Auckland Allergy Clinic

HOME

WHAT‘S NEW

ABOUT THE CLINIC

DOCTORS PROFILE

ALLERGY LIBRARY

ALLERGY DICTIONARY

MAKE AN APPOINTMENT

QUESTIONNAIRE

RELATED LINKS

GIVE US FEEDBACK

CONTACT THE CLINIC


Loading...

Fragrance (& Spice) Allergy

Article written: October 2001

Fragrances are among the most common causes of allergic contact dermatitis, and they are certainly the most common cosmetic ingredient causing allergic contact dermatitis. They can also cause photodermatitis, contact urticaria, irritation, hyperpigmentation and depigmentation of skin. Fragrances have widespread use and are found in:

Perfumes
Cosmetics
Hair products
Skin care products
Laundry products
Dentifrices (toothpastes), Mouth Wash
Cleaning products / Detergents
Pharmaceutical creams & suppositories
Insecticides
Food Flavours such as ice cream, chewing gum, bakery products, soft drinks, and sweets.

Usually the source of the fragrance exposure is a skin or hair care product rather than cologne or perfumes itself.

Fragrance raw materials can be of organic origin, derived from animal or plant sources, or from synthetic chemical source.

More than 5000 fragrance materials are in use today. A typical complete perfume may consist of 10 to 300 separate components.

The maximum concentration of fragrances in various products is as follows:

Masking perfumes, 0.1% or less
Cosmetics, 0.5%
Colognes, 4%
Toilet water, 5%
Perfume, 20%

Commercial perfumes are mixtures of essential oils and synthetic compounds, with at least 20 ingredients as a rule. The mixture of volatile substances determines the scent. To delay evaporation, "fixatives" are added. Common "fixatives" are balsams, benzoyl benzoate, benzyl salicylate and synthetic musks. Sensitivity to musks has been reported and sensitivity to balsams is common.

Screening for Fragrance Allergy:

Balsam of Peru
Fragrance Mix:
1. Oak Moss
2. Cinnamic aldehyde
3. Cinnamic alcohol
4. Alpha amyl cinnamic alcohol
5. Geraniol
6. Hydroxycitronellal
7. Isoeugenol &
8. Eugenol
Musk Ambrette and Moskene.

Balsam of Peru

Balsam of Peru (BP) is usually included in the standard screening patch-test series as an indicator of fragrance sensitivity. It is positive in 50% of cases of fragrance allergy. BP is a naturally occurring substance, obtained from fir trees. It is composed of many allergens including benzyl acetate, benzoyl alcohol, cinnamic acid, cinnamic alcohol, cinnamic aldehyde, eugenol, and isoeugenol.

Fragrance Mix

This is also used to screen for fragrance allergy. Typically it is a mixture of the 8 individual fragrances listed above.

Testing with BP and Fragrance Mix will probably detect about 75% of the cases of fragrance allergy.

Cinnamic Alcohol & Cinnamic Aldehyde

These 2 commonly used fragrances are well known allergens. Along with other chemically related compounds, they are used as flavouring agents, as well as fragrances. They are used in:

Beverages (cola), Vermouths, bitters
Chewing gums
Toothpaste & mouth wash
Toilet soaps

Hydroxycitronellal is a synthetic fragrance used widely in floralizing perfume materials. It is also used in insecticides and antiseptics.

Isoeugenol & Eugenol

Eugenol is a component of essential oils obtained from spices including cloves and cinnamon leaf, with an odour and taste of cloves. It is also present in pimento, calamus, cananga, camphor, sassafras, and nutmeg. In addition a number of flowers contain eugenol, including roses, carnations, hyacinths, and violets. It is found in Balsam of Peru and in the Fragrance mix. It has been used for a long time as a spice in the food industry and is approved by the FDA as a flavouring agent for ingestion. It has been used to preserve meats and other foods and has inherent insecticidal and fungicidal properties. Its usual concentration varies from 0.03% in creams and lotions to 0.4% in perfumes. Eugenol "quenches" non-immune contact urticarial reactions but has no effect on delayed-type hypersensitivity reactions to cinnamic aldehyde.

Uses

Cosmetics (clove and carnation scent)
Mouthwashes, toothpaste
Dental cements and packing agents
Antiseptics
Food flavour
Over-the counter medicines

Isoeugenol is manufactured by the isomerization of eugenol. It has a spicy clove-like odour. Isoeugenol and Eugenol may cross-react.

The North American Contact Dermatitis Group found 3.1% of their patients who were tested to the fragrance tray to be allergic to isoeugenol. Because of its sensitizing capacity, it has been recommended that isoeugenol be used at no more than 1% concentration in fragrance compounds.

Geraniol

Geraniol is the alcoholic extract obtained from geranium oil. It has a pleasant, sweet rose-like odour. Most geraniol on the market at present is synthetic. Geraniol is one of the most widely used terpenoid fragrance chemicals in soaps, detergents, and cosmetics. It is also a component of natural flavours and essential oils used in flavour compounds. It is found in over 250 essential oils and accounts for over 90% of palmarosa oil and a large portion of geranium and rose oils. The fragrance mix has geraniol as one of its component.

Oak Moss Absolute is a natural product derived from tree lichen. An essential oil is produced by solvent extraction of the plant. The part of the essential oil that is alcohol extractable is called absolute or isolate. It is a commonly used fragrance material in aftershave lotions to give them an earthy, woody, and "masculine" odour. Oak moss absolute is a component of the fragrance mix used in patch testing.

The prevalence of oak moss allergy reported by different investigators varied from 1% to 12%, depending on the concentration used for patch testing and other variables. Sensitivity to oak moss was found to be more common in whites than in Asians in a study conducted concomitantly in Europe, Japan, and the USA.

Benzyl Alcohol is a fragrance ingredient that is also used as an antiseptic topically and as a preservative in injectible medications.

Some Topical Products containing Benzyl Alcohol:

Aristocort A Cream
Lotrimin Lotion

Injectable Medications Containing Benzyl Alcohol:

Kenalog
Depo-Medrol
Intron A.

Musk Ambrette & Musk Moskene

Musk Ambrette is a synthetic chemical that has been used widely for the last 60 years. It is used in fragrances, soaps, detergents, creams, lotions, and dentifrices. Musk ambrette is a photosensitising fragrance. It can also cause an airborne allergic contact dermatitis of the face with hyperpigmentation. There was a reported case due to chronic burning of incense for several years.

Musk Moskene is related to Musk ambrette, but it causes less allergic contact dermatitis and photodermatitis.

Flavouring agents & spices

Contact sensitivity to spices occurs mainly from occupational exposure, but sensitivity to mustard, cinnamon, vanilla, allspice, oil of juniper and cloves is not uncommon, even among consumers. Cigarette & pipe tobaccos contain about 1% of spices and perfumes. The clinical consequence is unknown.

In modern food industry a large number of synthetic flavouring agents are used.

Strategies implemented to reduce the sensitising potential of fragrance materials:

Elimination of known sensitizers
Use of safe alternatives
Use of pure, standardised fragrance materials
Formulation of products that contain ingredients which may inhibit sensitisation ("quenching" agents). For example, cinnamic aldehyde, which is a strong sensitizer, when formulated with an equal weight of eugenol (quencher), prevents sensitisation.

International Fragrance association (IFRA) industry guidelines to restrict ingredient usage*

SELECTED FRAGRANCE COMMENTS
Cinnamic alcohol   Should not be used as a fragrance ingredient at a level over 4% in scented compounds
Cinnamic aldehyde   Use in conjunction with substances that prevent sensitisation (quenchers)
Colophony   Should not be used as a fragrance ingredient
Dihydrocoumarin   Should not be used as a fragrance ingredient
7-Methylcoumarin   Should not be used as a fragrance ingredient
Hydroxycitronellal   Should not be used as a fragrance ingredient at a level over 5% in compounds
Isoeugenol   Should not be used as a fragrance ingredient over 1% in compounds
Musk Ambrette   Should not be used as a fragrance ingredient
Balsam of Peru   Should not be used as a fragrance ingredient
Oak moss absolute   Should not be used in fragrance compounds at levels over 3%

*Extracted from the International Fragrance Association (IFRA) Code of Practise

Diagnosis of Fragrance Allergy

Patch Test to Balsam of Peru and Fragrance Mix is a good screen to start with.

Since most individual fragrances are not listed on most cosmetics labels, a Use Test (applying the new product to a clear part of the forearm twice daily for 5 days & observe for dermatitis) should be performed before starting a new perfumed product. This is also advisable in cases of cosmetic products labelled "unscented" as some still may contain a certain amount of fragrances (0.01%).

 

OTHER TOPICS