What are the other Names for this Condition? (Also known as/Synonyms)

• Perfume Dermatitis

What is Fragrance Dermatitis? (Definition/Background Information)

• Fragrance Dermatitis describes the manifestation of skin signs and symptoms on exposure of the skin to any fragrant or perfumed products, such as cosmetics, toiletries, food flavors, and any chemicals (with scent) one is exposed to at home or at work. An individual may be allergic to more than one product containing the allergen (i.e., fragrant chemical)
• Fragrance Dermatitis is an allergic condition that manifests as an abnormal immune reaction/response of the skin to certain ingredients found in scented or odorous chemicals. It should not be confused with fragrance allergy, which is an allergic condition that occurs when individuals inhale scented or smelly chemicals (from any source)
• Some individuals with sensitive skin may be higher prone to this form of allergy. Fragrance Dermatitis may be treated using moisturizing creams, topical steroids, and anti-allergic medications, including by avoiding the causative allergen, if known. In many cases, the prognosis is good

Who gets Fragrance Dermatitis? (Age and Sex Distribution)

• Fragrance Dermatitis may be observed in any individual whether child or adult. It is informed that nearly 1 in 50 children and 1 in 100 adults may have some form of Fragrance Dermatitis
• Both males and females are affected, and no gender preference is noted
• Worldwide, there is no racial or ethnic preference observed

What are the Risk Factors for Fragrance Dermatitis? (Predisposing Factors)

The risk factors for Fragrance Dermatitis may include:

• History of atopic dermatitis: Any family history of skin allergies may put one at a higher risk for the Fragrance Dermatitis
• Having one form of allergy may place one at risk for other allergy forms
• Individuals with sensitive skin
• Exposure of the skin to any of the following scented or perfumed product:
  • Cosmetics and toiletries including soaps, shampoos, and toilet wipes
  • Household cleaning agents including detergents, cleaning fluids, room fresheners, aromatic candles, etc.
  • Food items including flavorings, packaged foods, etc.
  • Certain topical ointments, creams, and nasal sprays
  • Industrial oils, solvents, fuels, and chemical products
• Working in bakeries, beauty salons, and supermarkets can place one at a higher risk for the condition

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Fragrance Dermatitis? (Etiology)

An allergic skin reaction occurs in an individual with Fragrance Dermatitis because the immune system recognizes certain chemical compounds in the fragrance/scent/odor as being dangerous and harmful to the skin. It is a form of allergic contact dermatitis.

Based on research, some of the natural and synthetic chemicals present in fragrances that are known to cause an allergic response on skin include:

• Isoeugenol
• Hydroxyisohexyl 3‑cyclohexene carboxaldehyde
• Balsam of Peru

What are the Signs and Symptoms of Fragrance Dermatitis?

The signs and symptoms of Fragrance Dermatitis may vary from one individual to another. It may be mild or severe and can include:

• Presence of red skin rashes on the area of exposure (i.e., region of direct skin contact with the allergen)
• In particular, the face, neck, shoulders, back, and arms may present these allergic skin rashes
• In men, the hands and legs may be more often affected apart from the face
• When the mouth is affected, it can result in swollen lips, gum inflammation, and ulcers
• Presence of swollen blisters with scale formation
• Pain, itching, burning/stinging sensation may be noted
• Scratching may result in excoriation (scratch marks)
• Continued exposure to the fragrant chemical may cause thickening of skin
• The non-exposure areas may also present the rashes due to transfer of allergens via one’s hands

How is Fragrance Dermatitis Diagnosed?

A diagnosis of Fragrance Dermatitis may involve the following exams and procedures:

• Physical examination of the individual and medical history evaluation, including use of sunscreens and other cosmetics
• Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin patch test and open application test
• Skin biopsy: A skin tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

A differential diagnosis may be necessary to eliminate other conditions that present similar signs and symptoms such as:

• Atopic dermatitis
• Contact urticaria
• Irritant contact dermatitis
• Other forms of allergic contact dermatitis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Fragrance Dermatitis?

The possible complications due to Fragrance Dermatitis include:

• Emotional stress due to cosmetic issues
• Superimposed bacterial and fungal skin infections
• Recurrence of the condition, which may be noted frequently or regularly
• Treatment complications

How is Fragrance Dermatitis Treated?

The treatment measures available for Fragrance Dermatitis include:

• Immediate stoppage of exposure to the known/identified causative allergen, where possible
• Use of moisturizing creams
• Use of topical steroidal creams
• Systemic steroidal therapy may be recommended based on the healthcare provider’s evaluation
• Anti-allergic medications, as necessary
• Administration of antibiotics or antifungals for secondary infections, as needed

It is generally difficult to treat Fragrance Dermatitis, unless the allergen (fragrant chemical) causing the condition is clearly identified.

How can Fragrance Dermatitis be Prevented?

Generally, in many cases, it may be difficult to prevent Fragrance Dermatitis. However, the following measures may be considered:

• Avoid products that one is allergic to (if known); use suitable alternatives
• Read product labels and educate oneself on items that potentially contain the allergenic substance
• Self-test products where possible, such as by putting a small sample on the arm, based on instructions provided in the product packaging material
• Avoid suspect products that do not clearly list out the ingredients on package labels
• Try to use unscented product alternatives, where possible

What is the Prognosis of Fragrance Dermatitis? (Outcomes/Resolutions)

The prognosis of Fragrance Dermatitis depends on the severity of the signs and symptoms, but it is generally good with appropriate treatment, including avoidance of the offending fragrant chemical substance.

Additional and Relevant Useful Information for Fragrance Dermatitis:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/