Thanks for another interesting article. However while reading it I was reminded of how a while ago a friend mentioned receiving patch testing as a way of telling whether you are actually allergic or not. Is this correct or is there another method that is more effective?
Hi Curiousreader,
I appreciate your comments and question. Patch testing is a way of identifying substances that may cause contact dermatitis (also referred to as contact allergy). The term "contact allergy" is a misnomer because the mechanism of the reaction does not involve IgE antibody.
Some fragrances may cause contact dermatitis which is an inflammatory reaction in the skin, often delayed by several hours to days after the skin exposure. Patch testing is available for a small number of fragrances. Positive test results confirm hypersensitivity of the skin to direct contact.
Patch testing will not predict whether an irritant respiratory reaction will follow the inhalation of a fragrance. Patch test negative patients may have severe breathing problems after inhaling a small amount of fragrance.
Thanks Again
Dr Thompson I thank you for such important subject. Im another one for the list and Im now scared to visit hospitals or even worse a dentist.I have a severe tooth ache and Im very afraid to get a reaction from the substances used in the clinic.I dont know what to do since Im thinking that anesthetics can make me sick.
How do you tell the difference between migraine headaches and sinus headaches? I think I have both. Fragrances bother my sinuses and cause my migranes.
Hi Dapeet,
Thank you for your question and comments. Migraine headaches may be triggered by a number of factors which include fragrances, strong odors and fumes. Certain foods and food additives, stress, hormonal drugs, oral decongestants and menstruation may also trigger migraines.
It may be difficult to distinguish sinus headache from migraine. Migraine head pain is more often located on one side of the head vs both sides or all over. Classically the migraine pain is over one eye but many migraine sufferers have different types of headaches. Headaches that are throbbing, very severe, disabling, associated with nausea or light sensitivity suggests migraine.
Sinus headaches are often located over the sinuses (above or below the eyes or over the bridge of the nose). They are not usually throbbing. Sinus headaches typically feel like a constant pressure in the face. The sinus pain may be worsened by bending over.
Yes, you may have both migraine and sinus headaches. Ouch! Both problems should be treated by your doctor.
The steps in my Sharepost on how to avoid fragrance may be helpful in preventing some of your headaches.
Good Luck!
As I understood from your article fragrances don't cause allergies but mimic allergy symptoms. I don't have asthma and haven't had any allergy till now. I wear perfumes, but I noticed that nowadays I feel so dizzy, having fatigue, headaches, tingling/prickling feeling at my eyes, burning feel at my face, tension at my spine especially at neck, sometimes tightness at chest, I m suspicious that perfumes causing this, or maybe I m developing allergy to something else, I m really confused. Generally happens at work through the lunch. At the office there is air condition which is the only source of fresh air. My practitioner told me it wasn’t allergy, what she told me is I should have at least runny nose and/or water eyes, itching, rash for an allergy. Are there really symptoms that every allergy must have? Thanks in advance.
Dear EU,
I'm sorry I missed the alert about this posting. Allergic rhinitis symptoms overlap non-allergic rhinitis symptoms in a major way. But you don't have to have a certain number of symptoms and/or signs to make it an allergy based problem. The nature of the trigger factor leading to the symptoms is what supports or fails to support an allergic mechanism. Some people have runny nose and burning of the eyes from ragweed pollen exposure while others may sneeze a zillion times but not have eye symptoms or nasal blockage. If all of the above symptoms occur after getting a whiff of tobacco smoke, it doesn't mean you are allergic to tobacco. Tobacco smoke is an irritant, not an allergen.
In conclusion, you were misinformed. The symptoms do not have to conform to a particular number or combination to be considered allergy based.
Hope this was helpful, although I know you may be in a different area code by now.
J. Thompson, MD
Is there anything one can do to neutralize the effect of irritating perfume? Once inhaled, it's like it burns an impression in my nose...I can continue to smell long after escaping the offensive smell, resulting in horrible headache and throat irritation.
Newer perfumes seem to be more oil based, or have some sort of property that allows them to hang in the air after the offending wearer has passed by. These newer perfumes (one example is "Angel" by Thierry Mugler/ Clairins) even get to my contact lenses, forcing me to remove them from my eyes asap because of an oily, slick film that is on them.
If I touch something the offending wearer has touched or used ( like a telephone, a shopping cart handle, entry door handle, gasoline pump handle), or even try-on clothes in dressing room that offending wearer has tried-on...the perfume smell immediately makes me feel ill.
It's easy to say, "avoid these smells", but it's as simple as having someone walk past you- and you are exposed.
Years ago, perfumes didn't seem to have the ability to "hang in the air" and attach themselves to another person walking by as easily as some of the perfumes today.
I find that once the smell has made the "imprint" in my nose/nasal passage there is nothing that I can do. Sometimes, taking an additional shower will remove the offending perfume odor from my hair and skin, but the nasal cavity will often take about 24 hours to return to an un-irritated state (where I can no longer smell the perfume).
Is there help? I'd be interested to hear useful tips from others.
PS- think about the poor dogs who are sprayed with doggie cologne...when their sense of smell is far superior to ours, they must suffer immensely.
Hi Valerie
I don't know if newer perfumes have been formulated to last longer or be more pungent but I wouldn't be surprised if this were the case. The level of tolerance of specific individuals to a specific fragrance varies just as much as the degree of appeal (how much one likes a particular fragrance). A sensitive person may be more or less sensitive to the same fragrance at different times in their life. So you see there are many variables which makes it difficult to understand or explain why you might be having more trouble with such vapors present day.
That said, avoidance is still the only ace card unfortunately. As you stated, it is impossible to completely avoid fragrances. There are too many people that drench themselves in their favorite cologne before going out into the world.
Nasal rinsing might help you get through an unexpected whiff. Try keeping a small bottle of nasal spray saline in your bag or pocket. Try to immediately get to a restroom and rigorously rinse out your nasal passages with the saline. If a restroom is not available, simply take several sniffs of the saline as if it were a nasal spray medication.
I have prescribed Astelin (which has a generic) or Astepro or Patanase for patients with fragrance intolerances. They have instructions to prepare for exposure by spraying 1 or 2 sprays 30mins before going into high risk environments (for example a shopping mall, department store or church). An alternative approach is to take 1 or 2 sprays of one of the above medications immediately after symptoms begin (but it may take 20-30 mins to start working). Patients that are bothered by fragrances almost every day may take one of the above sprays daily as a preventive. Discuss the use of these nasal sprays with your allergist or primary doctor.
I agree, if dogs could talk...
Best Wishes!
J. Thompson, MD
I am lately experiencing some kind of reaction when percieving the smell of a new purse, vinyl, paint etc. Even visiting a hospital in where the solutions they use like alcohols, iodine and anything that releases fumes can practically shoke me. Im scared to death and what I do is not to expose to certain places.Hardware stores, pharmacy, places with animals specially if there is urine smell around.Any sugestions on the subject is greatly appreciated.I now have to visit a dentist and Im afraid to get a reaction to the solutions they use as well.This is becomming a serious issue.Thanks
Thank you for a very informative article! Fragrences and I are always at war. I have a hard time when someone sits next to me in class and is wearing really strong perfume. I then spend most of the class hunched over because my chest is so tight. Is it possible to be so sensitive to fragrences? I cant tollerate candles, most perfumes, nail polish etc... It gets really hard because I dont want to tell people what to do, however in the same time my asthma goes crazy with a simple smell.
Hi SR,
Thanks for your comments. Yes! Fragrances and fumes can almost knock you off your feet when you have rhinitis or asthma (or both). I have several patients that suffer from such exposures at work, school or when in public places. Many times there are feelings of embarrassment and sometimes guilt. But you should try to minimize those feelings and work towards a plan of action when you encounter these triggers. A plan should be worked out between you and your doctor. See an allergy specialist if you continue to struggle.
Good Luck,
J. Thompson, MD
I have very bad reactions when I am with fragrances for any lenght of time. If I am in a room for a half hour with perfume my system breaks down more and it takes me longer to recover. The last time it was 4 months where it use to be a week or two. I now make my own hand soap and use only recommended washing products. I had to make many changes with my last attack. I am very scared it will happens again that I may not be able to live in my home. I even have problems with most shower curtains now. I bought cotton but hate them due to drying time and the weight of it. I believe this was caused by me working for a grocery for 20 years and having to wait on people with perfumes and buying so many types of soaps. I know SHIELD was one of the first to make me cough so hard. I broke my ribs at work twice due to being with the chemicals. Very hard to avoid these things. People do not understand this and just are not much help. Do not have many friends and do not go into others home. Some I go onto the deck but can smell the inside from there and know it is not a safe place for me to be. This is a bad way to live.
Testing with desensitising provocation therapy clearly establishes that. I suggest Dr Thompson persue this topic further, he is clearly lacking in information. When he has an allergic reaction to perfumes that causes severe pain, then and only then will he be in a position to write on the subject. What is written here is rubbish.
Hi Ms.Day,
Actually I do have hypersensitivity to fragrances and have firsthand experience with unavoidable exposures. My comments were based on years of training in respiratory diseases and my experience in evaluating and treating such people over the last 22 years. But I am open minded to other's research and teachings. Please share any specifics you have about treatment, prevalence and severity levels. I realize healthcare is a field which offers more to learn with each day. And I love to learn.
Thank you for your comments,
James Thompson, MD
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Thank you Dr. Thompson for the informative article, especially the different ways to reduce irritants. There is someone in my life who has asthma, and I have a feeling that if I tried some of your examples I may be able to make them more comfortable!
Good Stuff!
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