Cologne's Unpleasant Side Effect: Why The Fragrance Makes You Cough

Many people experience coughing fits due to fragrance sensitivity or allergies. Fragrance sensitivity occurs when your airways are irritated by ingredients or chemicals in natural or manufactured scents. Common triggers include perfumes, colognes, detergents, fabric softeners, and incense. Symptoms of fragrance sensitivity include coughing, sneezing, itchy eyes, and a ticklish feeling in the nose. Allergies, on the other hand, involve a specific immune system response to an ingredient or chemical in the perfume, causing the body to release inflammatory reactions. While less common, perfume allergies can cause severe symptoms such as swelling in the mouth, lips, or tongue, and anaphylaxis, requiring immediate medical attention.

Fragrance sensitivity

Perfumes and colognes are often associated with fragrance sensitivity, but fragrances are also added to toiletries, cosmetics, air fresheners, cleaning products, and pesticides. The specific chemicals that cause fragrance sensitivity include α-pinene (APN), limonene (LIM), linalool (LIL), and eugenol (EUG).

The symptoms of fragrance sensitivity generally develop within minutes of exposure and can last from a few minutes to several hours. The severity of symptoms depends on the length of exposure and the strength of the scent. Prolonged exposure to fragrances can lead to nausea and dizziness, while direct skin exposure can cause contact irritant dermatitis, resulting in skin redness, irritation, and a prickly rash.

If you suspect you have fragrance sensitivity, it is important to seek medical advice. A healthcare provider can help identify triggers and rule out other potential causes, such as asthma or allergies. Keeping a diary of when and where symptoms occur, as well as any potential triggers, can aid in diagnosis.

The best way to manage fragrance sensitivity is to avoid offending fragrances. This can be challenging due to the widespread use of fragrances in everyday products and the lack of ingredient disclosure on labels. However, reading ingredient labels and choosing unscented products can help reduce exposure. In workplaces and public spaces, it is important to communicate fragrance sensitivity to others to limit exposure.

Allergies

Fragrances can trigger allergic reactions in some people, and cologne is no exception. While cologne allergies are relatively uncommon, affecting only up to 4.5% of the general adult population, they can cause a range of uncomfortable symptoms.

Symptoms of a Cologne Allergy

Cologne allergies typically affect the skin, causing allergic contact dermatitis (ACD). This condition leads to an itchy rash on the skin that has been directly exposed to the cologne. The rash is often uncomfortable and can be accompanied by swelling, burning, or tenderness. In some cases, it may even cause blistering and weeping, resembling a poison ivy reaction.

Respiratory symptoms are also possible, including a feeling of suffocation, a stuffy or runny nose, and in rare cases, anaphylaxis. Other potential symptoms include headaches, nausea, and dizziness.

Causes of Cologne Allergies

Cologne allergies are caused by certain fragrance components called allergens. These allergens trigger an abnormal immune reaction, leading to the release of protective proteins called antibodies. This inflammatory response results in the typical allergy symptoms mentioned above.

It's important to distinguish between a true allergy and fragrance sensitivity. While both can cause similar symptoms, a true allergy involves an immune response with the release of immunoglobulin E (IgE), leading to allergy symptoms. Fragrance sensitivity, on the other hand, irritates the respiratory tract and mucous membranes of the eyes without triggering a whole-body immune response.

Treatment and Prevention of Cologne Allergies

The best way to manage a cologne allergy is to avoid exposure to the allergen. This may involve using fragrance-free or hypoallergenic personal care products and choosing unscented cleaning and laundry products. When exposure is unavoidable, such as in public spaces or workplaces, it's helpful to carry over-the-counter medications like antihistamines and nasal decongestants to manage symptoms.

In summary, cologne allergies are a type of fragrance allergy that can cause a range of uncomfortable symptoms. While relatively uncommon, they can significantly impact those affected and require careful management to prevent allergic reactions.

Irritants

Colognes and perfumes can cause coughing due to an irritant response. This is not an allergic reaction, but rather an irritation of the respiratory tract and mucous membranes of the eyes.

Strong perfumes and scents can trigger an "irritant" response, which leads to coughing. This occurs when the fragrances come into contact with the lining of the nose and lungs. The irritation causes a tickling sensation in the throat, which can lead to a cough. This can be particularly problematic for people with asthma, who may experience an asthma attack as a result of the irritation.

In addition, colognes and perfumes contain numerous chemicals that can act as irritants. On average, perfumes and colognes contain over 2,500 chemicals, which are often unlisted due to laws around "trade secrets". Some common culprits for fragrance sensitivity include α-pinene (APN), limonene (LIM), linalool (LIL), and eugenol (EUG).

To prevent coughing caused by cologne, it is best to avoid exposure to offending fragrances. This can include using unscented soaps and lotions, avoiding strong scents in public spaces, and asking friends, family, and colleagues to refrain from wearing strong perfumes or colognes.

If avoidance is not possible, over-the-counter medications can be used to treat the symptoms, such as pain relievers and nasal decongestants. For those with asthma, it is important to have asthma medications on hand to control any flare-ups.

Asthma

Perfumes, colognes, body sprays, and other scented products can act as triggers for asthma symptoms. These include coughing, wheezing, chest tightness, and shortness of breath. The severity of symptoms can vary depending on the individual and the level of exposure. It is important to note that not all fragrances will affect every person with asthma, as sensitivity can vary.

For those with asthma, it is crucial to identify specific fragrances or scented products that trigger symptoms and make a conscious effort to avoid them. This may involve reading product labels, choosing fragrance-free alternatives, and informing others about your sensitivity. Creating fragrance-free environments and using fragrance-free personal care products can also help manage asthma symptoms.

Additionally, it is important to consult with a healthcare professional if you suspect that you have perfume-induced asthma. They can conduct a thorough evaluation and determine if fragrance exposure is triggering your asthma symptoms. Once diagnosed, treatment options may include medications to manage symptoms and prevent asthma attacks.

Some practical tips for managing perfume-induced asthma include:

• Identifying and avoiding triggering scents.
• Encouraging fragrance-free policies in your home, workplace, and public spaces.
• Opting for fragrance-free or naturally scented personal care products.
• Consulting with a healthcare professional about appropriate medications to manage asthma symptoms.
• Developing an asthma action plan with your healthcare provider to outline steps to take in case of symptom exacerbation.

Vocal cord dysfunction

Overview

Symptoms

VCD can cause a range of symptoms, including:

• Difficulty breathing in
• A feeling of tightness in the throat
• A choking or suffocating sensation
• Noisy breathing on inhalation, known as stridor
• A sensation of a lump in the throat
• A tingling sensation in the hands and feet

Causes

The exact cause of VCD is not known, but experts believe that several factors may trigger episodes. These triggers can be grouped into the following categories:

• Exercise-induced laryngeal obstruction (EILO): Triggered by physical activity, this type of VCD is common in young athletes and can be mistaken for asthma.
• Medical conditions: Conditions such as asthma, gastrointestinal reflux disease (GERD), and upper respiratory infections can trigger or exacerbate VCD.
• Mental health conditions: Generalised anxiety disorder, clinical depression, obsessive-compulsive personality disorder (OCPD), and post-traumatic stress disorder (PTSD) can worsen VCD.
• Inhaled irritants: Substances like cold dry air, toxins, cleaning chemicals, strong smells (including perfumes and colognes), and smoke can trigger VCD.

Diagnosis

Diagnosing VCD can be challenging, and it is often misdiagnosed as asthma or croup. Healthcare providers may perform a physical examination, review the patient's medical history, and ask about potential triggers. Diagnostic tests may include:

• Laryngoscopy: A camera is inserted through the nose or throat to examine the vocal cords during breathing and speaking.
• Pulmonary function tests and spirometry: The patient breathes into a device that measures the amount and speed of inhaled and exhaled air.

Treatment

While there is no cure for VCD, treatments can help manage symptoms and prevent episodes. These include:

• Respiratory retraining therapy: Speech-language pathologists teach breathing exercises to help manage VCD episodes.
• Treating trigger conditions: Managing or treating underlying conditions, such as GERD or infections, that may cause VCD symptoms.
• Avoiding triggers: Identifying and avoiding situations or substances that trigger VCD episodes.
• Breathing exercises: Techniques like pursed lip breathing and diaphragmatic breathing can help manage breathing during VCD episodes.

Frequently asked questions