Allergy to Fragrance: Understanding Fragrance Additives and Choosing Products

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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. 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.

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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. 

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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. 

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Fragrance is not one substance: there are hundreds of different fragrance additives.

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Fragrance, and fragrance allergy, is complicated. There are actually hundreds of different fragrance additives, and many of them are chemically related to one another.  

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Fragrance on a Label: What It Means

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The word "fragrance" on a label can be very misleading. When you're reading that one word, it sounds as though it's one ingredient. In fact, studies have shown that that one word "fragrance" can actually indicate 40 or more different substances.

 

That one word "fragrance" on a label should really be "secret mixture of fragrance additives". 

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What is Fragrance?

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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. 

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Labeling Terms Are Not Always Helpful

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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. 

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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. 

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All-Natural Fragrances Are Just as Concerning 

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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". These terms may not be helpful, though, because even 100% natural fragrances frequently cause allergic reactions. 

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Hidden Fragrance Chemicals

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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 sweet almond oil, can act as fragrance additives.

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Other Products that May Contain Fragrance

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If you're allergic to fragrance, you do need to be aware of other sources. Be careful with household products, such as floor cleaners, room fresheners, aromatherapy products, and household cleansers. I've seen several reactions 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.  

 

 

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For product recommendations that are truly fragrance free, please see this list on hypoallergenic skin care products

 

 

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The Bottom Line: 

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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.