Fragrance Allergy Basics

Valentine’s Day often means luxurious gifts of roses and perfume that can have unintended consequences in allergic individuals. Fragrances are one of the most common causes of allergic contact dermatitis, a dermatological condition our Florida-based team regularly identifies for patients. In fact, fragrance allergies are second only to a metal allergy to nickel. It is estimated that up to 2 percent of the general population is sensitized to fragrances and an even higher percentage of people with atopic dermatitis or eczema are at risk. Dozens of both synthetic chemicals and botanical extracts have been identified as potential allergens. Fragrance is not limited to perfume alone and is found in a wide range of personal products, including cosmetics, moisturizers, soaps, and shampoos. 

Allergic reactions to fragrances usually present as a scaly, red dermatitis, although more severe reactions can present as small blisters and hives. The dermatitis most often occurs on the area of skin that has been in direct contact with the scent, especially the face and neck. Scented deodorants are a common cause of contact dermatitis in the armpits. Less often, the allergen can be transferred from a distant site, for example a scented moisturizer applied to the hands may produce a reaction on the more delicate eyelid skin. 

Avoidance of fragrance is the surest way for the allergic individual to prevent future reactions, but finding truly scent-free products can be challenging. Fragrances may be proprietary or in such low concentration that they are not listed on the ingredient label. Furthermore, products labeled as fragrance-free may contain so-called “masking fragrances” that block unwanted scents from other ingredients. Since botanicals and essential oils also can be allergens, even products containing natural scents can cause reactions. 

If you are experiencing an itchy red rash from a new perfume, what should you do?

• First, discontinue use of the product altogether. Remember it may take days to weeks for the allergy to completely resolve.
• Try not to scratch, which can increase redness, inflammation, and even lead to infection.
• For the itch, first consider simple measures such as cool compresses, calamine lotion, or bland moisturizers that you have used in the past without difficulty. Vanicream^® products are formulated to be free of both fragrance and masking scents so may be a safe option.
• Apply over-the-counter 1 percent hydrocortisone cream twice daily for up to one week. Look for one that is free from additional ingredients such as aloe.
• Non-prescription oral antihistamines such as loratadine or cetirizine may help relieve itch, redness, and swelling.
• If the rash persists, see your dermatologist who can prescribe stronger prescription topical steroids and even oral prednisone if necessary. Your dermatologist may also discuss patch testing to help identify the offending allergen.

For help with rashes of any kind, call Skin Wellness Physicians at 239.732.0044 or contact the team online to arrange a consultation.