My patient had developed a severe rash on her face: red, itchy, and pretty much constant. After she underwent patch testing, we sat down to review the results.
"It looks as though you're allergic to several ingredients, including several fragrance additives."
"I wondered about that. But it hasn't worked. I've already switched over to fragrance-free products, and I'm still having problems with my skin."
Here's the problem with that statement. Many people believe that fragrance-free products don't actually contain fragrance. But they're wrong.
In fact, products that are labeled as "fragrance-free" MAY actually contain fragrance additives.
And it's completely legal.
That's because of the legal definition of the term "fragrance-free". There is, in fact, an actual legal definition for the labeling term "fragrance." But this definition contains a very large loophole.
Many terms found on a product label can be misleading. For example, products that are labeled as "fragrance-free" may, in fact, legally contain fragrance additives
Legal Definitions and Large Loopholes: The Term "Fragrance-Free" Does Not Actually Mean What You Think It Means
The legal definition of fragrance is "any natural or synthetic substance or substances used solely to impart an odor to a cosmetic product. "
Do you spot the loophole?
If a fragrance additive is added to a product for purposes of moisturizing, or to act as a preservative (as opposed to just adding an odor) then it may legally be used in a "fragrance-free" product.
Of course, this doesn't change the fact that that particular chemical is still a fragrance additive, and it may still cause problems in people who are allergic to fragrance.
Fragrance Additives That Are Commonly Found in Products Labeled as Fragrance-Free
Some of the top chemicals that I see lurking in products that are labeled as "fragrance-free" are benzyl alcohol, essential oils, various flower and plant extracts, citrus oils, and linalool.
Benzyl alcohol is a fragrance additive, and it's also a preservative.
Rose oil is a fragrance additive, and it's also a moisturizer.
Many essential oils are fragrance additives AND moisturizing ingredients.
This is a widespread problem. In fact, a recent US study looked at the ingredients and labels of best-selling body moisturizers. The researchers 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.
What Labeling Term SHOULD I Look For If I'm Allergic to Fragrance Additives?
1. Forget the term "unscented". Unscented products don't have an odor, often because masking fragrances have been used to create a neutral odor. Those "masking fragrances" may still cause problems for people who are allergic to fragrance.
2. Terms such as "hypoallergenic", "for sensitive skin", and "dermatologist-tested" do NOT have a legal definition. Therefore, people with sensitive skin can't rely on these terms to choose products that are safe for sensitive skin. These particular terms, because they have no legal definition, can mean anything that the manufacturer chooses. Some may be fine, but many are NOT recommended for persons with sensitive skin.
In patients undergoing patch testing, the top 10 triggers of allergic reactions include 5 chemicals that are often found in skin care products.
These top triggers include fragrance, formaldehyde, and methylisothiazolinone.
This particular brand of body wash, labeled as hypoallergenic, is not one that I would consider hypoallergenic.
It actually contains several of the top 10 allergens, including fragrance, a formaldehyde-releasing preservative (DMDM Hydantoin) and methylisothiazolinone.
Unfortunately, there's not a single labeling term that I can recommend for individuals with sensitive skin that will accurately identify less allergenic products. At this point in time, I recommend that you consult with your dermatologist.
Members of the American Contact Dermatitis Society have access to a database known as CAMP (The Contact Allergen Management Program.) This database screens thousands of skin care products for certain ingredients. In the case of fragrance, the database is able to screen products for the presence of hundreds of different fragrance additives. The final list contains products that are truly fragrance-free.
I've created my own "short list" of products that I recommend for patients with allergies to skin care ingredients, including fragrance additives. When I'm choosing these products, I look at each and every ingredient in that product. This way, I know that the products I recommend are truly free of the fragrance additives that are more likely to trigger allergic reactions.
I maintain lists of these products on my website. These products do not contain the ingredients which are known to be more common triggers of allergic reactions. These products do NOT contain ingredients such as fragrance additives, formaldehyde preservatives, and methylisothiazolinone. The list includes skin care products, hair care products, and makeup.
This is a message that's very important. Certain labeling terms simply can't be relied upon for those with sensitive skin. The American Academy of Dermatology and my dermatology colleagues are working to get this message out. This post on www.today.com is helping to spread that message.
The bottom line: Be aware that terms such as "fragrance-free", "for sensitive skin", and "hypoallergenic" may be misleading. If you have sensitive skin, it's best to check with your dermatologist for product recommendations.
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.