Allergen, Not An Allergen Featured

PERFUME/FRAGRANCE: Allergen or Not An Allergen?

Allergen…and Photo-Allergen!

Perfume, Fragrance

And boy, what common and consistent allergens! Fragrance has the dubious honor of being the 2007 Allergen of the Year of the American Contact Dermatitis Society. Fragrance is everywhere, and even natural, organic fragrances can be top allergens. If you’ve patch tested positive for fragrance, there’s quite a bit to avoid, including:

You can find these ingredients where you’d expect: perfume, colognes, cosmetics, hair care, hair styling, shaving, and personal hygiene products…but also where you might not, like in:

  • Paints and certain industrial liquids (metal working, for example, where masking fragrances are used to offset strong smells)
  • Insect repellants
  • Laundry soaps and other products
  • Room sprays and candles (some people are sensitive enough to get rashes from inhaling the delicious-smelling vapors of candles)
  • Colas, sport drinks, or other pre-packaged drinks and juices, and
  • As flavors in bitters, gum, candy, and even in toothpastes and mouthwashes.

Pro tip: a product that smells good probably has fragrance in it. A product that doesn’t smelly perfume-y or like flowers or fruit or flavors but smells like “nothing” might have a masking fragrance in it (also allergens). A product is more likely to be truly fragrance-free if it smells like a lab…but this doesn’t guarantee that it doesn’t contain other allergens. Read the ingredients list to be sure.

If you have a history of sensitive skin, don’t guess: random trial and error can cause more damage. Ask your dermatologist about a patch test.

To shop our selection of hypoallergenic products, visit Need help? Ask us in the comments section below, or for more privacy (such as when asking us to customize recommendations for you based on your patch test results) contact us by email, or drop us a private message on Facebook.

For more:

On the prevalence of skin allergies, see Skin Allergies Are More Common Than Ever and One In Four Is Allergic to Common Skin Care And Cosmetic Ingredients.

To learn more about the VH-Rating System and hypoallergenicity, click here.

Main References: 

Regularly published reports on the most common allergens by the North American Contact Dermatitis Group and European Surveillance System on Contact Allergies (based on over 28,000 patch test results, combined), plus other studies. Remember, we are all individuals — just because an ingredient is not on the most common allergen lists does not mean you cannot be sensitive to it, or that it will not become an allergen. These references, being based on so many patch test results, are a good basis but it is always best to get a patch test yourself.

1. Warshaw, E.M., Maibach, H.I., Taylor, J.S., et al. North American contact dermatitis group patch test results: 2011-2012. Dermatitis. 2015; 26: 49-59

2. W Uter et al. The European Baseline Series in 10 European Countries, 2005/2006–Results of the European Surveillance System on Contact Allergies (ESSCA). Contact Dermatitis 61 (1), 31-38.7 2009

3. Wetter, DA et al. Results of patch testing to personal care product allergens in a standard series and a supplemental cosmetic series: An analysis of 945 patients from the Mayo Clinic Contact Dermatitis Group, 2000-2007. J Am Acad Dermatol. 2010 Nov;63(5):789-98.

4. Verallo-Rowell VM. The validated hypoallergenic cosmetics rating system: its 30-year evolution and effect on the prevalence of cosmetic reactions. Dermatitis 2011 Apr; 22(2):80-97

5. Ruby Pawankar et al. World Health Organization. White Book on Allergy 2011-2012 Executive Summary.

6. Misery L et al. Sensitive skin in the American population: prevalence, clinical data, and role of the dermatologist. Int J Dermatol. 2011 Aug;50(8):961-7.

7. Warshaw EM1, Maibach HI, Taylor JS, Sasseville D, DeKoven JG, Zirwas MJ, Fransway AF, Mathias CG, Zug KA, DeLeo VA, Fowler JF Jr, Marks JG, Pratt MD, Storrs FJ, Belsito DV. North American contact dermatitis group patch test results: 2011-2012.Dermatitis. 2015 Jan-Feb;26(1):49-59.

8. Warshaw, E et al. Allergic patch test reactions associated with cosmetics: Retrospective analysis of cross-sectional data from the North American Contact Dermatitis Group, 2001-2004. J AmAcadDermatol 2009;60:23-38. 

9. Foliaki S et al. Antibiotic use in infancy and symptoms of asthma, rhinoconjunctivitis, and eczema in children 6 and 7 years old: International Study of Asthma and Allergies in Childhood Phase III. J Allergy Clin Immunol. 2009 Nov;124(5):982-9.

10. Kei EF et al. Role of the gut microbiota in defining human health. Expert Rev Anti Infect Ther. 2010 Apr; 8(4): 435–454.

11. Thavagnanam S et al. A meta-analysis of the association between Caesarean section and childhood asthma. Clin Exp Allergy. 2008;38(4):629–633.

12. Marks JG, Belsito DV, DeLeo VA, et al. North American Contact Dermatitis Group patch-test results, 1998 to 2000. Am J Contact Dermat. 2003;14(2):59-62.

13. Warshaw EM, Belsito DV, Taylor JS, et al. North American Contact Dermatitis Group patch test results: 2009 to 2010. Dermatitis. 2013;24(2):50-99.

Want more great information on contact dermatitis? Check out the American Contact Dermatitis SocietyDermnet New Zealand, and your country’s contact dermatitis association.


Allergy to Fragrance: Understanding Fragrance Additives and Choosing Products

by Rajani Katta, M.D.

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.

If you’re allergic to fragrance, 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 contains some type of fragrance.

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. 

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

Fragrance on a Label:

What It Means 

The word “fragrance” on a label can be very misleading. When you’re reading that one word, it sounds like it’s one ingredient. In fact, studies have shown that this one word can indicate the presence of 40 or more different ingredients. That one “fragrance” word on a label should really be “secret mixture of fragrance additives.” 

What is Fragrance?

The term “fragrance” 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. 

Labeling Terms Are Not Always Helpful

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. 

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.

All-Natural Fragrances Are Just as Concerning

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”. This particular term may also not be helpful, though — even 100% natural fragrances frequently cause allergic reactions. 

This product advertises its natural ingredients…


…and (correctly) advertises that it contains no synthetic fragrances…

Hidden Fragrance Chemicals

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 rose oil, can act as fragrance additives. These ingredients may even be legally used in products that are labeled “fragrance-free”. This post discusses this issue in more detail. 

Other Products That May Contain Fragrance

If you’re allergic to fragrance, you do need to be aware of other types of products and exposures. 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.  

The natural fragrances in aromatherapy candles and essential oil diffusers can also trigger allergic reactions.

The Bottom Line

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.

Dr. Katta is the author of “Glow: The Dermatologist’s Guide to a Whole Foods Younger Skin Diet” and you can read more of her work in her blog.


Reposted with permission. We publish articles by doctors who wish to provide helpful information to their patients and the public at large, or who respond to our requests to use them as professional resources. Doctors may or may not prefer to remain anonymous and we respect this preference. These resource articles do not in any way imply an endorsement by the physician of or VMV HYPOALLERGENICS® — they are intended for informational purposes only. While written by or with resource professionals, these articles should not be relied on for diagnostic accuracy or applicability to your particular skin, which requires an in-person ocular consultation with a qualified physician and possibly additional diagnostic tests.


Dr. Rajani Katta  is a board-certified dermatologist and recognized expert in allergic contact dermatitis. She has a deep passion for developing well-researched and practical educational resources that help people take action. For at least 17 years, she was a member of the clinical faculty for both the Baylor College of Medicine and the McGovern Medical School. She also serves as a member of the Media Expert Team of the American Academy of Dermatology.

She is the author of numerous medical journal articles and seven published books on the link between skin and diet, as well as allergic reactions of the skin. Her latest book, Glow: The Dermatologist’s Guide to a Whole Foods Younger Skin Diet, provides an evidence-based and practical approach to eating for younger skin.

Dr. Katta is the recipient of multiple awards recognizing her commitment to excellence in patient care, teaching, and research. A few of these awards are the National Merit Scholar, American Medical Women’s Association Scholastic Achievement Award, Alpha Omega Alpha Honor Medical Society and Women’s Dermatological Society Mentorship Grant.

She has also been part of the  Texas Super Doctors® list  since 2016. Follow Dr. Katta and find out about the “GLOW” diet when you read her posts on expert tips for health, skin and soul!