Fragrance Allergies: Are Scents The Culprit?

Fragrances are everywhere, from air fresheners and cleaning products to body washes and perfumes. While they aim to make things smell better, they can also cause unwanted side effects such as headaches, rashes, sneezing, and coughing. Fragrance allergies are a common issue, with about 2.5 million Americans affected, according to the American Academy of Dermatology (AAD). Fragrances can affect both your nose and skin, causing cosmetic contact dermatitis, with symptoms ranging from itching and redness to blisters and swelling. Even natural fragrances, like strong-smelling flowers, can trigger migraine headaches or asthma attacks in some individuals. Fragrance sensitivity, on the other hand, is different from a true allergy as it irritates the airways and eyes without involving a whole-body immune response. This sensitivity can lead to symptoms like a ticklish nose, watery eyes, and coughing. Understanding and managing fragrance allergies and sensitivities is crucial for maintaining overall health and well-being.

Fragrance sensitivity vs. allergy

Fragrance sensitivity and fragrance allergy are two different things. Fragrance sensitivity is when your airways are irritated by ingredients or chemicals in natural or manufactured scents. On the other hand, a fragrance allergy involves an immune response in which a protein called immunoglobulin E (IgE) sets off a chain reaction that leads to allergy symptoms.

Fragrance Sensitivity

Fragrance sensitivity can happen to anyone but is more likely if you have asthma or allergies. Symptoms of fragrance sensitivity generally develop within minutes of exposure to a scent and can last from a few minutes to several hours. The triggering scents can differ from person to person, along with the severity of the symptoms, which tend to be worse the longer the exposure or the stronger the scent.

Symptoms of fragrance sensitivity include:

• A ticklish feeling in your nose
• A raw or burning sensation in the nasal passages
• Watery, itchy, or red eyes
• Nausea and dizziness (after extended inhalation of a scent)
• Contact irritant dermatitis (after direct skin exposure to a substance like perfume)

Fragrance Allergy

A fragrance allergy is a chronic condition involving abnormal immune reactions to ordinarily harmless substances in fragranced products. A fragrance allergy typically occurs when certain fragrance components called allergens come into contact with the skin, causing the immune system to react by making protective proteins called antibodies to defend against the allergens.

Symptoms of a fragrance allergy include:

• Skin reactions such as a rash, hives, or blisters
• Itchy, burning, or tender skin
• Hyperpigmentation (patches of skin that are darker than usual)
• Respiratory symptoms such as a feeling of suffocation or a stuffy or runny nose
• In rare cases, a severe allergic reaction called anaphylaxis, which can be dangerous and requires immediate medical attention

Diagnosis and Treatment

The best way to determine whether you have a fragrance sensitivity or a fragrance allergy is to see a physician and undergo a skin patch test.

The treatment for fragrance sensitivity and fragrance allergy is similar and involves avoiding offending fragrances and irritants. Over-the-counter medications can also help treat the symptoms, including pain relievers, nasal decongestants, and antihistamines. Topical treatments such as steroid creams and colloidal oatmeal baths can also be used to soothe and treat skin reactions.

Symptoms of fragrance allergies

Skin Symptoms:

• Allergic Contact Dermatitis (ACD): Fragrance allergies often cause allergic contact dermatitis, resulting in an itchy rash on the skin that has been in direct contact with the allergen. This can occur on the face, hands, neck, lower legs, or armpits. The rash may be scaly and erythematous (red and inflamed) and can be very uncomfortable. Continued exposure may lead to chronic dermatitis with lichenification and excoriation.
• Swelling, Burning, and Tenderness: Fragrance allergies can cause swelling, a burning sensation, and tenderness of the skin. In some cases, there may be vesicles, bullae, or blistering, which can be severe and mimic burns.
• Hyperpigmentation: People with darker skin may experience patches of skin that are darker than usual, known as hyperpigmentation.

Eye Symptoms:

• Redness and Irritation: Fragrance allergies can cause extreme redness and irritation of the eyes, making them watery and causing a burning sensation.
• Swelling of Eyelids: The eyelids may also become swollen due to the allergic reaction.

Respiratory Symptoms:

• Sneezing and Nasal Congestion: Inhaling strong fragrances can trigger sneezing, a runny or stuffy nose, and nasal congestion.
• Headaches: Fragrances can induce headaches, which may be triggered by strong smells or aromatic compounds.
• Breathing Difficulties: In some cases, individuals may experience breathing difficulties when exposed to strong fragrances or air fresheners.
• Anaphylaxis: Although rare, severe fragrance allergies can lead to anaphylaxis, a life-threatening allergic reaction. Symptoms of anaphylaxis include difficulty swallowing, a rapid or weak pulse, and severe respiratory distress.

Common fragrance allergy triggers

Fragrance allergies are a common form of allergic contact dermatitis, affecting around 1% of adults and 1.8% of children and adolescents. Fragrances are found in a wide range of products, from perfumes and cosmetics to cleaning supplies and air fresheners. Here are some common triggers of fragrance allergies:

Soaps, Detergents, and Cleaning Supplies

Common household products such as soaps, detergents, and cleaning supplies often contain fragrances that can trigger allergies. This includes laundry detergents, fabric softeners, dishwashing soap, and all-purpose cleaners.

Perfumes and Colognes

Perfumes and colognes are obvious sources of fragrance allergens. Even brief exposure to perfumes can cause allergic reactions in sensitive individuals, leading to symptoms such as itching, rashes, and respiratory issues.

Lotions and Deodorants

Personal care products like lotions and deodorants can also contain fragrance allergens. These products are often applied directly to the skin, increasing the risk of allergic contact dermatitis.

Air Fresheners and Scented Candles

Air fresheners and scented candles are intended to improve the scent of a space, but they can be a significant trigger for fragrance allergies. The chemicals released into the air can cause respiratory issues and skin irritation.

Fabric and Clothing

Certain types of fabric and clothing can also trigger fragrance allergies. This includes scented laundry detergents or fabric softeners that leave a fragrance on clothing, as well as scented dryer sheets.

It's important to note that even products labelled "unscented" or "fragrance-free" may still contain fragrances used to mask other chemical odours. To truly avoid fragrances, look for products labelled as "without perfume" or "fragrance-free."

How to treat fragrance allergies

Fragrance allergies can be extremely disruptive, especially if you live or work with people who wear perfumes or colognes. However, there are several ways to treat and manage the condition.

Identifying the Allergen

The first step in treating a fragrance allergy is to identify the specific allergen causing the reaction. This can be challenging, as fragrances can be complex mixtures of many different chemicals, and manufacturers are not required to disclose all ingredients. Patch testing by a healthcare professional can be helpful in identifying specific allergens, but it may not always be comprehensive. Keeping a diary of when and where symptoms occur and what fragrances were present can also aid in identifying triggers.

Avoidance

Once the allergen is identified, the best way to manage fragrance allergies is to avoid exposure to the substance. This may involve:

• Asking others in shared spaces, such as offices, to refrain from wearing strong fragrances.
• Using fragrance-free or unscented products, although it is important to note that "`unscented`" products may still contain fragrances to mask unpleasant odours.
• Using natural cleaning products or making your own with ingredients like baking soda or white vinegar.
• Using air purifiers or opening windows to improve air circulation.

Medication

In addition to avoidance, certain medications can help treat the symptoms of fragrance allergies:

• Topical corticosteroid creams, such as hydrocortisone, can be applied to itchy areas or rashes.
• Oral antihistamines, such as cetirizine (Zyrtec), diphenhydramine (Benadryl), or loratadine (Claritin), can help with itching and stuffiness.
• Colloidal oatmeal baths or compresses can soothe itching and inflammation.
• Inhaled corticosteroids can be prescribed to alleviate symptoms.
• Decongestants or steroid nasal sprays may be recommended by a doctor.

Medical Attention

For severe reactions, such as anaphylaxis or swelling of the mouth, lips, or tongue, seek immediate medical attention.

The chemicals in fragrances

Some of the common chemicals found in fragrances include phthalates, aldehydes, parabens, and aluminum-based salts. Phthalates are a family of chemicals known to mimic hormones in the body and are often added to fragrances to help smells last longer. Aldehydes, such as acetaldehyde, can adversely affect the kidneys, reproductive system, nervous system, and respiratory system. Parabens, such as methyl paraben and butyl paraben, are used as preservatives in cosmetics and have been linked to endocrine disruption and reproductive issues. Aluminum-based salts are used as antiperspirants and have been associated with breast cancer.

Other chemicals found in fragrances include limonene, ethanol, acetone, and benzene. These chemicals can have a range of effects on the body, including respiratory issues, skin allergies, and damage to the nervous system. Fragrances can also contain essential oils, which may contain allergens and can have the same allergic effects as synthetic fragrances.

The combination of these chemicals in fragrances can lead to a range of health issues for consumers, including allergies, skin irritation, respiratory problems, and even more serious conditions such as cancer and endocrine disorders. It is important for consumers to be aware of the potential risks associated with fragranced products and to choose products with transparency in their ingredient lists.

Frequently asked questions