What Is a Fragrance Allergy?

What Is a Fragrance Allergy?
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Fragrance allergy is a chronic condition involving abnormal immune reactions to ordinarily harmless substances in fragranced products. This type of allergy generally causes symptoms on the skin that can be treated with medication. An allergist can confirm the diagnosis.


Up to 4.5 percent of the general adult population may be allergic to fragrance materials.

What Is a Fragrance Allergy?

A fragrance allergy typically occurs when certain fragrance components called allergens come into contact with the skin. This causes the immune system to react by making protective proteins called antibodies to defend against the allergens. This inflammatory response leads to allergy symptoms.


In most cases, the reaction results in allergic contact dermatitis (ACD), an itchy rash that shows up on the skin that has been directly exposed to the irritating substance. The rash isn’t contagious, but it can be very uncomfortable.

Skin allergies to fragrance ingredients frequently involve the skin of the face, hands, or armpits.

Not every skin reaction is due to an allergy. Only an allergen can cause a true allergy.

In some cases exposure to certain substances can cause irritation, which does not provoke the immune system.

“Many people use the term ‘allergy’ for any type of reaction,” says Beth A. Miller, MD, director of the University of Kentucky’s Asthma, Allergy and Sinus Clinics and chief of the school’s division of allergy and immunology.

If you’re intolerant, as opposed to allergic, to a component of a fragrance, it will likely take much more of that component to elicit a reaction.

“Intolerance typically occurs in reaction to strong fragrances or [exposure to] large quantities, whereas an allergy can occur with just a trace amount,” says Tania Elliott, MD, an allergist and spokesperson for the American College of Allergy, Asthma & Immunology.

Signs and Symptoms of Fragrance Allergy

Symptoms of fragrance allergy generally affect the skin and include:


  • An itchy rash

  • Hyperpigmentation (patches of skin that are darker than usual), typically on people with darker skin


  • Swelling, burning, or tenderness

  • Bumps of blisters

“At times you can have weeping, blistering, poison ivy–like reactions,” says Purvi Parikh, MD, an allergist and immunologist at Allergy and Asthma Associates of Murray Hill and a clinical assistant professor at NYU Langone Health in New York City. “The more severe blistering can cause skin peeling and mimic burns.”

It’s also possible to develop respiratory symptoms. These can include:


  • Wheezing
  • Coughing
  • Chest tightness
  • Feeling of suffocation
  • Headache
  • Stuffy or runny nose
In rare cases a person can develop anaphylaxis, a severe allergic reaction that can be dangerous. These symptoms include:

  • Shortness of breath
  • Difficulty swallowing
  • Feeling lightheaded
  • Chest pain
  • A rapid or weak pulse
  • Nausea and vomiting
Allergic contact dermatitis can also lead to an infection if you repeatedly scratch the affected area, creating a place for bacteria to grow.

Causes of Fragrance Allergy

Common causes include:


  • Fragrances (perfume, cologne, aftershave, essential oils)

     
  • Personal care products (soaps, hand sanitizers, lotions, deodorants, sunscreens, shampoos)
  • Cleaning supplies (all-purpose cleaners, disinfectants, dishwashing soap)
  • Air fresheners and deodorizers
  • Laundry products (detergents, fabric softeners, dryer sheets)
  • Household products (scented candles, toilet paper rolls, trash bags, baby products)

How Is Fragrance Allergy Diagnosed?

Allergy specialists or dermatologists can usually look at a rash on the skin and be able to diagnose if it is due to an allergic reaction compared to other factors.


If you have an unexplained rash, a physician may suspect a fragrance allergy after talking to you about your history of past outbreaks or discussing what personal care products you used before having a skin reaction.


In order to definitively understand what is causing the reaction and whether or not it is related to fragrance compounds, you will have to undergo skin patch testing. Patch testing is generally to see whether a substance is causing allergic skin inflammation (allergic contact dermatitis).

Patch testing does not involve needles. Instead, allergens are attached to patches that are placed on the skin of your arm or back. During the test, your skin is exposed to extracts of substances that can cause contact dermatitis. You wear the patches for 48 hours.

Skin responses are evaluated after 48 hours and again at between 72 and 96 hours for delayed hypersensitivity reactions, says John M. James, MD, a board-certified allergist and president of Food Allergy Consulting and Education Services in Fort Collins, Colorado, and a spokesperson for the Asthma and Allergy Foundation of America.

“If standard patch tests results are negative but there is a high clinical suspicion of a fragrance allergy, extended patch testing with a broader panel of individual allergens can be done,” says Dr. James.

Treatment and Medication for Fragrance Allergy

Treatments for a fragrance allergy include:

You may want to call your doctor for an appointment if your rash:

  • Gets worse or keeps coming back
  • Lasts longer than three weeks
  • Affects your eyes or mouth
  • Impacts your ability to focus or sleep

Prevention of Fragrance Allergy

There is nothing you can do to prevent developing a fragrance allergy, but there are simple steps you can take to avoid substances that will trigger a reaction if you want to live a fragrance-free lifestyle.

Always check the label before buying different cosmetic or personal care products like shampoo or body wash.

  • Avoid products with ingredients labeled “parfum,” “perfume,” or “fragrance”
  • Choose fragrance-free or hypoallergenic personal care products

Even if you know which allergens you are trying to avoid, it can still be difficult to eliminate the potential threat.

“Fragrance manufacturers aren’t mandated to list all the chemicals they use to make their perfumes on the product packaging,” says Susan P. Raschal, DO, a board-certified allergist at Family Allergy & Asthma in Tennessee. “This can make it difficult to identify the culprit for a reaction.”

Another obstacle in managing fragrance allergy is the fact that even if a personal care product is labeled “unscented” or “fragrance-free,” it may still contain fragrance components, sometimes called masking fragrances, which cover up offensive odors that may naturally occur in a product.


Another complication is that people can develop allergies over time. So a product that contains an allergen they weren’t allergic to could become a problem if they develop an allergy.


Living With a Fragrance Allergy

Once you develop an allergy to a fragrance allergen, it is likely a lifelong condition.


While you can’t control exposure to fragrance allergens in all environments, there are steps you can take to reduce your risk of having an allergic reaction, including:

  • Ask family and friends to refrain from wearing fragrances when you are around them
  • When traveling, look for hotels that can accommodate a fragrance-free and hypoallergenic request
  • Request that your room be cleaned with fragrance-free products before your stay
  • Request that linens and towels not be cleaned with scented detergent during your stay
  • Consider bringing your own towels and bedding when you travel
  • Request fragrance-free environments in public or work spaces
“Air purifiers with HEPA filters have been shown to be effective at reducing aerosolized chemicals and allergens,” says Raschal. She suggests using a portable, stationary, or wearable unit with HEPA filtration to reduce exposure.

Raschal also suggests that people who experience allergy or asthma exacerbations upon exposure to fragrances create an allergy action plan. This plan is a detailed document that outlines the steps to be taken in case a person experiences an allergic reaction.

Common Questions & Answers

How can I tell if I am truly allergic or just sensitive to ingredients in a fragrance?
You will have to see a physician and undergo a skin patch test to definitively know if allergens in fragrances are causing a skin reaction.
See a physician immediately if your symptoms get worse over time or you have signs of infection or difficulty breathing.
While some people grow out of allergies, most fragrance allergies are a chronic condition that last a lifetime.

The Takeaway

  • Fragrance allergy is a chronic condition that generally affects the skin.
  • It’s difficult to avoid fragrance allergens because many products you use or regularly come into contact with contain substances that can trigger an allergy.
  • Treatment for allergic skin reactions include antihistamines and topical steroid creams.

Resources We Trust

jon-stahlman-bio

Jon E. Stahlman, MD

Medical Reviewer

Jon E. Stahlman, MD, has been a practicing allergist for more than 25 years. He is currently the section chief of allergy and immunology at Children’s Healthcare of Atlanta's Scottish Rite campus and the senior physician at The Allergy & Asthma Center in Atlanta. He served as the president of the Georgia Allergy Society, has been named a Castle Connolly Top Doctor, and was listed as a Top Doctor by Atlanta magazine. His research interests include new therapies for asthma and allergic rhinitis as well as the use of computerized monitoring of lung function.

He received his bachelor's and medical degrees from Emory University. He completed his pediatric residency at Boston Children’s Hospital and his fellowship in allergy and clinical immunology at Harvard University’s Boston Children’s Hospital and Brigham and Women’s Hospital. After his training, Dr. Stahlman conducted two years of clinical research at Boston Children’s Hospital and was part of the faculty at Harvard Medical School, where he taught medical students and allergy and immunology fellows.

Stahlman is board-certified and recertified in allergy and clinical immunology. He served as a principal investigator on phase 2 through 4 studies that are responsible for most of the U.S. Food and Drug Administration–approved therapies for allergies and asthma available today.

Outside of the office, he centers his interests around his wife and three daughters, coaching soccer for many years, and his hobbies include cycling and triathlons.

Barbara Kean

Author

Barbara Kean has worked as a reporter, researcher, editor, and writer for a number of newspapers and magazines including Vogue, The New York Times Magazine, the Boston Herald, Martha Stewart Living, Rolling Stone, Vanity Fair, Health, Glamour, and Self. After earning a bachelor’s degree in English and Spanish from Tufts University and a master’s degree in English from University College London, this Boston native began her career in journalism at the Boston Herald newspaper before moving to New York.

She was previously the research director at Vogue magazine for many years. She has worked on several books, including The End of Karma: Hope and Fury Among India’s Young (Somini Sengupta), Grace: 30 Years of Fashion at Vogue (Grace Coddington), Vogue Living: Houses, Gardens, People (Hamish Bowles), and The World in Vogue: People, Parties, Places (Alexandra Kotur and Hamish Bowles).

Kean loves cooking, painting, fashion, travel, music, reading, and theater. She especially enjoys interviewing scientists and doctors who are working on new treatments for chronic diseases like cancer, and sharing that information with readers.

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
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