- Rajani Katta MD
Allergy to Fragrance: Understanding Fragrance Additives and Choosing Products
Updated: Jan 18, 2021
What do you think of when you hear the word "fragrance"? Many of us think about perfume or cologne. If you're allergic to fragrance, though, it doesn't stop there.
If you're allergic to fragrance, you need to be careful with perfumes. But there are many other products that contain fragrance.
You should definitely avoid perfumes, but fragrance is found in MANY other products.
In fact, the vast majority of personal care products sold in the United States contain some type of fragrance.
That means that you'll need to be careful with all sorts of creams, lotions, cosmetics, hair care products, and other skin care products. In other words, you'll need to be cautious with ALL of your skin care products.
You'll also need to read labels. And you'll need to learn some basic facts about fragrance allergy, because this is a surprisingly complicated area.
You can't just choose a "fragrance-free" or "all-natural" product and be done with it.
Fragrance, and fragrance allergy, is complicated. There are actually hundreds of different fragrance additives, and many of them are chemically related to one another.
In this post, I'll discuss allergic skin reactions to fragrance, and how to protect yourself against fragrance additives. But it's important to remember that there are different types of reactions to fragrance additives.
There are different types of allergic reactions to fragrance
In this post, I’m focusing on allergic skin reactions to fragrance. But it’s important to recognize that there are different types of allergic reactions and sensitivities.
Irritation of the airways: For some people, just smelling fragrances can trigger off irritation of their nasal passages (inside the nose) and/or their airways (the throat, larynx, bronchi, and lungs). This type of irritation may cause symptoms of nasal congestion, sneezing, coughing, difficulty breathing, and more.
Allergic reactions of the nasal passages and airways: Allergic reactions are more than just irritation. In an allergic reaction, the immune system recognizes a fragrance additive as a threat and responds by activating the cells of the immune system.
That kind of immune system activation can cause a whole range of symptoms.
In the nasal passages, these symptoms might include sneezing, nasal congestion, stuffy nose, runny nose, or sneezing. In the airways, these symptoms might include coughing, difficulty breathing, and even a worsening of asthma.
Allergic reactions may also involve the eyes (specifically, the membranes that cover your eyeballs). Some people develop allergic conjunctivitis, with red, itchy eyes that develop within minutes to hours after exposure to airborne fragrances.
Skin rashes can also occur. Sometimes this can just be irritation from a fragrance. At other times, people may develop an allergic reaction called allergic contact dermatitis. In this condition, you might be exposed to a perfume or a skin care product that contains fragrance additives. Then (typically) 2 to 3 days later your skin will break out in a rash.
What can I do if I have sensitivity of my nasal passages or airways to fragrance additives?
First of all, it's so important to pay attention to ALL different types of exposures. That's because fragrance additives are added to so many different products. If you have sensitive nasal passages, sensitive airways, or asthma, it’s important to try to eliminate any of the following sources of fragrance additives that you can.
Perfume or cologne worn by you
Perfume or cologne worn by your friends or loved ones
Skin care products that have added fragrance additives
As discussed more below, even products that are labeled "fragrance-free" may legally contain fragrance additives
Air sprays that have fragrance, such as room freshener
Essential oil diffusers
Plug-in fragrance diffusers for the home
Plug in car fragrance diffusers
If you have sensitive airways and are worried about exposure to fragrance in the workplace, this article has some more information
Fragrance on a Label: What It Means
The word "fragrance" on a label can be very misleading. When you're reading that one word, it sounds like it's one ingredient.
In fact, studies have shown that this one word can indicate the presence of 40 or more different ingredients.
That's because that one word "fragrance" on a label should really be "secret mixture of fragrance additives."
What is Fragrance?
The term “fragrance” actually refers to a group of substances. There are hundreds of different substances that can be categorized as fragrance additives. Many of these are all-natural substances, derived from plants. Others are synthetic chemicals. Since many of these ingredients are chemically related to each other, it’s common for patients to react to more than one.
Labeling Terms Are Not Always Helpful
Even using products labeled “fragrance-free” or “unscented” may not help, as some of these can legally contain fragrance additives. In fact, a recent US study that looked at best-selling body moisturizers found that for products that claimed to be "fragrance free", 45% of these products actually contained at least 1 fragrance cross-reactor or botanical ingredient.
That's why I DON'T just tell my patients to use products labeled as "fragrance-free"
Instead, I recommend a short list of products. These are products for which I've personally reviewed the entire ingredient list and can confirm that they are truly fragrance-free.
All-Natural Fragrances Are Just as Concerning
Many of my patients in recent years have turned to essential oils or all-natural products for their sensitive skin. Some have turned to products that are labeled with the term "no synthetic fragrances". This particular term may not be helpful though. That's because even 100% natural fragrances frequently cause allergic reactions.
This product advertises its natural ingredients...
And (correctly) advertises that it contains no synthetic fragrances
But it still contains natural fragrance additives. These additives, including ylang ylang oil and limonene, may potentially trigger allergic skin reactions
Hidden Fragrance Chemicals
It’s difficult, even if you’re reading labels carefully, to identify all fragrance additives. You should definitely avoid products with “fragrance” or “perfume” or “parfum” in the ingredient list. However, even preservatives such as benzyl alcohol, or moisturizing ingredients such as rose oil, can act as fragrance additives. These ingredients may even be legally used in products that are labeled "fragrance-free". This post discusses this issue in more detail.
Other Products That May Contain Fragrance
If you're allergic to fragrance, you need to be aware of other types of products and exposures.
Be careful with household products, such as floor cleaners, room fresheners, aromatherapy products, and household cleansers. I've also seen several reactions recently from essential oil diffusers, so be cautious.
Even products worn by your spouse or children can cause problems, if they come into contact with your skin.
The natural fragrances in aromatherapy candles and essential oil diffusers can also trigger allergic reactions.
The Bottom Line
Fragrance allergy is a complex area, and fragrances can be challenging to avoid. Be careful with all skin care products, and ask your dermatologist for product recommendations that are truly fragrance-free.
Dr. Rajani Katta is the author of Glow: The Dermatologist's Guide to a Whole Foods Younger Skin Diet. To receive future updates on preventive dermatology and the role of diet, sign up here.