[Contact allergy for perfume ingredients in cosmetics and toilet articles]

Fragrance materials are not only present in products primarily used for their scent such as perfume, eau de toilette, deodorant and aftershave, but also in cosmetics, toiletries, household products and industrial materials. Of the general population, approximately one percent are allergic to fragrance materials, men nearly as frequent as women. Of patients consulting the dermatologist because of dermatitis, 6-11% have a positive patch test to the fragrance mix. Allergic contact dermatitis due to fragrances usually consists of erythema and desquamation, often localized in the neck, behind the ears, in the arm-pits or around the eyes. It can worsen pre-existing dermatoses such as hand eczema, atopic dermatitis, perianal dermatitis or vulvar dermatitis. The diagnosis of contact allergy to fragrances is made by epicutaneous tests with the European standard series (including some markers for fragrance sensitivity: the fragrance mix, balsam of Peru and colophony) and the patient's own contact materials. A positive patch test reaction must be followed by evaluation of its relevance. Advice to the patient is directed towards avoidance of fragranced products, if possible, and explanation of how use tests can identify fragranced products which can be used without ill effects.