Introduction

Fragrance was declared the Contact Allergen of the Year for 2007 by the American Contact Dermatitis Society (ACDS). See Fragrance allergy.

There are more than 5000 different fragrances that are in use today. In any one product, the number of fragrances used can be many. Fortunately, only a small number of fragrances are actually common sensitisers and cause allergy in sensitive individuals.

What is fragrance mix and where is it found?

Fragrance mix is a mixture of 8 individual fragrances that are used in patch tests to screen for fragrance allergy. The 8 listed are the most common allergy-causing fragrances that are used across many products for their fragrant and flavouring properties.

Components of Fragrance Mix Fragrance Used/found in Cinnamic alcohol Odour of hyacinth

Ester in natural fragrances such as Balsam of Peru, storax, cinnamon leaves, hyacinth oil and propolis

Fragrance and perfumes, cosmetics, deodorants, paper, laundry detergent products, toilet soap, personal hygiene products

Flavouring in beverages (cola, bitters, Vermouth), chewing gums, toothpaste and mouthwash Cinnamic aldehyde Warm spicy odour with a taste of cinnamon

A constituent of cinnamon oil Eugenol A powerful spicy odour of clove with a pungent taste

Found in oils of clove and cinnamon leaf

Also found in roses, carnations, hyacinths and violets

Fragrance in perfume, cosmetics, colognes, toilet waters, hair cosmetics, aftershave, personal hygiene products

cosmetics, aftershave, personal hygiene products The flavouring in toothpaste, mouthwash and food flavourings

Used in dental cement and packing agents thus giving the characteristic odour of dental surgeries

Inherent insecticidal and fungicidal properties — used to preserve meats and other foods

Pharmaceutical creams and lotions for its antiseptic properties Isoeugenol An odour of clove weaker than that of eugenol

A constituent of nutmeg oil and ylang-ylang oil

Isomerisation of eugenol Geraniol A sweet floral odour of rose

Constitutes a large portion of rose and palmarosa oil, geranium oil, lavender oil, jasmine oil and citronella oil

Present in over 250 essential oils

Most widely used fragrance in perfumes, colognes, facial make-up and skincare products Alpha amyl cinnamic alcohol An intense odour of jasmine

Synthetic essential oil

Found in perfumes, soaps, cosmetics and toothpaste Hydroxycitronellal Sweet fresh odour of lily of the valley

Synthetic floral fragrance

Found in perfumes, soaps, cosmetics, eye cream , aftershaves

, aftershaves Also used in insecticides and antiseptics Oakmoss absolute Earthy, woody, masculine odour

The essential oil produced by solvent extraction of tree lichen

Commonly used in colognes, aftershaves and scented products for men

Fragrances may also be found in the workplace. Paints, cutting fluids and metalworking fluids may contain fragrances to mask offending odours. Fragrances may also be circulated through air conditioning.

What are the reactions to fragrance mix allergy?

Typical allergic contact dermatitis reactions may occur in individuals allergic to fragrance mix or any other chemically related substances. The dermatitis is characteristically located on the eyelids, face, hands and arms. There may be intense swelling and redness of the affected area within a few hours or the rash may appear after a day or two of the product being used. Sometimes symptoms may only be redness, dryness and itching.

Oral exposure may cause sore mouth (tongue) and a rash of the lips or angles of the mouth. Flare-ups of dermatitis in fragrance-sensitive individuals may occur if they use or consume products containing fragrance allergens.

Contact allergy to fragrance Patch tests Patch tests Contact allergy to fragrance in aftershave

Am I allergic to fragrances?

Sensitivity to a perfume, cream or lotion is usually the first indicator of an allergy to fragrance. Patch testing using fragrance mix and Balsam of Peru detects approximately 75% of fragrance allergy cases. A positive patch to fragrance mix indicates that you are allergic to one or more fragrance chemicals. An estimated 1–2% of the general population is allergic to fragrance.

Self-testing a product for fragrance allergy is possible but should be done only after first talking with your doctor. Open application tests should be done only with products that are designed to stay on the skin such as cosmetics and lotions. Apply a small amount (50 cents sized area) of the product to a small tender area of skin such as the bend of your arm or neck for several days in a row. Examine the area each day and if no reaction occurs, it is unlikely you are allergic to it. However, it may still not be suitable for you as it can still cause an irritant reaction. Products such as shampoos, conditioners, soaps and cleansers should not be tested in this way as they frequently cause an irritant contact dermatitis if they are covered or overused on tender areas.

What should I do to avoid fragrance allergy?

If you have a fragrance allergy the best way to avoid any problems is by avoiding all products that contain fragrances of any sort. Unfortunately, fragrance allergy is usually life-long and gets worse with continued exposure.

There are more than 5000 different fragrances that are in use today. In any one product, the number of fragrances used can be many. Fortunately, only a small number of fragrances are actually common sensitisers and cause allergy in sensitive individuals.

Often products are only labelled as containing fragrance and do not identify the individual chemicals used to make up the fragrance. You should avoid all products that are labelled with any of the following names. These include other names for fragrances, individual fragrance allergens and other related substances.

Other names for fragrances Individual fragrance allergens Other potential allergens Perfumes

Toilet water

Colognes

Masking perfumes

Unscented perfumes

Aroma chemicals

Essential oils Amylcinnamic alcohol

Anisyl alcohol

Benzyl alcohol

Benzyl salicylate

Cinnamic alcohol

Cinnamic aldehyde

Coumarin

Eugenol

Geraniol

Hydroxycitronellal

Isoeugenol

Musk ambrette

Oakmoss absolute

Sandalwood oil

Wood tars Balsam of Peru

Cassia oil

Cinnamon

Cloves

Citronella candles

Ethylene brassylate

Be wary of products that are labelled fragrance-free or unscented, as these terms may not necessarily mean they do not contain fragrance chemicals; they just imply the product has no perceptible odour. These products may possibly contain a masking fragrance that is used to cover up the odour of other ingredients.

Note that clothes washed in scented laundry detergent can be a problem with prolonged skin contact of the garment in the presence of moisture and heat. It would be best to use fragrance-free laundry detergent.

Alert your doctor or dentist to the fact that you have an allergy to fragrance mix. If you are highly sensitive, your doctor may also recommend a special diet that eliminates foods to which these allergens or related allergens are added as a flavouring.

Your dermatologist may have further specific advice, particularly if you are highly sensitive to fragrance mix.

Further information

Compound Formula CAS number: Cinnamic alcohol C 9 H 10 O 104-54-1 Cinnamic aldehyde C 9 H 8 O 104-55-2 Alpha amyl cinnamic aldehyde C 14 H 18 O 122-40-7 Eugenol C 10 H 12 0 2 97-53-0 Isoeugenol C 10 H 22 N 2 97-54-1 Hydroxycitronellal C 10 H 18 O 2 107-75-5 Geraniol C 10 H 18 O 106-24-1 Oakmoss absolute

Cross-reactions

Balsam of Peru

Cassia oil

Cinnamon

Cloves

Citronella candles

Ethylene brassylate

Tiger balm

Sensitisers

Cinnamic alcohol, cinnamic aldehyde, alpha amyl cinnamic aldehyde, eugenol, isoeugenol, hydroxycitronellal, geraniol, oakmoss absolute

Patch test

Fragrance mix 8%