- Chrysanthemums – Chrysanthemum genus, aster family
- Common Rue (Ruta graveolens)
- Russian sage (Perovskia atriplicifolia)
Those who are into botany will notice that the top six plants on the list are all related to each other (they are members of the Apiaceae family). Some of you may have also heard about getting blisters from wild parsnip or poison parsnip, but may not have realized the garden parsnips can also cause burns. Garden parsnip and wild parsnip are both different varieties of the same species – Pastinaca sativa. The veggies typically cause burns on agricultural workers and grocers, who handle large quantities of plant material.
The Medscape site shows a rather nasty blister that covers about 1/3 of the forearm of a flight attendant who spilled lime juice on her skin. The phytophotodermatitis from limes is also referred to as “margarita dermatitis” because of all those poor folks who have sucked on their limes in the summer sun.
The wild parsnip burns (and those from other wild plants like hogweed or queen Anne’s lace) can be some of the worst, because people do terrible things like running weed whackers with shorts on and get their legs all covered with little bits of parsnip (and sap), like the poor guy featured in the article “Burned by Wild Parsnip” in Wisconsin Natural Resources magazine. The photo below is as example of how large the blisters can get.
I’m Going to Stop Growing “Poison Parsnips” Because They’re Too Dangerous
No. I’m not. I’m not skipping the carrots, parsley or celery, either.
In all my years of gardening, these past couple of decades on my own and helping mom out growing up, I’ve never been burned by garden parsnip before. I did get about an inch long blister from wild parsnip, but none from garden parsnip.
Here’s what I screwed up:
I was working in the morning, so the plants were covered in dew. More moisture = wet skin.
It was hot, so I was sweating = more wet skin + heat, both triggers for phytophotodermatitis.
The area I was working on was roughly 80 square feet, very thickly planted, mostly with carrots and parsnips. I had thinned and weeded the patch when the plants were younger, but this round of thinning took place when the plants were a couple feet tall.
The only way to reach the roots to pull them out was to stick my arm into lots of foliage. (Lots of exposure.) I gathered up the bundles of plant tops after removing the roots with my bare arms. (More exposure.)
By the time I finished, it was pushing midday, with a bright, beaming blue sky = lots of nice, intense sunlight.
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In my 2018 case of phytophotodermatitis, I allowed queen Anne’s lace to grow in the greenhouse as companion plants for the tomatoes. I was trying to thin them out as the greenhouse became more crowded. It was hot, humid and sunny. I must have broken some of the stems, and got the sap on my hands and feet.
What I Should Have Done:
The simplest thing I could have changed was to wear long sleeves and gloves to cover up my skin. Problem solved.
Alternatively, not handling the broken plants with bare skin, or thinning harder when the plants were small so I didn’t need to stick my arms into a thicket would probably also have done the trick. That said, we have been enjoying the carrots and parsnips I picked. 🙂 No more wild carrots in the greenhouse. It’s simply too easy to get accidental exposure while working around the plants in close quarters.
How do you Treat Phytophotodermatitis
Like a standard burn, you can apply cool compresses to relieve the pain, and try to keep blisters intact as long as possible to protect the tender skin underneath. Over the counter itch cream like those for poison ivy may also help, along with anesthetic creams like Aspercreme.
I hit the pantry and the garden for treatment options.
On the first couple of blisters, I used fresh plantain and yarrow leaves, mashed and applied as a poultice. As more blisters showed up, I coated the worst blisters with manuka honey to promote healing and fight infection. You can read more about using honey for wound treatment in the post, “Honey as Medicine“. With over 30 blisters on my arms and hands, the honey was a little awkward to try and use on all of them, so I made up some comfrey salve with lavender essential oil.
I coated the burns several times per day with the salve, and at one week after exposure, some of the scabs fell off to expose new skin underneath. The burns on my hands and elbow didn’t heal quite as fast. My hands spend way too much time being beat up during canning and gardening season, so I can’t keep bandages on them, and the elbow is just awkward to keep bandaged.
Be patient. Badly affected areas may take weeks to months to heal, depending on the damage. I still have dark areas on my skin a year after exposure from the worst spots.
Comfrey and Lavender Salve Recipe
Adapted from the Herbal Academy
Ingredients
- 1 cup organic extra virgin olive oil
- 50 drops of lavender essential oil
- 1 ounce organic dried comfrey leaf
- 1 ounce beeswax
Directions
- Pour olive oil into a double boiler or small, heavy bottom pot. Add comfrey leaves.
- Heat over low heat for 60 minutes, stirring occasionally. You’re looking for gentle heat, not boiling.
- Remove from heat. Strain and compost comfrey, reserving infused oil.
- Melt beeswax in a clean pan over low heat.
- Once melted, add herbal infused oil and lavender essential oil. Mix well.
- Quickly pour salve into tins or glass jars and allow to cool before placing lids on and labeling.
The HANE website notes that “Comfrey contains allantoin, an anti-inflammatory phytochemical that speeds would healing and stimulates growth of new skin cells.” The HANE burn cream recipe also includes one ounce each of dried plantain, calendula and St. John’s wort to bump up the healing power a little more.
Photos of Phytophotodermatitis
Just so you can see how the eruptions progressed, I’ve included some comparison photos of the affected skin below. The image at the top of the post is my left elbow on day three after exposure. 24 hours earlier (48 hours after exposure), there was only one blister.
My left hand at day 3 and day 7 after exposure. Day seven may not look much better, but it feels much better. No more burning and itching.
One last shot. A blister on my right arm that was one of the first to appear that I treated with a plantain poultice followed up by a day of honey and ongoing use of the comfrey salve.
Don’t fear the plants, just don’t handle them in such a way that you set yourself up for some serious discomfort. Learn from my mistakes. 🙂
July 2019 – I’ve run into this again. After helping to clear an overgrown area near the greenhouse in shorts and a t-shirt, I ended up with blisters on my arms and legs. I didn’t see any queen Anne’s lace or other trigger plants, but they must have been in the mix.
I suspect repeated exposure may make you more likely to have a skin reaction.
The video below highlights this year’s exposure. (Make sure any ad blockers are off to get the video to display.)
You may also find useful:
- 9 Home Remedies for Dry Skin – Soothe Dry and Flaking Skin Naturally
- Grandma Called it Medicine Leaf
- Herbal Antibiotics – the Top 15 Herbal Antibiotics
Originally posted in 2014, updated in 2018.
Oh my goodness!! I am SO grateful to have found this site, and had the opportunity to glean from Laurie’s experience and advice. I Have been to 5 Dr’s one naturopath in the last 6 days. I was pruning and cleaning up old barberry, haydrangea, yukka, roses and other garden shrubs on the hottest day we’ve had so far this spring. After a shower, I enjoyed a long hot tub (and a lime margaritas LOL) and two days later broke out in about 10 red itchy spots in the crease of my left arm and forearm. I took a bleach bath. Over the next 4 days the very itchy ‘rash’ spread face to feet, red angry pigmentation, and eventually formed small oozing pimple like sores, some on my left foot have blistered quite badly. I’m on day 8 today. I’ve been put on cortisone cream and two strong antibiotics – which I am feeling very defeated about cause I know it’s wiping out my but and microbiome flora – which I work hard to keep healthy. No answers made sense (scabbies, staph or strep bacterial infections, shingles…) until the last dr came in and said, “oh yes, I just had another patient with the same thing – phytophotodermatistis” they put me on prednisone, and told me to stop the antibiotics and cortisone cream. The prednisone seemed to help reduce the redness a little and seems to have ‘mostly’ stopped new clusters of itchy popping up. I feel like a guinea pig, and the ironic thing is the morning my red itchy spots first appeared, I was starting my month long parasite, liver, metals, yeast and mold cleanse, launched it with a 2 day water fast. I had hopes that the fast at least would support my immune system to flush whatever what was in my system. It was just so odd how it wasn’t just localized, but as many others have shared, the ‘rash’ blisters spread systemically – in different parts of the body??? Any odeas on this, as opposed to only manifesting where the toxin was in contact with skin? So grateful for your site, love to hear any feedback or suggestions, and how to decrease scaring or darker pigmentation as it’s all over my arms, back and feet , hmmmph.
The information on phytophotodermatitis online is so sparse, it’s like everyone is copying off each other’s papers, and almost none of them have actually dealt with the condition.
I wonder if the bath might have spread the oils all over your body? I know that showering doesn’t get rid of it, so it makes me wonder if soaking might spread it?
Flipping doctors want to bludgeon everything with a sledgehammer. Lidocaine cream takes the pain level down if it gets too bad, or you can make up the comfrey and lavender salve, or a plantain and lavender salve. Cold packs help, too.
In my experience, all of it fades with time, even the scarring. Some topicals that might speed up the process include vitamin E, honey, comfrey salve, plantain salve, and aloe vera. There are also tons of different scar creams on the market. I’ve used honey, plantain, and comfrey.
Nurture you microbiome with as assortment of live culture foods, time working in good quality soil, and outside time in general. Contrary to popular dogma, we do need sun exposure, but you’ll want to be gentle with it while you heal.
It’s funny/not funny how we make plans to tackle one thing, and end up dealing with something else entirely. I hope your skin heals quickly. PPD is the pits.
I feel for all of you. late spring of 2022 I did everything a person could possibly do to cover much of my body with hogweed sap and mash.. I haven’t touched a weed whacked since. when I contacted Worksafe BC for answers they were very giving. At 63 yrs of age, and the massive amount of skin exposed to this chemical, their data base estimated my recovery time to be 4 to 10 years. They commented that the morbidity of this affliction was near the top of the scale.
I won’t burden you with my misery except to say I dont know how anyone could stand this torture. The only advise I was given was to avoid these plants completely. The hospital told me not to come in unless a secondary infection was brewing. There is really nothing out there to relieve the symptoms and no quick fix. The scientists know of only one little worm that chews Parsnip leaves, that has evolved to process this toxin with zero negative effects. oh they also couldn’t find an atomic half life for it. so once you’ve reacted as it seems we all have, you could pick up some dead yard litter and burst out again. I have keloid type scars all over the back of my calves, big hard bumps with no doubt some toxin encased in it just waiting to ruin my day. im healing. But im not healed yet. I feel self concious to show my skin, I toss my clothes every 6 mths or so because it attaches to the frayed seams in the washer and gets on me that way.. I try to feel sorry for myself on Thursday mornings between waking and 10 a.m. I cry about it and curse it out a lot. its too late for us but we can warn everyone we know so that they may be spared this nightmare. oh and two people have died from it. one fellow with type 3 diabetes and a young girl in New York State. not sure what her compli,cation was. I pray you all get through this and never ever get hurt by it again
Hi Sandra.
So sorry you are having to deal with this, especially such a severe case. I have found that Lidocaine cream dulls the pain some. I’m wondering if you could use oatmeal baths or bentonite clay to help draw out the toxins.
Thank you kindly for sharing such important information. I remember exactly when this event occurred in my garden handling celery mid-day and staying in the sun walking my dog after. My rash seems to be a bit different though. The blisters seem to appear randomly on different body parts. Even on my skull under my hair. The worst was on my face and neck. I had blisters on my fingers and hands as well. It is more spread out. I have found a new cluster daily for 4 days now. There is no pain, and the itching was managed with calamine lotion. Strangely, I got the flu the same day. At first, I thought it was poison ivy given to me by my dog. We have not found any poison ivy on the property. I found your information during my research. Thank you very much <3
I hope your skin heals quickly.
I am over 70 and have worked in the garden all my life. I have never had anything like
phytophotodermatitis (always grow lots of carrots). I always break the tops off with my hands when harvesting to feed to the horses and have never had any kind of reaction. The closest I have ever had is poison ivy and a reaction t o plant sap.
Is it possible that you and those who get this are allergic to the carrot sap? I once got a little sap on my wrist from a tropical plant and developed small spot of itchy blisters. I just figured I was allergic to the sap from the plant. Otherwise I have never had anything like it since (other than the poison ivy). The poison ivy occurred a few times when I was a kid but as soon as learned to identify it and remember to watch for it, I never got it again.
I am thankful for this post and will be more careful around the carrots. We all can develop allergies during our life time.
It’s definitely more than a straightforward allergy, but it does seem like some people are more sensitive to it. It also requires very specific conditions to trigger the blisters. I’d worked around carrots for decades with no issues, until I got in just the right conditions to run into trouble.
Can exposure to tomatoe plants cause this? And can it stay on you for a year? Last summer I broke out with blisters after being in the tomatoe plants. nothing would heal it. The Doc gave me steroid creme which helped but didn’t get rid of it. It burns, stings and itches at times. Lately it seems to be spreading. It’s been 10 months. Doctors can’t answer what it is. I have appointment with dermatologist but not till June.
Tomatoes don’t cause phytophotodermatitis, but they can trigger contact dermatitis. Dermatitis is basically a fancy way to say “skin inflammation by contact with something”. (Derma = skin, itis – inflammation)
Typically, contact dermatitis resolves within hours, or at the very most, days – once you’re out of contact with problem material. Since you’re still dealing with irritation months later, something is keeping your immune response in overdrive.
Our skin is our body’s largest organ, and our main detox organ. If there’s an ongoing flare up, things are working in the body quite as they should. Your dermatologist may give you a diagnosis of dermatitis, psoriasis, eczema, or something else, but in the end you need to do the healing, and topical creams can’t address everything.
I’d start with making sure that standard detox pathways are clear. Reduce or eliminate antiperspirant use. (Deodorant is okay.) Encourage sweating through exercise, detox baths, or IR sauna. If you can tolerate the sun (and have access), outside time in heat is good, too. If sun exposure makes the itching worse, avoid it.
If you have access to a rebounder (mini trampoline), use it. Rebounders are great for getting the lymphatic system moving to clear out waste.
Look at your diet and lifestyle. Any chance of food allergies or sensitivities, or extra stress lately? How frequently do you urinate and have bowel movements? There is so much garbage in our food supply that passes for food but isn’t good for our bodies.
Have you noticed more spraying in your area? Some municipalities now spray for mosquitoes and other pests, which leaves chemical residue for everything and everyone else, too. There’s also been more aerial spraying. Our skies look like a checkboard some days.
Have you made any changes in medications? Sometimes adding and eliminating medications can trigger skin reactions.
I dealt with psoriasis in 2015, 2016, and 2019, and am happy to say that my skin is now clear, but it took some time. At one point the itching and redness was so bad that I looked like a burn victim. After the main outbreak cleared, I had a brief relapse on my hands after I went off my medication.
My skin story and how I cleared it starts here – https://commonsensehome.com/psoriasis-the-year-my-face-exploded/
I’m wondering the same thing. I came in contact with tomato plants last September and everywhere the plant touched was itching and had blisters. I went in the garden in a sleeveless top and shorts. My arms, thigh, and elbows are scarred. I too got a steroid cream that didn’t really help. I had to use calamine every night and that’s what gave me relief. I too have an appointment at the dermatologist in June. Nothing seems to get rid of this scarring.
As noted, that’s likely contact dermatitis, but it’s unusual that it would last that long. Plantain leaves, jewelweed, chickweed all have soothing and drawing properties and may be of help if you have any of them available for a poultice.
Wonderful advice. Wonder if anyone else tried applying stinging nettles to the area. That worked for my husband who had been affected numerous times.
Interesting. I’ve heard of stinging nettles for arthritis, but not phytophotodermatitis. How did he apply them, as a poultice?
Tecnu. Helps better than anything to get the sap out of the skin.
I see that it’s listed as a poison ivy soap. Does it help after blisters show up, or only to remove sap after initial exposure, before blisters show up?
I got skin blister and itchiness from contact with lime tree and sun exposure, while trimming lime tree without shirt on. I noticed the reaction only on my bare chest, back, and not any other part of my bare skin, arms and hands.