Brief Reports
Accidental bullous phototoxic reactions to bergamot aromatherapy oil☆

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Abstract

Oil of bergamot is an extract from the rind of bergamot orange (Citrus aurantium ssp bergamia) that has a pleasant, refreshing scent; until a few years ago it had been widely used as an ingredient in cosmetics but was restricted or banned in most countries because of certain adverse effects. More recently, oil of bergamot preparations have been gaining renewed popularity in aromatherapy. Oil of bergamot possesses photosensitive and melanogenic properties because of the presence of furocoumarins, primarily bergapten (5-methoxypsoralen [5-MOP]). However, 5-MOP is also potentially phototoxic and photomutagenic. Despite its increasing application, there are only a few recent reports of phototoxic reactions to bergamot aromatherapy oil. We describe two patients with localized and disseminated bullous phototoxic skin reactions developing within 48 to 72 hours after exposure to bergamot aromatherapy oil and subsequent ultraviolet exposure. One patient (case 2) had no history of direct contact with aromatherapy oil but developed bullous skin lesions after exposure to aerosolized (evaporated) aromatherapy oil in a sauna and subsequent UVA radiation in a tanning salon. This report highlights the potential health hazard related to the increasing use of psoralen-containing aromatherapy oils. (J Am Acad Dermatol 2001;45:458-61.)

Section snippets

Case 1

A 54-year-old woman of Fitzpatrick skin type III presented with painful, red, edematous, sharply demarcated areas with bullae and crusting on the face in a butterfly-like distribution (Fig 1).

. Case 1. Facial phototoxic reaction, with red, edematous, sharply demarcated lesions displaying butterfly-like distribution. The patient holds the bottle containing the bergamot aromatherapy oil preparation that she had used.

She gave a history of having unsuspectingly used a bergamot aromatherapy oil

Discussion

The use of aromatherapy oil has increased in recent years, primarily because of a growing interest in aromatherapy, a form of alternative medicine involving application of essential oils often in combination with massage to achieve therapeutic effects.9 Despite the growing popularity, to our knowledge there are only two reports documenting accidental phototoxicity to oil of bergamot-containing aromatherapy preparations.4, 10

Phototoxic reactions in our two cases developed within 48 to 72 hours

Acknowledgements

We thank Dr W. Ramer (Gerot Pharmazeutika, Vienna, Austria) for performing HPLC analysis on 5-MOP levels of the oil of bergamot preparation.

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Copyright © 2001 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.