The frequency of fragrance allergy in a patch-test population over a 17-year period

Abstract

Fragrances are widely encountered in our daily environment and are known to be a common cause of allergic contact dermatitis. We have reviewed our patch test data from 1980 to 1996 to establish whether the pattern of fragrance allergy has changed with time. During this period, 25,545 patients (10,450 male, 15,005 female) were patch tested with the European standard series. The mean annual frequency of positive reactions to the fragrance mix was 8.5% in females (range 6.1-10.9) and 6.7% in males (range 5.1-12.9). Females were 1.3 times more likely to be allergic to fragrance (P < 0.001, 95% confidence interval, CI 1.17-1.41). Males with fragrance allergy were older than females by 5.6 years (mean age 48.2 vs. 42.6 years; P < 0.001, 95% CI 3.9-7.3). The incidence of a concomitant positive patch test to balsam of Peru in fragrance-sensitive patients showed wide variation, suggesting that it is not a reliable marker of fragrance allergy. There was a positive correlation between the isomers isoeugenol and eugenol. Oak moss remained the most common overall allergen throughout the study, positive in 38.3% of females and 35.6% of males who were tested to the constituents of the fragrance mix. During the period of the study the incidence of positive tests to oak moss increased by 5% yearly (P = 0.001, 95% CI 2.2-8.7). The frequency of allergic reactions to eugenol and geraniol remained relatively constant. Isoeugenol and alpha-amyl cinnamic aldehyde sensitivity increased and hydroxycitronellal showed a slow decline. There was a striking reduction in the frequency of sensitivity to cinnamic aldehyde (by 18% yearly; P < 0.001, 95% CI 14.3-21.0) and cinnamic alcohol (by 9% yearly; P < 0.001, 95% CI 5.2-12.9); these are now uncommon fragrance allergens. These data show temporal trends which may reflect the frequency of population exposure to individual fragrances.

The prevalence of allergic contact sensitization in a general population in Tromso, Norway

“…These figures are in line with a previous study from Denmark (1,25), however, lower than reported in out-patient clinic studies (18,28). Moreover, there does not seem to be a concomitant positive patch test to balsam of Peru in fragrance-sensitive patients, which suggests that balsam of Peru is not a reliable marker of fragrance allergy (27).…”

“…The target group of the cosmetic industry has been women, but men, and more recently children, are the new and growing consumer groups. It is therefore to be expected that fragrance allergy will be an increasing health problem in these groups (26,27). Few reactions were found to colophony and balsam of Peru.…”

Adverse reactions associated with the use of eugenol in dentistry

“…Reassuringly, there does not appear to have been any increase in eugenol hypersensitivity over the past two decades. 25 Furthermore, the oral implication of epi-cutaneous patch testing of dental materials is unclear. In general, the mouth and the oral mucosa appear to be less sensitive to contact allergens than the skin, possibly because allergens are constantly diluted and washed away by the saliva.…”

Comparison of Marketed Cosmetic Products Constituents with the Antigens Included in Cosmetic-related Patch Test

“…If patch test was used to investigate patients suspected of developing contact dermatitis, approximately 42∼54% would demonstrate positive reaction 1,6,18 . The reason behind such a high positive rate is that fragrances are included not only in the perfume but also in the various types of cosmetic product, detergent, medical product and others [19][20][21][22] . In this study, more than half of the tested products contained fragrance, which were confirmed to be included in various cosmetic product types other than the aroma products.…”