April 1, 2008
In 2007, "fragrance" was the allergen of the year.
"Fragrance allergy is the most common cause of cosmetic
contact dermatitis. Many occult sources of fragrance exist.
Those which cause the most concern are some
'fragrance-free' products that contain fragrance raw
ingredients. Thus, the very patients requiring
fragrance-free items may be exposed to potential perfume
allergens or cross-reactors in seemingly safe products...."
When many think of avoiding fragrances, they think of
avoiding perfume. In many cases, the fragrances that cause
irritation are found added to other products such as
lotions, soaps, and cleaning products--even if they are
labeled as "fragrance-free."
"Contact dermatitis is an inflammation of the skin that
results from direct contact with certain substances, such
as soap, cosmetics, jewelry or weeds, including poison ivy
or poison oak. The resulting red, itchy rash isn't
contagious or life-threatening, but it can be very
uncomfortable. Successful contact dermatitis treatment
consists primarily of identifying what's causing the
inflammation. Then, if you can avoid the offending agent,
the rash usually resolves in two to four weeks."
Cosmetic dermatitis can be caused by many things, not just
fragrances. While most people think to avoid poison oak or
poison ivy because they know it will irritate their skin,
many do not know what to avoid when it comes to cosmetics
and fragrances. Both mislabeling and lack of labeling can
lead to problems. Additionally, it can be difficult to know
what is causing the problem and what should be avoided.
"Fragrances are complex substances. One perfume may contain
hundreds of different chemicals. Trying to pinpoint
specific fragrance allergens has challenged patch testers
for years. The fragrance industry is both lucrative and
competitive. The composition of a successful fragrance
compound is an asset, which has led to a situation in which
the fragrance industry is not always eager to disclose the
chemicals it uses."
With companies not always willing to disclose exactly what
is in their products, and fragrance-free products that have
been found to contain raw ingredients that can cause
irritation, what can a sensitive consumer do to keep reduce
the chances that they will have a reaction?
"It is no longer sufficient to recommend the use of
products labeled fragrance-free to fragrance-sensitive
patients. These patients must be educated to read labels
and look for plant extracts that are potential perfume
sensitizers and cross-reactors. Rose oil, which has been
felt to be a rare sensitizer, may be a more common allergen
than previously recognized, perhaps because of its
existence in a popular 'fragrance-free' soap and,
conceivably, in many 'all-natural' products. Further
testing with rose oil should be conducted in the future.
Finally, manufacturers need to be more forthright in the
labeling of their products."
While it is one thing for those who are sensitive to
fragrance to read labels and be careful what products they
put on their own skin, it is quite another for them to go
out into the world and spend their days breathing in the
scents of those around them who have used scented lotions,
laundry detergents, hair sprays, soaps, deodorants, and
"'Women have a stronger sense of smell than men. Certain
ethnic groups have better abilities to smell,' Hirsch says.
'And there are also different physiological states that
will intensify olfactory abilities, like when you're hungry
or you're pregnant or if you have certain diseases or
conditions.' Indoor smoking bans have also had an impact on
our noses. 'People are no longer being inundated by smoke,'
he says. 'They're aware of the ambient aromas around them
and they're also more sensitized to them.' The problem is
that what some consider ambient aromas, others perceive as
a relentless chemical assault on their respiratory
While one person's lotion may not cause an irritation on
another person's skin, it can still cause problems when
inhaled by a scent-sensitive person.
"[A] 2003 study of more than 10,000 mothers and their
infants in England found air fresheners, deodorants and
aerosols were 'significantly associated' with headaches in
moms and earache, vomiting and diarrhea in their babies."
In addition to headaches, fragrances have been found to
trigger respiratory problems, as well.
"Respiratory impairment is a generic term that refers to a
number of medical conditions that can affect the
respiratory system and may result in limitations such as
labored breathing or asthma attacks, fatigue and difficulty
with mobility, heightened sensitivity to ordinary
substances and chemicals, and compromised immunity to
infection. ... The ADA [Americans with Disabilities Act]
does not contain a list of medical conditions that
constitute disabilities. Instead, the ADA has a general
definition of disability that each person must meet (EEOC,
1992). Therefore, some people with respiratory impairments
will have a disability under the ADA and some will not. ...
[T]here have been several ADA cases involving people with
For some people whose ability to work is impaired by the
fragrances of those around them, there are accommodations
they can request.
"Employees who need accommodation can review the definition
of disability and if they believe they meet the definition,
they can proceed with their accommodation request.
Employees may want to attach medical documentation to their
accommodation request to show that they have an impairment
(this usually means a diagnosis) and to show how the
impairment limits them in their major life activities. ...
Even if employees do not think that they meet the ADA's
definition of disability, they may want to discuss
accommodation needs with their employers anyway; some
employers may choose to accommodate employees even if they
do not meet the ADA definition of disability."
While some argue that their sensitivities to fragrances are
so strong that they need those around them to eliminate
scented products, others argue that it is simply a control
issue where those with fragrances sensitivities are trying
to tell others what to do. In fact, it may be a little bit
"Hirsch, the smell expert, says seizing control of a smelly
situation may actually be part of what makes scent
sensitive people feel better. 'People perceive smells as an
intrusion on their body space,' he says. 'But if you can
control the smell, you're much less bothered by it than if
you can't control it. It's an instinctive perception, like
a dog marking its territory.' Hirsch says a person's
perception of a smell will also change depending on whether
it's coming from someone or something they like or not.
'You can clear a room with a bad smell and give people all
kinds of headaches,' he says. 'But you can put that same
smell on a Disney ride and no one will complain.'"
Questions of the Week:
What do those with fragrance allergies or sensitivities
need to know when reading labels and choosing products?
What challenges do they face when trying to find products
they can safely use? What reasonable accommodations can
those who react to fragrances expect those around them to
make? When might there times when accommodations are
refused? When might there times that accommodations should
be suggested, but not required? When should accommodations
be required? Regardless of the policies set up by the
school or workplace, what can those who go to school (or
work) with someone who has a fragrance allergy do to help
create a healthier environment for that person?
Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.
I look forward to reading what you have to say.
Health Community Coordinator
Access Excellence @ the National Health Museum