Fragrance Allergies: A Sensory Assault

The use of fragrance in products is on the rise -- and so is the number of people affected by them. WebMD offers ways to protect yourself if you're sensitive to scents.

From the WebMD Archives

Do any of these scenarios sound familiar?

  • You catch a whiff of a co-worker's new fragrance, and within minutes, you have a whopper of a headache.
  • You pop open that new bottle of dish-washing liquid, and by the time you've washed the pots and pans, your hands and arms are covered in hives.
  • You walk into a friend's home and smell freshly baked pumpkin pie. Only after you start sneezing uncontrollably and feeling dizzy, weak, and sick to your stomach do you learn she hasn't been baking -- she's been burning a scented candle.
  • Your favorite fashion magazine arrives, and as soon as it's out of the mailbox your eyes are watering and you're sneezing nonstop. The culprit: scented fragrance advertising inserts.

If this sounds like you, you may be one of a growing number of people with fragrance allergies or sensitivities that can have mild to severe health consequences.

"Scent sells. So not only are there definitely more fragranced products in the world, the fragrances themselves are also more complex. And for many people, repeated exposures can bring about a constellation of symptoms," says Tracie DeFreitas Saab, MS, a human factors consultant with the Job Accommodation Network at West Virginia University. DeFreitas frequently works with employers and employees on work environmental issues.

Those symptoms, she tells WebMD, can range from classic "allergic" reactions, such as sneezing, runny nose, and watery eyes; to headaches, inability to concentrate, and dizziness; to respiratory issues, such as breathing difficulties and wheezing; to skin reactions, such as itching, hives, and other rashes.

According to the American Academy of Dermatology (AAD), fragrances are considered the leading cause of cosmetic contact dermatitis. As a health problem, this sensitivity alone affects more than 2 million people, and studies suggest that sensitivity is on the rise.

(What do you do when faced with fragrance sensitivity or allergy? Talk with others on the Health Cafe board.)

Fragrances and Our World

Experts theorize that one reason fragrance allergies appear to be increasing is that fragrances themselves have become such a prominent part of our world. According to the AAD, some 5,000 different fragrances -- and countless other fragrance combinations -- are used in products today. And they can be a powerful, toxic brew.

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"From hair shampoos to carpet shampoos, from laundry detergent to shower gels, from home sprays to hair sprays to moisturizers, cosmetic, and personal care items, the scent industry has literally exploded. And for many people, it's a real sensory overload," says Pamela Dalton, PhD, MPH, an olfactory researcher at the Monell Chemical Senses Center in Philadelphia.

We do have some control over what we allow into our homes and other personal spaces -- we can toss that magazine with the inserts or switch shampoo -- but it can really become an issue when our senses are assaulted in common areas, such as the workplace or a college classroom, places where we have to be.

"Being forced to breathe in others' fragrance choices is a lot like being forced to breathe in secondhand smoke," Dalton tells WebMD. "It's a loss of control over your personal environment, and for some it can have serious personal health consequences."

And that is precisely the logic behind several recent legal actions aimed at cleaning up our personal air space.

  • In July 2007, a government worker from Detroit sued her employers under the Americans With Disabilities Act for what her lawsuit claims is "fragrance toxicity" in the workplace. Her claim: Exposures to fragrances also means increased exposure to chemical neurotoxins that adversely impact brain function. The suit is pending.
  • In the fall of 2007, a group of students from California State University, Stanislaus, became so concerned about these same chemical exposures they asked campus officials to institute a fragrance-free policy. Their request cited headaches, nausea, and inability to concentrate, all caused by overpowering fragrance use among some students and faculty. The students are waiting for the administration's decision.
  • Workers in the Portland, Ore., Bureau of Emergency Communications were recently banned from wearing fragrances under what has become one of the nation's first government workplace "fragrance-free" policies. Portland State University followed suit, and now similar programs are in place at Cecil College in Maryland.

Fragrance Allergies: Nailing Down the Culprits

It can be hard to imagine that what smells divine to one person can cause a myriad of miserable symptoms in another, but experts say that how our bodies respond to a particular fragrance lies in our individual physiologic makeup.

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"There are definitely people who can smell things at lower levels than others, and it's totally due to the internal geometry of the nose, including the number of olfactory receptors, which can differ significantly. So some people may actually be getting a bigger dose of a fragrance," Dalton says.

Women, particularly during their reproductive years, she adds, have the ability to detect odors much more vividly than do men -- and they become more sensitive with repeated exposures.

For most people, fragrance allergy symptoms abate once the scent is out of range. But this isn't always the case. For some, repeated exposures cause an increase in symptoms that occur more often and last longer. According to the American Academy of Allergy and Immunology, a small but growing segment is affected by a little understood and even somewhat controversial condition known as multiple chemical sensitivity (MCS).

For people with MCS, Dalton says sensitivity to one fragrance or odor can snowball into a crippling multiple chemical sensitivity that leaves its victims defenseless in the face of an ever-widening number of chemical odors and fragrances.

To further complicate matters, doctors can't quite agree on what's behind any fragrance reaction, and whether it's even a true allergy or simply a response to an irritant.

"Sensitivity is a general term under which you can have a true allergic reaction, but you can also have irritant reactions, meaning the problem with fragrance could be that it's an irritant. With others, it could be an allergic reaction. It's just not well known what actually is occurring when these reactions develop," says dermatologist Marjorie Slankard, MD, clinical professor of medicine at Columbia Eastside, a division of Columbia Presbyterian Medical Center in New York City.

Some experts aren't even sure if it's the fragrance itself that is the real culprit, or just one part of a mix of chemicals -- as many as 200 or more -- that are used to create both fragrances we smell and the masking agents used in unscented products.

"Because the 'fragrance' is what we smell when we have an onset of symptoms, we blame the fragrance. But, in fact, it's possible that the reaction we are getting may instead be the result of the many chemicals used in the formulation of the fragrance," Dalton tells WebMD. This, she says, includes both products we can smell and those labeled as "unscented," which frequently rely on a whole host of chemicals to dampen the scent.

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So what's someone who suspects a fragrance allergy to do when it comes to finding a product that won't cause a reaction? Ultimately, experts say, it's all about trial and error.

Slankard advises trying an unscented product first. If you don't have a reaction, then the scent most likely is the culprit. If you do have a reaction, then it is probably a chemical reaction, not a true fragrance reaction. At that point, it becomes like any other chemical reaction: You have to try to nail down the exact cause with the help of an allergist, but at least you know it's chemical in nature.

Single-note fragrances, like a rose scent or freesia scent, may be less likely to cause problems than a multicomponent scent -- unless, of course, it's the single note you are reacting to, she says.

Fragrance Sensitivities: What You Can Do

Regardless of what is behind your fragrance allergy, experts agree that reducing exposure is key.

"The most important thing you can do in that respect is to remove yourself from the offending fragrance." Avoidance is really the most effective treatment, Slankard tells WebMD.

But what if you can't? Experts say there are still ways to get control.

"One important thing you can do is get other people to recognize that it's a problem, not only for you, but for everyone who is exposed. And if you do it in a courteous way, you can sometimes get good results," says Saab.

This means simply asking the person whose fragrance is overbearing to tone it down -- or asking your employer to educate workers about fragrance allergies, including what each person can do on an individual level to help reduce the "fragrance overload" in a work or learning environment.

"If they bring it up as an awareness issue, without singling out one person, people will be better informed and hopefully will be more selective about what they wear in the work environment, Saab says.

Here are six more solutions offered by Saab and the Job Accommodation Network.

  1. Change workstation location. Either move away from the person whose fragrance you find offensive, or move away from a common area where people congregate, such as a foyer, break room, or restroom. Being in contact with fewer people will mean less exposure to fragrances overall, and that can help.
  2. Telecommute at least a few days a week. The more time you can spend outside of the environment, the less potent your symptoms may be when you do have to be there.
  3. Modify your work schedule. Going in to work at 6 a.m., for example, usually means you will have less contact with co-workers. And leaving earlier in the day reduces the amount of time you will be exposed to the offending fragrances, which will give your body a better chance at recouping after exposures.
  4. Try an air purifier. But be aware that air cleaners and air purification units work less efficiently in a cubicle situation than in a private office where you can shut the door. Also be certain to choose a unit with an appropriate filter, such as gas or carbon. Simply using a system with dust filtration won't help alleviate odors.
  5. Use a portable fan. A small fan can blow stagnant air away and keep odors from lingering in your personal space.
  6. Develop alternate methods of communication. Work via email, phone, or fax as much as possible to limit contact with those whose fragrances you find offensive.

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Slankard says you may also control some symptoms with a nonsedating over-the-counter allergy medicine. "You can also talk to an allergist or an environmental medicine specialist, who may be able to prescribe additional medications that can help," she says.

For more help: Visit the Job Accommodation Network web site at www.jan.wvu.edu or call (800) 526-7234. To get help from the Americans With Disabilities Act, visit their web site at www.usdoj.gov/crt/ada/adahom1.htm

WebMD Feature Reviewed by Louise Chang, MD on January 11, 2008

Sources

Tracie DeFreitas Saab, MS, Human Factors Consultant, Job Accommodation Network, West Virginia University.

Pamela Dalton, PhD, MPH, Monell Chemical Senses Center, Philadelphia.

Marjorie Slankard, MD, clinical professor of Medicine, Columbia Eastside, Columbia Presbyterian Medical Center, New York City.

American Academy of Dermatology.

Fox News: "Eau de Lawsuit: Woman Sues Over Scent," July 5, 2007.

Cosmetics Design: "Claims for fragrance free university campus in California," Oct. 4, 2007.

American Academy of Allergy & Immunology, position statement: "Idiopathic environmental intolerances."

© 2008 WebMD, LLC. All rights reserved.

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