Anisha Riggs
Illness can significantly alter our sense of smell, and by extension, the way we perceive perfumes. This phenomenon is called parosmia, where a person can detect an odour but it smells wrong to them. For example, fresh bread might smell rotten, or coffee might smell unpleasant. Parosmia usually occurs after a virus or other health condition damages the olfactory neurons in the nose, which transmit messages to the brain about smells. Illnesses such as Covid, the flu, parainfluenza, other coronaviruses, dental infections, sinusitis, and even neurodegenerative diseases like Alzheimer's and Parkinson's can all cause parosmia. In addition to parosmia, illnesses can also cause a loss of smell, or phantosmia, where people experience phantom smells. Fragrance sensitivity can also be a factor, causing symptoms such as nausea, dizziness, and skin irritation. Changes in body odour due to illness can also occur, indicating underlying medical conditions. Therefore, it is clear that illness can profoundly impact the way we perceive perfumes and other scents.
| Characteristics | Values |
|---|---|
| Illnesses that change the perception of smell | Covid, flu, parainfluenza, other coronaviruses, chronic sinusitis, dental infection, neurodegenerative diseases (Alzheimer's, Parkinson's), traumatic brain injury, liver disease, kidney disease, infectious diseases, diabetes, thyroid problems, depression, migraine auras |
| Symptoms | Loss of smell, distorted sense of smell, phantom smells, fragrance sensitivity, nausea, dizziness, skin redness, irritation, rash, asthma, allergies |
| Treatment | Over-the-counter medications like Tylenol, nasal decongestants, asthma or allergy medications |
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What You'll Learn
Covid-19 and olfactory dysfunction
Olfactory dysfunction is one of the most common symptoms of COVID-19. It is estimated that 25–70% of patients infected with SARS-CoV-2 experience some form of smell impairment. This develops approximately 4 days after infection and lasts an average of 8–9 days. However, some patients experience olfactory dysfunction for 3 months or longer as part of the long-COVID syndrome.
COVID-19-associated olfactory dysfunction is likely multifactorial. Evidence suggests that infection of sustentacular cells and associated mucosal inflammation may cause acute, transient smell loss. On the other hand, alterations in other components of the olfactory system, such as olfactory receptor neuron dysfunction, olfactory bulb injury, and changes in the olfactory cortex, may lead to persistent, long-term olfactory dysfunction.
Several treatments have been explored to manage olfactory dysfunction in COVID-19 patients. These include:
- Zinc supplements: While zinc sulfate therapy has not shown significant improvements in olfactory function, one study found that zinc therapy shortened recovery time for olfactory dysfunction.
- Retinoic acid (Vitamin A): Supplementing with 10,000 IU of vitamin A did not show any benefits. However, combining topical vitamin A with OT resulted in significant clinical improvement.
- Probiotic strains: A study found that intranasal treatment with L. lactis W136 for 14 days reduced symptom intensity and improved olfactory impairment.
- Theophylline: Oral administration of this phosphodiesterase inhibitor has been shown to increase olfactory function.
- Sodium Citrate: Intranasal administration of sodium citrate has shown promising results.
- N-Methyl D-aspartate antagonist: Caroverine, an NMDA antagonist, has been found to enhance odor thresholds and recognition in individuals with post-viral olfactory dysfunction.
- Topical Intranasal Insulin: This treatment has been shown to increase odor sensitivity in 60% of patients, with modest improvements in odor discrimination.
- Alpha Lipoic Acid: Applying ALA, a fatty acid used to treat diabetic neuropathy, resulted in a modest increase in olfactory function.
While olfactory dysfunction was frequently reported during the first two years of the pandemic, its incidence has decreased with the emergence of the Omicron variant. Nevertheless, many patients continue to suffer from persistent dysosmia and dysgeusia, making COVID-19-associated olfactory dysfunction an ongoing health concern.
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Parosmia: when scents smell wrong
Illness can indeed change the way perfume smells to you. Parosmia is a condition where a person can detect an odour that's present, but the scent smells "wrong" to them. For example, freshly baked bread might smell overpowering and rotten instead of subtle and sweet.
Parosmia usually occurs after the scent-detecting neurons, or olfactory senses, have been damaged due to a virus or other health issues. These neurons line the nose and transmit messages to the brain about how to interpret the chemical information that makes up a smell. Damage to these neurons changes the way the brain receives information about scents. Olfactory bulbs underneath the front of the brain receive signals from these neurons and convey whether a scent is pleasing, enticing, appetizing, or foul. These olfactory bulbs can be damaged, causing parosmia.
Traumatic brain injuries (TBI) have been linked to olfactory damage, and the severity of the damage depends on the injury. Symptoms of parosmia after a TBI are not uncommon, and can also lead to a complete loss of the sense of smell.
Parosmia has been observed in patients recovering from COVID-19. A 2021 study reported two adults recovering from COVID-19 who experienced parosmia. The first, a 28-year-old male, reported smelling burnt rubber 87 days after getting sick. The second, a 32-year-old female, reported smelling onions after 72 days. COVID-19-related parosmia is considered rare, and other medical professionals point out that it may be a sign that the olfactory system is recovering.
Other viruses, such as the flu, parainfluenza, and other coronaviruses, can also lead to smell dysfunction. Chronic sinusitis can impair the sense of smell or cause smell loss. Neurodegenerative diseases, such as Alzheimer's and Parkinson's, have also been linked to problems with smell.
It is important to speak to a doctor if you experience any changes in your sense of smell. Fragrance sensitivity can cause nausea, dizziness, and skin irritation. Keeping a diary of symptoms and when they occur can be helpful in identifying the offending fragrance. Medical evaluations can also help determine if asthma or allergies are contributing factors.
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Fragrance sensitivity and allergies
Fragrance sensitivity is not uncommon and can be quite severe, with some people reporting that they have missed work or even lost their job due to feeling ill from exposure to fragrances in the workplace. Fragrance sensitivity can cause allergy-like symptoms, known as non-allergic rhinitis. These symptoms can include headaches, nausea, and difficulty breathing.
The most common substances that induce fragrance sensitivity include α-pinene (APN), limonene (LIM), linalool (LIL), and eugenol (EUG). Fragrances can also trigger an allergic reaction in some people. Symptoms of a fragrance allergy generally affect the skin and include itchy, red rashes, hyperpigmentation, weeping, and blistering. In rare cases, a person can develop anaphylaxis, a severe allergic reaction that can be dangerous. Fragrance allergies can also cause respiratory symptoms, such as coughing and shortness of breath.
If you suspect you have a fragrance sensitivity or allergy, it is important to speak to a healthcare provider. They may recommend allergy tests to check for IgE antibodies or your response to common allergens. They may also suggest patch testing to see if a substance is causing allergic skin inflammation. To prevent fragrance sensitivity or allergy symptoms, it is recommended to avoid offending fragrances by buying unscented soaps and lotions, decorating with fake flowers, and banning cigarettes indoors. It is also important to speak up and let your friends, family, and colleagues know about your sensitivities so that they can avoid triggering your symptoms.
It is worth noting that illness can also change the way you perceive smells. This condition is called parosmia and usually occurs after the scent-detecting neurons have been damaged due to a virus or other health condition. People with parosmia can detect an odor that is present, but the scent smells "wrong" to them. For example, freshly baked bread might smell overpowering and rotten instead of subtle and sweet. Parosmia is often linked to recovery from infections, including COVID-19.
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Neurodegenerative diseases and phantosmia
Olfactory disorders are noted in a majority of neurodegenerative diseases. Phantosmia, also known as olfactory hallucination, is smelling an odour that is not actually present. It can occur in one or both nostrils. Unpleasant phantosmia, or cacosmia, is more common and is often described as smelling something burnt, foul, spoiled, or rotten. Experiencing occasional phantom smells is normal and usually goes away on its own. However, when these hallucinations persist or recur, they can be very upsetting and disruptive to one's quality of life.
Phantosmia can be caused by common medical conditions such as nasal infections, nasal polyps, or dental problems. It can also be a result of neurological conditions like migraines, head injuries, strokes, seizures, brain tumours, and neurodegenerative diseases. Parkinson's disease, for example, has been linked to phantosmia, with patients reporting strong olfactory sensations ranging from pleasant perfume scents to unpleasant odours like "wet dog". In some cases, phantosmia symptoms disappeared with treatment for Parkinson's disease.
Alzheimer's disease, another neurodegenerative condition, has also been associated with phantosmia. Atrophy in the temporal lobe, which is implicated in phantosmia, occurs in Alzheimer's patients. However, olfactory delusions are more common in Alzheimer's, and it can be challenging to convince patients that these are hallucinations. Progressive Supranuclear Palsy (PSP) is another neurodegenerative disease that has not been linked to smell dysfunction, suggesting that olfactory testing may aid in differential diagnosis.
While phantosmia can be distressing, it is important to note that it is usually temporary and often resolves without intervention. However, if hallucinations persist or significantly impact one's quality of life, seeking medical advice is recommended.
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Body odour changes and medical conditions
Body odour is caused by a combination of bacteria and sweat on the skin. The amount of sweat does not necessarily impact body odour; rather, it is the interaction of sweat with the bacteria on the skin that causes an odour. This odour can be sweet, sour, tangy, or similar to onions.
Body odour changes can be caused by a variety of factors, including:
- Environment
- Food consumption
- Medication
- Shifts in hormone levels
- Underlying disorders or medical conditions
For example, changes in body odour can be caused by puberty, excessive sweating, or poor hygiene. However, sudden and persistent changes in body odour can sometimes indicate an underlying medical condition. Some of the medical conditions associated with changes in body odour include:
- Overactive thyroid
- Liver disease
- Kidney disease
- Infectious diseases
- Diabetes
In the case of liver or kidney disease, a person's body odour may give off a bleach-like smell due to toxin buildup in the body. For people with diabetes, a fruity body odour may be a sign of diabetes-related ketoacidosis.
Additionally, stress and anxiety can lead to increased sweating and stronger body odour. Hyperhidrosis is a condition characterised by excessive sweating, which may be secondary to an underlying condition or influenced by factors such as genetics or medication.
It is important to monitor sudden changes in body odour and consult a doctor if there are accompanying symptoms or concerns.
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Frequently asked questions
Yes, illness can change the way perfume smells to you. This is because illnesses can damage your olfactory senses, which are the scent-detecting neurons in your nose that tell your brain how to interpret the chemical information that makes up a smell. This damage changes the way smells reach your brain.
There are several illnesses that can cause you to smell perfumes differently. These include the flu, parainfluenza, other coronaviruses, chronic sinusitis, dental infections, depression, migraine auras, head trauma, Alzheimer's, and Parkinson's.
Illnesses can change the way you smell perfume in a few different ways. One way is through parosmia, where you can detect an odor that is present, but the scent smells "wrong" to you. For example, perfume may start to smell rotten or foul instead of pleasant. Another way is through phantosmia, where you smell something that isn't there, such as burning rubber or smoke.
