Garlic (Allium sativum)-Induced Chemical Burns-A Current Review of Treatment Techniques and a Case Report

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Abstract
Garlic (Allium sativum) is widely known for its cardiovascular, antimicrobial, and potential anticancer properties. Despite these benefits, topical application may lead to adverse effects, including allergic reactions, anticoagulant effects, and chemical skin burns. Such burns are rare and under-recognized. This systematic review synthesizes the available clinical evidence on garlic-induced skin burns and complements it with an illustrative case to support clinical decision-making. A systematic PubMed search was conducted to identify clinical reports of garlic-induced skin burns with documented treatment and outcomes. Inclusion criteria comprised case reports or clinical studies on cutaneous garlic burns with available clinical intervention and outcome data. Exclusion criteria included studies published before 2000, non-English publications, mucosal or oral burns, animal or in vitro studies, review articles and editorial texts without patient data. In total, 45 studies were screened and 18 studies met the inclusion criteria. Extracted variables included patients' demographics, burn depth, treatment modality, and healing course. Additionally, a case of a woman with deep dermal, circumferential burns of the knee following the self-application of crushed garlic under occlusion is presented. Most reported cases involved superficial to deep dermal burns caused by prolonged or occlusive garlic application. Conservative treatment-topical antimicrobials, corticosteroids, and advanced dressings-was effective for superficial burns. However, deeper injuries often required surgical intervention including debridement, and in selected cases, split-thickness skin grafting. Healing times ranged from 7 to>56 days, with surgical management associated with faster recovery in deep lesions. Garlic-induced burns represent an uncommon but clinically relevant chemical injury. Prolonged occlusion increases risk for deep dermal necrosis. Early recognition and appropriate surgical management may optimize outcomes and prevent complications. Increased clinician awareness and patient education are essential. Due to heterogeneous case-based evidence, further research is warranted to inform standardized treatment guidelines.

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