Fragrance Sensitivity

About Fragrance Sensitivity

Fragrance sensitivity is either an irritation or an allergic reaction to some chemical, or combination of chemicals, in a product. Although perfumes and colognes are generally what come to mind when discussing fragrance sensitivity, fragrance is often added to a variety of daily use items including but not limited to toiletries, cosmetics, air fresheners, cleaning products, and pesticides. Ingredients used in fragrance are not required to be disclosed on labels, which can make it difficult to identify the ingredient or product that is responsible for the sensitivity. Regardless of what the specific allergen is or whether it has been identified, common reactions to exposure include headaches, respiratory problems, asthma, and skin irritations. 

There are two types of allergy symptoms due to fragrance sensitivity – respiratory or skin allergy symptoms. Symptoms of fragrance sensitivity can include headaches, nausea, and a skin allergy like contact dermatitis, which causes redness, itching, and burning. Watery, itching, burning, and red eyes; sneezing; runny nose; and congestion are also common. In some cases, individuals experience breathing difficulties, such as wheezing, a tight feeling in the chest, or worsening of asthma symptoms. Frequency and level of sensitivity can differ from one individual to another and identifying the exact cause of the irritation or allergy can be difficult because of the complex chemical formulas in many everyday use products. 

The potential for exposure can be high as fragrances are added to of everyday products, and there has been an increase in the amount of time spent in indoor environments. Those with asthma, allergies, or other respiratory disorders may be more susceptible to the effects of fragranced products. The best way to prevent fragrance sensitivity is to remove, block, or avoid the offending substance. Discussing the fragrance sensitivity with people at work and at home also can also help to limit exposure to other people’s fragrances.

Because there is no requirement for manufacturers to list all the ingredients in their products, finding a product that is truly fragrance free can be challenging. Even some products that are labeled as being “unscented” or “fragrance free” contain herbal ingredients or oils from botanicals. The U.S. Environmental Protection Agency’s (EPA) Design for the Environment (DfE) program helps identify cleaning and other products that have been determined to be effective and safer for human health and the environment. These products carry the Dfe label and a list of all partners and products recognized under the DfE Safer Product Labeling Program. 

When dealing with fragrance sensitivity, there are really three main options to consider as accommodations:

1) Remove the offending fragrances.

When possible, an employer should try to remove the offending fragrance, especially if the fragrance is unique to the work environment, minimal, and/or the employer has more control over it. However, as mentioned earlier, under the ADA it is probably not reasonable for an employer to have and enforce a total no-fragrance policy because it is difficult if not impossible to enforce, especially if non-employees such as clients and volunteers come into the workplace.   
  
2) Remove the employee from the area where the fragrances are located.

When it is not possible to remove the offending fragrance, an employer may be able to move the employee away from the fragrance. This usually means working at home or in a private office with no exposure to coworkers, clients, or other members of the public. Regarding work at home, unless the employee wants to work at home, other options should be explored first to keep the employee in the workplace.

3) Reduce the employee’s exposure to the fragrances.

If the offending fragrance cannot be removed and the employee cannot be moved completely away from the fragrance, it may be possible to reduce the employee’s exposure to an acceptable level. This usually means a private office with its own ventilation and minimum exposure to others. It can also mean allowing the individual to wear a mask or respirator. Some individuals are able to wear masks/respirators while others are not or may not be comfortable wearing them. Employers should keep in mind that they cannot force an employee to use a mask/respirator.

Sample Policy Language:

The following are examples of fragrance-free workplace policy statements.

• Anonymous City Law Enforcement Agency Policy: “To reasonably accommodate bureau employees who have written memoranda documenting chemical sensitivity to perfume, employees will wear no perfume or cologne during business hours when they are scheduled to be within the bureau during their shift. This policy will not affect those bureau employees who are in an off-site training class, on city business, or out of the office for an entire shift.”
• Anonymous Employer: “(Name of employer) strives to ensure the comfort and safety of staff and visitors by encouraging a smoke free and fragrance free environment. “
• Anonymous State Community Development Agency, Employee Administrative Bulletin: “Given that chemically sensitive individuals may react to different products with widely varying degrees of severity, it is very difficult to ensure a consistently comfortable and accommodating work environment under every conceivable set of circumstances. Even so, it is the general consensus of the Labor/Management Committee and the desire of the (company name) to minimize to the extent possible the barriers and difficulties experienced in the workplace by both employees and clients subject to chemical/fragrance sensitivities. The (company name) requests that all offices and spaces used by the staff and their visitors remain free of chemical-based scented products.”
• Anonymous Employer, Staff Memo from Executive Director: “I ask that we refrain from applying spray colognes, hairsprays, and or air fresheners in the office, as the use of such products may trigger allergic reactions and create health problems. “
• Anonymous Employer, Administrative Manual Policy, Subject: Employee Appearance: “Cologne, perfume, aftershave lotions, scented lotions, or body washes are not to be worn in the Medical Center.”
• State Protection and Advocacy Agency: “This is a fragrance free office. Thank you for not wearing any of the following: cologne, after shave lotion, perfume, perfumed hand lotion, fragranced hair products, and/or similar products. Our chemically-sensitive co-workers and clients thank you.”
• Anonymous Employer: “This is a fragrance free office. Please help us to accommodate our co-workers and clients who are chemically sensitive to fragrances and other scented products. Thank you for not wearing perfume, aftershave, scented hand lotion, fragranced hair products, and or similar products.”
• Anonymous Employer, Memo to All Staff: “You may have noticed the signs up on the front door and on the library doors stating that this is a fragrance-free office. Please cooperate with this request because there are several of us on staff and visitors to our office who are chemically sensitive to varying degrees. Our bodies have a hard time when we come into contact with a variety of chemicals and each episode takes its toll on our bodies. Please use only unscented products during work hours. This does not include deodorant or bath soap at this time.”
• U.S. Access Board: “Under this policy, the Board requests that all participants refrain from wearing perfume, cologne, and other fragrances, and use unscented personal care products in order to promote a fragrance-free environment. This request is included in notices and on displayed signage for the Board’s meetings, hearings, and other public events. In addition, the Board will work with the operators of meeting sites to prevent the use of deodorizers and cleaning products immediately before the event in and around meeting locations.”

Fragrance Sensitivity and the Americans with Disabilities Act

The ADA does not contain a list of medical conditions that constitute disabilities. Instead, the ADA has a general definition of disability that each person must meet. A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).

Accommodating Employees with Fragrance Sensitivity

People with fragrance sensitivity may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with fragrance sensitivity will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.

Questions to Consider:

1. What limitations is the employee experiencing?
2. How do these limitations affect the employee and the employee’s job performance?
3. What specific job tasks are problematic as a result of these limitations?
4. What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
5. Has the employee been consulted regarding possible accommodations?
6. Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
7. Do supervisory personnel and employees need training?

Accommodation Ideas:

Situations and Solutions:

Fragrance Sensitivity: When Scents Cause Symptoms

If you sneeze every time you get a whiff of perfume or room deodorizer, you may be one of millions of people with a fragrance sensitivity.

As many as 30 percent of people surveyed in a study from the University of West Georgia said they find scented products irritating. Those with asthma or chemical sensitivities may find strong scents particularly problematic due to the allergy-like symptoms they cause.

Unlike tree pollen or dander, for example, perfumes and scents aren’t actually allergens, they’re irritants — but that doesn’t mean that they can’t trigger allergy symptoms like sneezing.

So what’s the difference between an allergen and an irritant? In fairly simple terms, a true allergen causes a person’s immune system to release chemicals to fight the invader. On the way to the battle, inflammation could result — eyes could water, nose could fill, and so on.

“An allergen is a protein that is known to cause an IgE-mediated reaction,” explains Beth A. Miller, MD, director of the University of Kentucky’s Asthma, Allergy, and Sinus Clinics and chief of the school’s division of allergy and immunology in Lexington. IgE, or immunoglobulin E, is an antibody produced by the body in response to exposure to an allergen.

An irritant, on the other hand, doesn’t provoke the immune system. But it has no problem making eyes water or noses run.

It’s not understood how or why this happens. “An irritant is a chemical or product that causes symptoms without a known immunologic cause,” says Miller, so it does not cause an IgE-mediated reaction.

“Sensitivity is really a non-specific term,” notes Miller. Only an allergen can cause a true allergy, while “irritants cause sensitivities.”

Bottom line: What people call a “perfume allergy” is either fragrance sensitivity or an allergy to some chemical in the perfume.

Symptoms of Fragrance Sensitivity

You can have two types of allergy symptoms due to fragrance sensitivity — respiratory, nose and eye symptoms, much like that of seasonal allergy symptoms — or skin allergy symptoms.

Symptoms of fragrance sensitivity can include:

• Headaches
• Difficulty breathing
• Wheezing
• A tight feeling in the chest
• Worsening asthma symptoms
• Runny and stuffy nose
• Sneezing
• A skin allergy like contact dermatitis — an itchy, red rash that appears on the skin

The Rise of Fragrance Sensitivities

People who have asthma may be more sensitive to fragrances and may experience allergy symptoms or worsening asthma symptoms from exposure to perfumes, fragrances, and other chemicals. Although, says Miller, there isn’t really an established link between asthma and fragrance sensitivity.

People who already have allergies, like seasonal allergies or allergies to indoor allergens like molds and animal allergens, may be more likely to experience fragrance sensitivities.

“Often patients with allergies are more sensitive to these irritants due to their baseline allergic disease,” says Miller. And with more than 50 million Americans dealing with allergies, that’s a lot of people at an increased risk for fragrance sensitivity.

Combine that increased sensitivity with a constantly increasing level of irritating chemicals and fragrances that are ever-present in our environment and the things we use every day (over 5,000 types used today), and it’s no surprise that fragrance sensitivities are more common than initially believed.

Preventing and Treating Fragrance Sensitivities

If you’re dealing with allergy symptoms caused by fragrance sensitivity, there are some things that you can do for relief.

Nasal antihistamine and nasal corticosteroid medications can effectively control allergy symptoms caused by these sensitivities. But the best medicine is really an ounce of prevention — and that means keeping all fragrances off yourself and out of your environment.

There just aren’t any “safe” fragrances or products that Miller can recommend for anyone who has experienced allergy symptoms due to fragrance sensitivities.

“Any product with a scent can be irritating to patients,” notes Miller. “I suggest patients utilize scent-free products if at all possible.” That means fragrance-free:

• Lotions
• Soaps
• Skin care products
• Laundry detergents
• Fabric softeners

You should even be cautious with cleaning and deodorizing products that you use at home — look for products that don’t contain fragrance, which could cause your allergy symptoms.

You may also need to ask your friends, spouse or partner, and co-workers to avoid wearing or using heavily-fragranced products around you to prevent your allergy symptoms.

Of course, there’s no hard and fast rule about what you can and can’t use — fragrance sensitivity is an individual issue.

“This type of sensitivity can vary among individuals,” says Miller. “In some patients all scents are bothersome, and in others only strong smells [like chlorine] are irritating.”

But rather than run the risk of having allergy symptoms from fragrance sensitivity, it’s best to be conservative — and avoid all products containing fragrance for the best chance at avoiding your allergy symptoms.

Scent-free policies generally unjustified

The list of symptoms people with scent sensitivities attribute to chemical fragrances is a lengthy one that includes everything from coughing, sneezing, gagging, shortness of breath, rhinitis and asthma attacks, to debilitating headaches, anxiety and dizziness.

As a result, many workplaces and institutions — schools, hospitals and other government buildings — have some sort of scent-free or scent-reduction policy in place, which asks people entering the building not to wear perfumed products.

But the science supporting such policies is fuzzy and inconclusive. While scents can trigger both physiological and psychological symptoms in some individuals, there is no reliable diagnostic test for fragrance allergies.

Allergies to substances where a protein is easily identifiable can be tested with a skin test, so determining an allergy to peanuts, cat dander or pollen requires only a simple scratch test. Scents, however, are more complicated, as one fragrance can be made up of many different ingredients.

“When someone is smelling something, what they’re smelling is usually not the protein, it’s the volatile hydrocarbon, or whatever is giving off that scent,” says Dr. Susan Waserman, professor of medicine in the division of clinical immunology and allergy at McMaster University in Hamilton, Ontario. As such, scent sensitivities are usually a reaction to an irritant when it reaches a certain concentration, not an allergy to a specific protein.

Much of North American research into scent sensitivities comes from the Monell Chemical Senses Center, an independent, nonprofit scientific institute in Philadelphia, Pennsylvania, where researchers study taste and smell. Pamela Dalton, a psychologist at the center, says that simply telling people that an odourous material is going to cause an adverse reaction is enough to make the test subjects feel poorly, even if the odour is entirely innocuous.

While scents can trigger both physiological and psychological symptoms in some individuals, there is no reliable diagnostic test for fragrance allergies.

Image courtesy of © 2011 Jupiterimages Corp.

People who have one adverse reaction to a scent, or who associate a scent with adverse reactions, can develop anxiety about being exposed to fragrances in future instances, she says.

“When it comes to scents that are used in air fresheners, or someone else’s perfume or carpet freshener or that sort of thing, there is an element of loss of control that I think plays in the sense of personal space and that their lungs are being invaded,” Dalton adds. “I think that heightens the anxiety about the exposure.” This anxiety can cause real physical symptoms, including elevated heart rate and blood pressure, rapid breathing, increased stress hormones and hyperventilation. It can also cause people to isolate themselves for fear of coming into contact with a trigger scent.

Dalton says some fragrance materials have direct physiological effects, but she estimates those affected are probably a smaller subset of individuals than the ones who have a more psychological-based reaction.

Since there is no diagnostic test to confirm the diagnosis of what many scent-sensitive individuals refer to as multiple chemical sensitivity, it creates room for unconventional medicine to fill the void, including homeopathy and naturopathy, says Dr. Susan Tarlo, a respiratory physician and professor of medicine at the University of Toronto in Ontario. “Unproven tests and unproven treatments have been offered to patients which is, in my opinion, very unfortunate,” she says.

Given that a proportion of people are sensitive to scents, Tarlo views scent-reduction policies as a good move — in some instances. “I think that’s very reasonable for places like hospitals, even though we don’t understand the mechanism, just to accommodate people who feel uncomfortable in that setting. ”

Rather than implementing blanket bans on scented products, Dalton recommends that institutions address scent conflicts on a case-by-case basis. “As a general policy, it hasn’t ever been shown to work very well,” she says. “If somebody is wearing something that really bothers coworkers, I think it can be mitigated within the workplace.”

Greg Noel, executive director of the Newfoundland and Labrador Lung Association, takes a similar approach in helping workplaces address scent sensitivities. “Most often, people will know what they are sensitive to and to what degree,” Noel says. The solution could be as simple as moving an employee’s desk to a new location. In one instance, an employee was sensitive to a floor cleaner and was able to recommend another cleaner that she could tolerate.

Noel also urges people to maintain an arm’s-length policy when using scented products. If you can smell a perfume, body wash or deodorant from more than an arm’s-length away, that person is wearing too much, he says.

Consumers should choose unscented or fragrance-free products, he adds. “Having no fragrance does not mean you are going to smell bad; it’s not an issue of poor hygiene, or not using personal hygiene products.”

When it comes to treating scent-sensitive patients, Dalton advises that health care professionals take a measured approach and avoid alarmist messages that may increase anxiety. “Health care professionals themselves can over-sensitize some of their patients into believing they will have a reaction to fragrance material when, most likely, they won’t.”

Fragrance sensitivity: why perfumed products can cause profound health problems | Health & wellbeing

If you flew abroad this summer, you probably passed through an airport’s duty-free perfume section. Perhaps you paused to spritz yourself with an expensive scent you had no intention of buying, before making the obligatory trip to WH Smith for overpriced crisps and bottles of water.

For most people, the wafting odours of perfume counters are not a problem. But, for some, the trip through duty free is a choking, cloying experience.

Research published this year found that one in three adults claim to have experienced health problems caused by fragranced products, whether perfumes, cosmetics, laundry detergents or soap. The study found that fragrance sensitivity caused migraines, watery eyes and respiratory issues. More than 4,300 people from the UK, the US, Australia and Sweden responded, including 1,100 from the UK. Speaking to the New Scientist, the lead researcher, Dr Anne Steinemann – a professor at the University of Melbourne – characterised fragrance sensitivity as a healthcare epidemic of which we don’t yet know the scale. She suggested that fragrances should carry clear labels about their ingredients.

Increasingly, airports are recognising the problem, with Helsinki, Vancouver and Copenhagen among those offering perfume-free routes for passengers with fragrance sensitivities. Legislators are also responding to the need for fragrance-free public spaces: most hospitals and schools in Halifax, Nova Scotia, ban employees from wearing perfume, while in Oakland, California, city officials ask residents not to wear scents to public meetings. And you can forget about dousing yourself in Old Spice before slinking into your weekly encounter with the Almighty: a church in suburban Seattle made headlines in 2013 after introducing fragrance-free zones.

One day, all public spaces may be scent-free. It is bad news for the perfume manufacturers, but good for people such as Lesley Heidinger, a 46-year-old call-centre worker from Edmonton in Canada. Heidinger has multiple chemical sensitivity (MCS), a little-known condition characterised by heightened sensitivity to a wide range of chemicals, many of which are commonly found in soap, detergent, sanitiser gels and perfumes. She can tolerate natural scents, including most essential oils, but synthetic fragrances are bothersome. If Heidinger inhales a colleague’s scent, her sinuses will become irritated, she will wheeze and cough and it will bring on a migraine that can last for days. Other reported symptoms of MCS include muscle pain, exhaustion and disorientation.

“It’s a constant battle,” Heidinger says. She has been off work for much of the year, as her symptoms have been particularly bad. Although her employers have implemented a scent-reduced zone around her desk – meaning that colleagues in her immediate vicinity have been asked not to wear fragrances – this doesn’t apply to communal spaces. “I don’t know if people realise the real impact of it,” she sighs. “It makes me incredibly ill. Having a migraine for a week is really unpleasant.”

Heidinger is also sensitive to smoke and the fragrance from washing powder and fabric conditioners. Things got so bad that she had to sell her flat, because it had a shared laundry room, and move somewhere with its own washer-dryer, so she wouldn’t be exposed to the smell of other people’s laundry. On a recent flight to Italy, Heidinger had to switch seats because the woman next to her was wearing perfume. “I could smell it as soon as she sat down. I just said: ‘I can’t sit next to you.’”

Heidinger’s MCS is medically recognised: she has been diagnosed by her doctor and receives disability benefits when she is unable to work. But not everyone is met with compassion and validation by medical professionals. Online forums for people with MCS are full of stories of not being taken seriously by doctors, while there is debate within medicine about whether MCS is physiological or psychological. A US study in 2011 found that only 30% of doctors surveyed had received formal training about MCS. The NHS website does not publish treatment guidelines for MCS.

“These people are orphans of conventional medicine,” says Dr Apelles Econs, an allergy specialist at the Burghwood Clinic in Surrey. As people with MCS are intolerant of chemicals, rather than allergic to them, allergy tests often come back negative. “They may be told they’re imagining it, and referred to psychiatric colleagues to see if they can manage the condition,” Econs says. “But, in reality, the root of the problem has not been addressed properly.”

“It’s an under-recognised condition,” agrees Prof Howard Hu, a leading environmental health expert at the University of Washington School of Public Health. (MCS is sometimes referred to as environmental illness, as sufferers are triggered by external chemicals in their living and working environments.) But Hu believes the medical community’s perspective on MCS is changing. “There’s some decent research coming out … In my opinion, the evidence is good that there’s something neurological going on that’s triggered by an odour and leads to a cascade of events in the brain that manifest as these symptoms. Is it physiological or psychological? It’s somewhere in between – the tools we have to investigate these disorders are still pretty primitive.”

Until more is known about MCS, offering fragrance-free public spaces would be a welcome move. “It would be miraculous, because of how ill being exposed to something makes me,” Heidinger says. “It’s really demoralising not to be able to go to work and enjoy life to its fullest because of this. It’s not a fun way to live.”

Tips for dealing with scent sensitivity — CoverMe Blog

Perfumes and scented products can be found just about everywhere – from beauty products to cleaning supplies. These scents can make us feel cleaner, more attractive or trigger happy memories, but for many Canadians who have allergies, asthma and scent sensitivities, these scent products can make them downright miserable and even have adverse health effects. In fact, about one-third of Canadians experience symptoms when exposed to perfumes and other scented products.

About 72% of people with asthma have adverse reactions to perfumes and, according to the Canadian Lung Association, people with asthma and other lung diseases can have severe reactions to scents, such as:

• Headaches
• Dizziness
• Weakness and fatigue
• Shortness of breath
• Nausea
• Cold-like symptoms
• Worsening asthma symptoms

These symptoms not only affect their quality of life but their very health. That’s why many workplaces, hospitals and schools have policies banning or limiting the use of scented products to protect the health of their employees and the public. The Canada Human Rights Act protects people with environmental sensitivity.

“A few years ago, I was diagnosed with an allergy to fragrance which has made life a bit more difficult for me,” says Tammy Cutler, a graphic designer in Toronto. “I suffer from skin rashes, migraines and nausea when I come into contact with perfumes, body and hair care products or cleaners containing fragrance. Since my employer instituted a scent-sensitive policy, I am able to feel safe from experiencing reactions in my workplace. Scents can be hard to avoid on public transit, in restaurants and other public places. That’s why I’m glad to know I’m at least more protected at work.”

Sometimes, it’s hard to know what might trigger reactions in scent-sensitive people. They might not react to all chemicals, just some, which can make it hard to avoid them.

Tips for dealing with scent sensitivity

• Keep a journal to record whenever you seem to have a reaction – perhaps you get a headache after seeing a certain friend wearing a specific perfume or get itchy after trying a new laundry soap. You don’t need to stop seeing your friend but can ask they forgo the scent when they’re around you.
• Look for natural cleaning or personal care products or make your own with such items as vinegar and baking soda.
• When planning group gatherings, such as parties, try to move them outdoors rather than having cocktails in a cramped living room.
• Avoid stores that have heavy odours, such as department stores with perfume counters.
• Keep your immune system up with a healthy diet and exercise.
• See your doctor about doing a patch test for allergies and ask about action plans for treatment.

If you have a friend or family member with scent sensitivity, get to know what might trigger them and avoid using or wearing those products around them.

It’s important to note that a product can be labelled unscented but might have chemicals that are just masking the smell of the product – and it’s not the actual smell people with sensitivities have reactions to, it’s the chemicals in the product.

How can you avoid scents at home?

• Keep your home well-ventilated, which help to improve air quality, by opening doors and windows, and installing vents and fans to circulate the air.
• Try an air purifier, which can help clean your home’s air.
• Use scent-free personal care products (this website compares safety brands of many products)
•  Always read ingredient labels and avoid products that say perfume or fragrance on the label. Here are just some of the chemicals you should avoid:
  • Acetone
  • Benzene
  • Benzyl acetate
  • Bisphenol A
  • Camphor
  • Ethanol
  • Formaldehyde
  • Parabens
  • Phthalates
    (A good tip is if you find an ingredient very difficult to pronounce, you might want to avoid it!)

Even if you or your family members don’t think you are sensitive to scents, it might be a good policy to limit the use of scented products in your home and on your person. Look for products that are guaranteed to be less toxic for you and your family, especially if you have very young children, as well as those you come into contact with.  

Fragrance allergy | DermNet NZ

Author: Elaine Luther, Medical Student, Ross University School of Medicine, Barbados, West Indies. Medical Editor: Dr Helen Gordon, Auckland, New Zealand. DermNet NZ Editor in Chief, Adjunct A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. Copy edited by Gus Mitchell. July 2020.

What is a fragrance allergy?

Fragrance allergy is an allergic contact dermatitis to a fragrance chemical.

Fragrances and perfumes can either be made from a natural extract or synthesised. They produce a pleasant scent or disguise the unpleasant odour of a product.

Allergy requires prior sensitisation to the fragrance chemical. Subsequent skin contact with the chemical causes a delayed hypersensitivity reaction (type IV) in the hours to days after exposure.

Who gets a fragrance allergy?

Fragrance allergy is common and is believed to affect around 1% of adults [1]. Rates in children and adolescents are around 1. 8%. Fragrance allergy is second only to nickel allergy as a cause of allergic contact dermatitis. However the frequency of relevant positive reactions in dermatology departments is falling due to the reduced use of oakmoss absolute as a fragrance.

Allergic contact dermatitis occurs as frequently in people with and without a history of atopic dermatitis.

Fragrances are not limited to perfumes and cosmetics. They are also found in:

• Personal care products such as body wash, lotions, shampoos, conditioners, deodorants, baby wipes, and sanitary pads
• Household products such as laundry detergents, fabric softener, air freshener, cleaning agents, candles, pot pourri, and toilet paper
• Flavours added to food and drinks, lipsticks, lip balms, and toothpaste.
• Work place chemicals may also have aromas added to cover unpleasant smells, for example coolant oils, histology solvents, industrial solvents.
• Occupational dermatitis due to fragrance allergy is seen in hairdressers, in chefs and bakers due to flavouring agents and citrus fruit, and in aromatherapists and masseurs due to use of scented natural oils.
• Topical medicaments and balms.
• Electronic cigarettes.

Anyone who uses or is exposed to fragranced products can become sensitised to them over time. Consort allergy is well-recognised.

What causes fragrance allergy?

A European Scientific Committee on Consumer Safety review of fragrances in 2011 listed 82 substances that had been established as contact allergens including 54 synthetic chemicals and 28 natural extracts. Twelve of the chemicals and 8 of the natural extracts were listed as being at high risk of causing sensitisation.

Among the most common are the 15 fragrances that can be identified by patch testing with balsam of Peru, Fragrance Mix I (FM I), and Fragrance Mix II (FM II). Isoeugenol is the most common positive allergen in Fragrance Mix I, and hydroxyisohexyl 3‑cyclohexene carboxaldehyde (Lyral) in Fragrance Mix II.

Patch testing

What are the clinical features of fragrance allergy?

Fragrance allergy presents as a dermatitis which is often in a streaky pattern where there has been direct contact with the fragrance allergen.

• In women, the hands, face, and neck are most commonly affected.
• In men, the hands, face, and lower legs are most often affected.
• The fragrance chemical can be transferred to an unexpected site, for example, via the hands onto the face.
• Involvement of the armpits is common in both sexes.
• Other locations affected include perianal skin if perfumed toilet paper wet wipes, or haemorrhoid preparations are used.

Typically, fragrance allergy presents as scaly erythematous plaques.

• There can be swelling, vesicles, and bullae.
• Continued exposure to the allergen may result in chronic dermatitis with lichenification and excoriation.
• The dermatitis is itchy and may also burn and sting.
• Dermatitis can be complicated by a secondary bacterial infection.

Fragrance allergy may affect the mouth (allergic contact stomatitis) resulting in cheilitis, gingivitis, blisters and erosions, or oral lichen planus.

Photoallergy to fragrances has become less common in those countries where the use of musk ambrette has reduced.

Areas affected by fragrance allergy

How is fragrance allergy diagnosed?

A diagnosis of fragrance allergy will typically require a detailed patient history and is confirmed by patch testing.

• Around 10% of those undergoing patch testing are found to have a fragrance allergy.
• The relevance of a positive patch test should be determined by the distribution of the rash and the products used.
• A weakly positive patch test can be due to irritation by the fragrance chemical rather than a true contact allergy.

Patch test diagnoses

Which allergens test for fragrance allergy?

Patch testing for fragrance allergies usually begins with a baseline series of allergens. These should include balsam of Peru, Fragrance Mix I, and Fragrance Mix II.

Balsam of Peru is extracted from the Myroxylon pereirae tree. It cross-reacts with other fragrances and a positive reaction occurs in around 50% of patients with fragrance allergy.

Fragrance Mix I can identify 75% of those with fragrance allergy when combined with balsam of Peru. It is a mixture of eight fragrances:

• Oakmoss absolute
• Isoeugenol
• Eugenol
• Cinnamyl alcohol
• Cinnamaldehyde
• Hydroxycitronellol
• Geraniol
• Amyl cinnamaldehyde.

Fragrance Mix II increases the sensitivity of testing as it is a mixture of a further six fragrances:

• Lyral
• Citral
• Farnesol
• Coumarin
• Citronellal
• Alpha-hexyl cinnamaldehyde.

Fragrance Mix II reactions

The fragrance series

A patient identified as having a fragrance allergy can be tested with the 26 individual fragrances that require labelling in the European Union. A patient with a positive patch test result to one of the members of the fragrance series can avoid that fragrance by reading labels. See Appendix at the end.

What are the limits of patch testing?

Even if a specific fragrance chemical is identified as causing allergy, it can be difficult to avoid every product that contains it.

• Manufacturers may not list any or all of their ingredients.
• Ingredients can be changed without giving notice to consumers.
• The allergen may be present in low concentration, and ingredients must only be listed in a regulated product if they surpass a specified threshold concentration.

It can be futile to test for fragrances that are never labelled since the patient will not be able to identify which products contain the fragrance they have reacted to.

What other tests can be done?

Any leave-on product the patient suspects is causing an allergy can be applied as a customised patch for testing. Patch testing is not suitable for undiluted wash-off products as they are often irritate if left on the skin.

The ‘repeat open application test’ is often more practical and cost-effective than patch testing. Before using a new fragrant leave-on product, the patient applies a dot of the product to the same area of the forearm or inner upper arm twice a day for two weeks. If a rash develops, the product should not be used.

What is the differential diagnosis for fragrance allergy?

The differential diagnosis for fragrance allergy may include:

What is the treatment for fragrance allergy?

Treatment of fragrance allergy requires identification of the allergen followed by avoidance if possible. Treating the allergic contact dermatitis that results from exposure to a fragrance allergen may include:

What is the outcome for fragrance allergy?

Fragrances are ubiquitous and avoidance can be a challenge.

• The sensitive person can be allergic to several fragrances.
• Identifying every product that contains the fragrance is virtually impossible — ingredients may not listed and often have multiple names; for example, balsam of Peru has 13 names according to the Contact Dermatitis Institute.

The fragrance-allergic patient is best to avoid products that are unlabelled or contain any fragrance.

Select products labelled ‘fragrance-free’ (so-called ‘unscented’ products) but these could still include masking fragrances. Products may contain an unidentified fragrance, for example, if they list ‘botanical’, ‘herbal’, or ‘natural’ ingredients.

The fragrance-allergic patient can use the open application test to screen any new products.

APPENDIX: 26 Fragrances that require labelling in the European Union

The 26 fragrances in the fragrance series are:

• Amyl cinnamal
• Cinnamal
• Cinnamyl alcohol
• Eugenol
• Geraniol
• Hydroxycitronellol
• Isoeugenol
• Citral
• Citronellal
• Coumarin
• Farnesol
• Alpha-hexyl innamal
• Hydroxyisohexyl 3-cyclohexene carboxaldehyde (Lyral)
• Alpha-amycinnamyl alcohol
• Anise alcohol
• Benzyl alcohol
• Benzyl benzoate
• Benzyl cinnamate
• Benzyl salicylate
• Limonene
• Butylphenyl methylpropional
• Linalool
• Methyl 2-octynoate
• Alpha isomethylionone
• Evernia furfuracea (tree moss extract) and Evernia prunastri (oakmoss extract)
• Sorbitan sesquioleate.

Perfume Allergy

A perfume or fragrance allergy is the second most common cause of skin allergies according to contact dermatitis expert, Dr. Sandy Skotnicki-Grant, from the Bay Dermatology Centre in Toronto.

Fragrance sensitivity can be defined as irritation or adverse reaction to chemicals in a perfume or other scented products such as air fresheners and cosmetics. Sensitivity to strong odors can make those who are allergic to these products severely ill. People with asthma or other respiratory illness can be more susceptible to fragrance allergies compared to healthy individuals.

Image Credit: Africa Studio / Shutterstock.com

Symptoms of fragrance allergy

Sensitivities to perfumes or fragrances, in general, can trigger various unpleasant reactions in those affected. Some common symptoms of perfume allergy include:

• Mild to severe headache
• Skin irritation, itching, and rashes
• Sneezing, coughing, and runny nose, also called allergic rhinitis
• Breathing difficulties, dizziness, and fatigue
• Muscle aches
• Watery, red, and itchy eyes
• Wheezing
• Inability to concentrate
• Swelling (angioedema)
• Nausea and vomiting

Studies have shown that for individuals suffering from migraines, strong fragrances from perfumes or colognes can even trigger a migraine attack.

Can smells make you sick? Scent sensitivity could be dangerousPlay

Fragrance chemicals in perfumes and other products

Perfumes contain a mix of several ingredients that include a complex blend of natural essences, as well as synthetic chemicals. The average perfume or cologne contains about 14 chemical ingredients that are capable of triggering mild to severe allergic reactions in fragrance-sensitive individuals.

Individuals with widespread exposure to these sensitizing chemicals are at risk of contact sensitization to such fragrances. Many of these chemicals are highly unstable and readily oxidize during storage or as a result of their exposure to sunlight and air. These oxidation products act as phototoxic agents and potent sensitizers.

One such fragrance chemical, limonene, is used in cleaning products as a solvent. Limonene can not only break down and form potent sensitizers but also has the potential to react with ozone generating hazardous pollutants such as acetaldehyde and formaldehyde, which pose a serious risk of various health concerns. Another commonly used fragrance chemical is linalool, which is a component of lavender oil.

The derivatives of linalool, which include linalyl acetate and linalyl anthranilate, generate contact allergens upon exposure to air. In addition to fragrance ingredients, perfumes, and body sprays also contain stabilizers, solvents, preservatives, ultraviolet (UV0 absorbers, and dyes. Apart from affecting the user, fragrance allergies also cause passive reactions to others in contact with or sharing space with the wearer.

How to prevent/treat fragrance sensitivity

One way to prevent fragrance sensitivity is to avoid products containing the sensitizing substance(s). Carefully observing labels on products and choosing products labeled “fragrance-free” or “unscented” can help, although these labels are not always reliable and the product can still contain herbal ingredients that may induce a reaction.

In addition to this guidance, it is also recommended that individuals with these fragrance allergies limit their exposure to perfumes or scents worn by others at public places or workplaces. Fragrance-sensitive people should ensure that their coworkers are aware of their condition.

A dermatologist or allergist can recommend safe products based on individual sensitivities. The allergen causing the sensitivity is usually diagnosed with the help of a patch test on the skin of the affected individual.

A mix of several fragrance ingredients is used for testing. A positive patch-test for a particular ingredient would indicate that the person is allergic to that fragrance chemical. With that knowledge, the person could avoid products containing that ingredient in the future. This is not easy though, as labels on fragranced products normally don’t reveal every single ingredient.

Fragrance sensitivity at the workplace

Employers are becoming increasingly accommodative of fragrance-sensitive individuals. Some companies have stopped the usage of air fresheners and use fragrance-free cleaning products in order to minimize the use of fragrant chemicals in indoor environments. Companies are also educating employees about this issue and implementing a voluntary fragrance-free policy to the extent possible.

References

Further Reading

90,000 Hyperosmia – symptoms and causes

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Hyperosmia is an increased sensitivity to odors. This condition can lead to discomfort and disrupt the usual rhythm of life. First of all, the susceptibility to perfumery, household chemicals, aromatic candles increases.

The causes and accompanying symptoms of hyperosmia can be varied. The otolaryngologist will help you understand the situation and suggest the most rational options on how to cope with the existing problem. The main thing is to see a doctor in time.

Causes of hyperosmia

There are several factors that determine the increased sensitivity to odors.These could be:

• Genetic predisposition – some people do have a heightened sense of smell than others. This pattern is often seen among perfumers.
• Pregnancy. Hormonal changes occurring during gestation, especially in the first trimester, can lead to the fact that a woman’s sense of smell is exacerbated. Pronounced aromas can even cause nausea and vomiting due to overexcitation of the corresponding centers of the medulla oblongata.
• Autoimmune pathologies. Quite often, adrenal insufficiency and systemic lupus erythematosus lead to an exacerbation of the sense of smell.
• Borreliosis. About 1 in 2 people who are bitten by a borrelia-infected tick have an increased sensitivity to odors.
• Type 1 diabetes mellitus. In the absence of adequate compensation for carbohydrate disorders, the activity of nerve receptors changes.
• Brain lesions. A similar situation can be observed in Alzheimer’s disease, Parkinson’s pathology, epilepsy, multiple sclerosis.
• Pathological processes of the nasal mucosa and paranasal sinuses. This is hyperosmia in the focus of inflammation, in the area of ​​polypoid growths, etc.
• Long-term administration of vasoconstrictor drugs. These agents can stimulate or depress the olfactory receptors.
• Hypovitaminosis. Especially often, hyperosmia develops against a background of cyanocobalamin deficiency.
• Migraine. This disease is accompanied by a headache, which is often combined with nausea and vomiting.

Recently, doctors have to deal with hyperosmia in coronavirus. Of course, for this infection, a decrease in the sense of smell is more characteristic, however, in some patients, an increased susceptibility to odors is also encountered.

Symptoms of hyperosmia

Symptoms associated with hyperosmia are determined by the nature of the pathological process. Taking into account the underlying disease, the following manifestations may occur:

• skin rashes;
• runny nose, cough, fever, soreness of the nasal mucosa;
• hand tremors, headaches, dizziness, decreased memory and concentration;
• increased sensitivity of taste buds and a burning sensation of the tongue.

Treatment of hyperosmia

Hyperosmia in men and women is treated taking into account the main etiological factor. So, with inflammatory lesions of the nasal mucosa and paranasal sinuses, corticosteroids, immunomodulators and antibiotics are prescribed when the opportunistic flora is activated. The predominant route of administration is local (in the form of sprays, drops).

If polyps of the nasal cavity are detected, they must be removed. The operation is performed using a minimally invasive endoscopic method, which is characterized by low trauma and a short rehabilitation period.

At the stage of recovery with persistent hyperosmia and the inability to avoid the appearance of odors, distracting therapy is recommended. It can be peppermint-flavored gum or hard candy.

If you are faced with the problem of hyperosmia, then do not tolerate this unpleasant condition. Make an appointment with qualified otolaryngologists at the Ear, Nose and Throat Clinics. Our experts will help you to understand the reasons that led to the violation of the sense of smell, and draw up a program of personalized treatment.Otolaryngologists at the Ear, Throat and Nose Clinic provide treatment in accordance with international protocols for the provision of medical care for hyperosmia.

A timely visit to a doctor will help maintain your health.

Do not postpone treatment, call now. We work around the clock.

90,000 A world without odors: when a person has no sense of smell | Culture and Lifestyle in Germany and Europe | DW

“I was eight years old when it dawned on me that there is such a thing as the ability to detect smells, but I myself am devoid of it,” says Michael Merkers.This 32-year-old boy has been born with a disease called anosmia: he has no sense of smell. But how can you explain to a person who has no sense of smell what a smell is, what it means to smell pleasantly, what is the scent of an apple or a rose, how does sweat smell?

Accidental discovery

Once Michael was wandering around the outskirts of the city with his friends. One street led them to a field where tires were burned. The guys began to turn away and pinch their noses in disgust. To the puzzled questions of Merkers about why they are doing this, the boys answered in surprise that the rubber stinks! And Michael could not understand what they mean in any way.

Human is able to recognize smells thanks to the olfactory bulb. In humans, it is laid even in intrauterine life. She never developed in Merkers. When we breathe, various aromatic molecules enter our nostrils, which then migrate into the so-called olfactory cleft. It is located between the lower edge of the middle turbinate and the nasal septum and goes up to the upper wall of the nasal cavity. As Thomas Hummel of the Center for Interdisciplinary Research on the Smell and Taste at the University Hospital Dresden explains, when they enter the olfactory gap, aroma molecules begin to interact with olfactory cells, which are bipolar cells with cilia.When the molecules of odorous substances reach the cilia, they transmit information to them, which they, in turn, send through the olfactory nerve further to the brain. We breathe and smell automatically. We don’t even think about how difficult this process is.

Features of perception of aromas

Smells differ not only in that they are pleasant and unpleasant, but also in that they function as a warning signal. “The first thing I did when I moved to my own apartment was to install smoke detectors everywhere,” says Michael Merkers.And this is understandable: if there is a fire in the house, he, like an anosmic person, will not feel the smell of smoke. But his sense of taste is well developed. According to Michael, he can distinguish food with his eyes closed. But at the same time, the young man admits: as a person devoid of smell, he would still not be able to work as a cook.

Sense of taste and sensitivity to odors are directly related. On the one hand, our sense of smell is ortonasal, that is, smells are “read” by the nose from the air drawn in from the outside.On the other hand, we also perceive aromas retronasally, when a drink or food is in the mouth, and smells rise to the sinuses along the back of the throat.

“When you look into a person’s mouth, you’ll see a small ridge on the back of the palate. This uvula is a muscle that covers the area from the nasal cavity to the olfactory gap. how air comes out of the nose at the end of the swallowing process, ”explains Thomas Hummel.According to him, this is how aromatic molecules enter the olfactory cleft during food and drink.

The role of smells in our life

Smells play a big role in our life. They affect our social behavior, emotional state. If we like the smell of this or that person, then it seems to us more beautiful and attractive than, perhaps, it actually is. Smell plays an important role in the choice of a partner.

Smell can influence the choice of a partner

Approximately one in 10 thousand people is born without smell and has no idea what a smell is.But pathology can also be provoked by a traumatic brain injury resulting from an accident, sinusitis or persistent infections.

It can also happen that there is a rupture of the olfactory fibers responsible for transmitting signals from the nose to the brain. True, in more than half of the cases, they regenerate over time. To stimulate the sense of smell and increase the sensitivity of patients suffering from such a disorder, doctors, among other things, use aromatherapy. Neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease can also lead to loss of smell.

With age, the sense of smell worsens

For most people, over the age of 50, the sense of smell begins to deteriorate. “Among 70-year-olds, the proportion of those who have similar problems is about one third. And among people over the age of 80, those are already a good half. It cannot be said that they do not smell at all, but their perception is far from as intense as that of an 18-year-old, ”emphasizes physician Thomas Hummel. According to him, one of the main reasons lies in the fact that during life the number of olfactory cells in us decreases.In addition, the olfactory fissure and the olfactory bulb diminish over time.

People deprived of their sense of smell are pathologically afraid of getting into an unpleasant situation because of their illness. Am I overdoing it with perfume? Has the apartment been sufficiently ventilated? Do my clothes smell good? Questions like this haunt them all the time. “Once on the street I stepped on a dog waste, but did not notice it. But the client, with whom I had an appointment that day, immediately smelled a bad smell. I just didn’t know where to go out of shame,” recalls Michael Merkers.

His greatest desire is to live up to the time when a replacement for the olfactory bulb will be invented. After all, if this does not happen, he will never know what smells are.

See also:

• Hazardous and wholesome food

  Which food do you prefer?

  For the 60th time in most countries on May 29, World Day for Healthy Digestion is celebrated, established by the World Organization of Gastroenterology (WOG) and the World Health Organization (WHO).It is held to draw public attention to the problems of digestive disorders and to find effective ways to combat them. So which foods are good for us and which should be avoided?

• Dangerous and healthy food

  Sweets

  Say no to chocolates, gummy bears, lemonade, Coca-Cola, Fanta, other sweets and tonic soft drinks! All of them contain simple carbohydrates, which, when processed, take fluid from the body and dehydrate it.Simple carbohydrates also have a detrimental effect on the state of collagen fibers, on which the elasticity of the skin depends: wrinkles appear, the oval of the face sags.

• Dangerous and healthy food

  Fast food

  The main disadvantage of fast food is the trans fats it contains, obtained from vegetable oils during the hydrogenation process: liquid vegetable oils are saturated with hydrogen bubbles at high temperatures. As a result, trans-isomers with a distorted molecular structure are formed.Once in the body, such molecules disrupt metabolic processes in cells, which can lead to chronic inflammation.

• Dangerous and healthy food

  Alcohol

  It is known that red wine can be good for the body – but only if you drink one glass. Consuming more is only harmful. And even more so when it comes to stronger alcoholic beverages. Alcohol abuse is strongly reflected on the face: it turns red and swells.In addition, alcohol contains a lot of sugar that breaks down collagen fibers.

• Dangerous and healthy food

  Salty

  Anyone who is addicted to chips and foods similar to them consumes not only too many unhealthy trans fats, but also salt. And its main component – sodium – has the ability to retain water in the body. As a result, blood pressure can jump. Excessive salt disrupts metabolism, causes heart problems, and worsens the complexion.

• Dangerous and wholesome food

  Carbohydrates

  Permanently exclude white bread and pasta from your diet! The fact is that they contain too many carbohydrates, which are nothing more than sugar molecules. The overuse of white flour baked goods leads to glycation – the sugaring of collagen fibers, sticking them together and breaking them down. As a result, our skin loses its elasticity and ages quickly. Not to mention digestive disorders.

• Dangerous and healthy food

  Coffee

  Coffee speeds up metabolism, which means it stimulates weight loss.On the other hand, research shows that as early as two to three cups of coffee a day can cause sudden changes in blood pressure, which can lead to heart problems. Drinking coffee on an empty stomach increases the acidity of the stomach, and this is a direct path to the development of ulcers and gastritis. And coffee also has a diuretic effect, which causes dehydration of the body, kidneys suffer.

• Dangerous and healthy food

  Coconut oil

  Coconut oil is one of the richest foods in saturated fatty acids.It contains 90 percent of these healthy fats. Among them is lauric acid, which has a pronounced antimicrobial effect, which helps to strengthen the body’s immunity in the fight against viruses, fungi, infections, inflammations. Coconut oil also contains vitamin E, which is effective against wrinkles.

• Dangerous and healthy food

  Green tea

  Green tea is a storehouse of antioxidants, including polyphenols and flavonoids, which prevent skin aging and the appearance of wrinkles, as well as protect us from cancer and other diseases.The composition of its leaves also includes a unique amino acid – L-theanine, which has a relaxing effect and protects a person from the effects of stress on his body.

• Dangerous and wholesome food

  Bitter chocolate

  Cocoa, which is 80 percent dark chocolate, is a real source of powerful antioxidants, saturated fatty acids and flavonoids, which help to improve the elasticity of blood vessels, blood circulation, and the normalization of arterial pressure.Not to mention, this product evens out the complexion and protects the skin from the harmful effects of the sun.

• Dangerous and wholesome food

  Papaya

  The fruits of this tropical plant are a valuable dietary product, because they have a very low calorie content: there are only 39 calories per 100 grams of pulp. The low fructose content of papaya promotes proper digestion, while its beta-carotene, vitamins C and E improve complexion and protect the skin from sunburn.

• Dangerous and wholesome food

  Carrots

  In addition to improving eyesight, carrots also have a wonderful effect on the skin. The fact is that this product is rich in beta-carotene, which is synthesized in the body into vitamin A, and it helps prevent the overproduction of cells in the epidermis, where excess sebum, combined with dead cells, clogs the pores. Carrots are also good for improving bowel function and strengthening the immune system.

• Dangerous and wholesome food

  Seeds

  Seeds of sunflower, pumpkin, flax, chia (Spanish sage) are truly the elixir of youth.Due to the content of selenium, vitamin E, magnesium, protein, omega-3-unsaturated fatty acids, other vitamins and minerals, they are very useful for moisturizing the skin, smoothing out folds on it and preventing the appearance of wrinkles on the face.

• Dangerous and wholesome food

  Spinach

  What is not in this green herb! It is rich in iron, folic acid, chlorophyll, fiber, vitamins E, C and A, magnesium, proteins, and these are the guarantors of good health, since they help to improve the functioning of the intestines, cleanse the body of harmful substances, and are an effective means of combating skin aging.

• Dangerous and healthy food

  Salmon

  This fish is a valuable source of beauty and a superfood for those who often deal with stress. Salmon is rich in vitamin D, the role of which is both in strengthening bones and protecting the body from skin diseases, heart and brain diseases, cancer, and depression. And the presence of omega-3-unsaturated fatty acids in it makes it a product that helps to eliminate wrinkles.

  Author: Natalia Koroleva

Life without odors: what the loss of smell deprives us of

• Emma Young
• BBC Future

August 26, 2015

Photo author, Getty

Losing the sense of smell deprives a person of not only the ability to perceive smells and aromas. It entails the most dramatic consequences – which ones, the correspondent of found out.

BBC Future .

Nick Johnson glances over the menu at the White Dog Café, a jumble of tiny little rooms and closets in the university quarter of Philadelphia.

“Empanadas (pies – Ed. ) with beef … I would not mind using them. But the beef stew will be wasted for me. I avoid ordering” fish and chips “(fish fried in batter and with potatoes – fries – Ed.) – for me all fried food is for one taste. I guess I’ll go for a taco (Mexican tortilla) with fish. I know I’ll get the heat of the hot spices and a touch of pineapple aroma, hot pepper and avocado that will make you feel something in your mouth. ”

He orders tacos, we are served a draft beer called Nugget Nectar (native nectar – Rev. ) and is brewed at the local craft brewery where Johnson has worked for the past 10 years

Nugget Nectar was once his favorite. “It has a lovely balance of sweetness and hops. But now,” he says, his face darkening, “to me it is nothing more than the semblance of its old self.”

It can describe the smells of beer – the aromas of pine needles, citrus fruits, grapefruit. But he is no longer able to feel that bouquet.

Photo by, iStock

Caption,

Our nose may be able to distinguish far more odors and aromas than we think

animals.But, as evidenced by scientific research, odors can have a powerful subconscious effect on human thoughts and behavior.

People who lose their ability to distinguish between odors due to an accident or illness say that they are experiencing a sense of tremendous loss that affects their lives in such a way that they could not imagine.

Perhaps we do not put the sense of smell very high in the ranking of our senses – and most likely because we are hardly aware of the role it plays in our life.Until we lose it.

Johnson, now 34, can pinpoint the day he lost his sense of smell. This happened on January 9, 2014. He played hockey with friends on a frozen pond in the town of Collegeville, Pennsylvania, where his parents live.

“I’ve done this a million times,” he recalls. “I was slowly rolling backwards, and then the skate hit a furrow on the ice. My legs gave way. I fell back and hit the right side of the back of my head. I passed out, and when I came to, then he was already in the ambulance.People were leaning over me, blood was flowing from my ear. “

He tore his eardrum, and his skull cracked in three places. He had a cerebral hemorrhage, he was shaking with convulsions.” I had no idea what was happening to me. “

He recovered quickly, got permission to drive six weeks later and returned to work as Regional Sales Manager for Tröegs Brewery

Soon he was among the attendees of a new beer meeting. hops in it? I didn’t feel it. Then I tasted it. The guys said: “he has such a pale biscuit aftertaste”, but I did not feel this aftertaste. Then I tried another variety, more intoxicated, but now I did not feel the aroma. Then something clicked in my head. “

The stress caused by the trauma and the taking of various kinds of medication can probably explain the fact that he did not immediately realize that he had lost his sense of smell. At first, the discovery caused a shock. however, he clearly understands what this led to.

Loss of pleasure in eating and drinking is a common complaint for people who have lost the ability to smell.

Photo author, Thinkstock

Caption,

Johnson is very painful that he no longer smells his child

Our tongue tastes sweet, salty, bitter, sour and umami ( the so-called fifth taste that some flavoring additives, for example, monosodium glutamate – Red ).

More complex flavor combinations, such as grapefruit or barbecued steak, are scent dependent. But for Johnson and many people like him who are unable to perceive smells, there is another absolute loss.

At the time of the Johnson incident, his wife was eight months pregnant, expecting their second child.

At lunch he said: “I sometimes joke that I don’t smell my daughter’s diapers. But I don’t smell her own scent either. She woke up at four in the morning. I held her in my arms, we lay in bed. I know how my son smelled, and when he was a baby, and when he grew up a little.Sometimes it didn’t smell very good, but I have a memory of the wonderful smell of a child connected with it. I didn’t have to experience anything like this with my daughter. ”

How it happens

According to various estimates, the number of individuals who do not smell is a few percent of all adults. This means that millions of human beings live without smell.

Someone was born that way, someone lost this ability in the course of life. One of the most common causes of loss of smell in young people is chronic sinusitis or inflammation of the mucous membrane of the paranasal sinuses.

Photo author, Thinkstock

Photo caption,

Our tongue can smell strong aromas, but for the sake of completeness, we also need a smell

Another risk factor is that the olfactory nerves end in the upper parts of the nasal cavities, the mucous membrane of the nasal concha and the nasal septum, which makes them very vulnerable to toxic substances in the environment and to various infections.

Older people, but not elderly people, have problems with smelling more often due to viral infections.Even a common cold can be dangerous, but no one can say why some people lose their sense of smell through her fault, while others do not.

By the age of 70-80, few people manage to avoid a significant weakening of their sense of smell. The body has the ability to regenerate: nerve cells are constantly dying off and replaced by new ones. However, with age, this process slows down, and areas of the surface of the nasal mucosa, devoid of olfactory receptors, become more extensive.

Nick Johnson probably suffered catastrophic damage to the olfactory nerves.Passing from the nose to the brain, these nerves penetrate a porous bone plate called ethmoid bone.

When he hit his head on the ice, the sudden displacement of the brain inside the skull could cause the olfactory nerves to be severely damaged or even cut by bone, preventing signals from the nose from reaching the brain.

How Smell Works

Johnson sniffs heavily at the contents of his glass of Nugget Nectar, once his favorite.Volatile chemicals that rise from the surface of the liquid penetrate deep into his nostrils and reach the top of the nasal cavity, which is responsible for smelling.

Then he takes a small sip, and these substances fall from the larynx into the same part of his nose. So far, everything is going as it should.

Next. The molecules are absorbed into the mucus in the nose. This is very important for those substances, which, by definition, must be odorous.

Now no one will undertake to say, looking at a molecule, how it will smell, and whether it will smell at all.What we know for sure is that if a substance is odorless in nature, its molecules must evaporate easily so that they can be carried through the air and can be inhaled. In addition, they must dissolve in mucus to be detectable.

Photo author, Thinkstock

Photo caption,

Nerve endings of the olfactory receptors are hidden in the nasal mucosa

With healthy people, sniffing beer, or their own child or a T-shirt belonging to their partner, this is exactly what happens: they have a kind of ” the olfactory image of “a beer or a person, a complex aromatic whole that is barely conscious.”

The nerve endings of the olfactory receptors are hidden in the nasal mucosa. These nerve cells lead directly to the brain.

And although we have millions of such cells, there seem to be only about 400 species of them, each of which is associated with a specific molecule.

The number of cell types remains the subject of controversy. Some people believe that there are no more than 100.

Based on the sequence of activation of various receptor types, when I sniff Nugget Nectar, I realize that I have beer in front of me.Johnson does not smell any – his olfactory nerves were damaged or even killed as a result of the fall, so his brain does not receive any signals about the smell of the drink.

Until Johnson survived the injury, he had a very sensitive nose. Unlike me, he would easily distinguish Nugget Nectar from other beers. This ability comes with experience.

After the received signal about the smell is processed, this information is transmitted to various parts of the brain, including those responsible for memory and emotions, as well as to the cortex, where the thinking process takes place.

We can quickly learn to match the receptor activation pattern to the source of odor molecules.

Until recently, it was believed that humans are capable of capturing no more than 10,000 different odors. However, these concepts have undergone a radical overhaul, according to Joel Mainland, who is researching the fundamentals of odors at the Monell Center for the Study of Chemical Senses in Philadelphia, PA (which is one of the world’s leading institutes specializing in tastes and smells).

According to a recent article in the journal Science, humans are capable of capturing over a trillion odors. There were some problems with the methodology of this study, and the reliability of the figure itself is controversial, but Meniland believes that we clearly underestimate our abilities.

By the nature of his job, Johnson had to go through all kinds of sensory training to improve his perception of smell and taste. All other people, too, presumably, have inexhaustible possibilities, hidden for the time being.

Yes, dogs are renowned for their ability to detect human scent at the other end of the field. When Mainland was still a graduate student, his supervisor asked him to tackle the question of whether it is possible to teach people the same. As it turned out, yes, it is possible.

Photo author, Thinkstock

Caption,

Cows have more olfactory receptors than dogs

Dogs have more olfactory receptors than humans. However, as Mainland points out, cows have more of them than dogs – about 1200 versus 800 – but this does not mean that cows have a sharper sense of smell.

In this sense, people’s reputation is tarnished by the fact that they smell relatively little, and this exercise, with regular repetition, could develop the sense of smell.

What results could we achieve if we sniffed more thoroughly the world around us?

Emotional state

One of the reasons that would force us to develop our own sense of smell, would be the desire and need to improve the ability to navigate the social environment.

Some people who are born with no sense of smell have difficulty identifying the emotional state of those around them, says Mainland. They understand that while they themselves are guided mainly by facial expressions, their friends, endowed with smell, pick up signals that elude them.

These signals are so strong that they can refute emotional information that is conveyed by a smile or frowning grimace.

You can imagine a conversation in a group of friends, explains Mainland, and here one of them says: “She was very upset.”They answered: “She looked quite content with life.” First: “Yeah, she looked pleased, but obviously she was uncomfortable.”

Scientists have found that smell can change the mood and behavior of people. George Pretai of the Monell Center and his colleagues found that armpit scent extract not only affects women’s physiology by altering the level of hormones involved in regulating the menstrual cycle, but also makes women feel more relaxed and less stressed.

Together with cognitive psychologist Pam Dalton, fellow at the Monell Center, Pretai discovered evidence that humans – often unknowingly – are able to pick up body odors from stress.

(Pamela Dalton, before coming to the Monell Smell and Taste Center, worked for the US Department of Defense, where she was engaged in the development of non-lethal weapons, in particular the effects that intensified bad odors have on enemy personnel.- Ed.)

Thus, it turns out that people without a sense of smell miss a lot of delicate social signals. Is there anything you can do for them?

There are some quite effective treatments. If the sense of smell disappears due to chronic sinusitis, the loss of the sense of smell is reversible, sometimes quite quickly – you just need to cure the disease.

However, the possibilities for caring for patients like Nick Johnson, alas, are not very great.

He turned to the Morell Center for help, and the main recommendation he received from the scientists there was that he actively sniff different smells a couple of times a day.

This is believed to help stimulate the olfactory system and may promote recovery.

This may change in the future. One of the research teams at the Monell Center is experimenting with nasopharyngeal stem cells. Now scientists are busy trying to convert stem cells into nerve cells.

Photo author, Thinkstock

Photo caption,

Johnson realized what he lost when he could not distinguish the aroma of beer

They hope that this method will provide new olfactory nerves for people whose own receptors have undergone irreversible damage as a result of injury or were born defective.

The research team plans to start testing on animals as early as September 2015, and if the experiments are successful, move on to working with humans in five to ten years.

There are some promising signs already, and this is a ray of hope for Nick Johnson. Some strong-smelling things give him a smelling sensation, although it is always the same.

It used to be the eerie stench of burnt vegetable oil, he says. A few months later, he began to smell some kind of sweetish smell.Perhaps this may be some sign of the beginning of the restoration of the olfactory system.

Johnson says he is in a positive mood and intends to live as close as possible to what he was before the injury. He started playing hockey again, though now, he smiles, he had to get the best helmet you can buy.

He understands how serious the accident that happened to him was, but at the same time realizes that everything could be much worse.

“I had a cerebral hemorrhage. I could easily die. My position is this: I am happy that I survived. If the loss of smell is a price for life, I accept it.”

This is an abridged version of the article originally published

on the Mosaic website. It is reproduced under license Creative Commons . You can find out more about the topic covered in the article by visiting the website Mosaic (in English).

Loss of smell in COVID-19, causes and treatment

The ENT doctors of our clinic often see patients with complaints of decreased sense of smell (hyposmia) or lack of it (anosmia). Most of those who applied also note a loss of taste (ageusia). These signs are characteristic of the SARS-CoV-2 coronavirus infection, an outbreak of which the World Health Organization (WHO) has officially recognized as a pandemic.

Why does the sense of smell disappear with COVID-19?

The virus enters the human body through the mucous membrane of the nasal cavity, causing it to swell.The edema blocks the olfactory receptors, making the perception of odors impossible.

With covid, the sense of smell is impaired, even if there is no runny nose and swelling of the mucous membrane. This is because the virus blocks the transmission of impulses that travel from the olfactory receptors in the nose to the cerebral cortex. In this case, the brain does not identify the smell.

What is the reason for the loss of taste in anosmia?

Sense of taste is a complex process in which not only taste buds are involved, but others, including the olfactory ones.Without the usual aroma, the taste of the dish seems different. The severity of ageusia with deterioration of the sense of smell depends on the degree of damage to the olfactory analyzer and the characteristics of the organism.

How is anosmia in COVID-19 different from anosmia in colds?

In acute respiratory illness, a decrease in the sense of smell occurs gradually, as the swelling of the mucous membrane increases. Once the swelling has subsided, the ability to smell is restored.

With SARS-CoV-2, anosmia develops suddenly, even with free nasal breathing.Sensitivity to odors recovers within a few weeks, sometimes months.

What to do if the sense of smell disappears?

Observe the self-isolation regime, take the coronavirus test. If the test is positive, inform your physician and follow the recommendations given. If infection with coronavirus infection has not been confirmed, and anosmia persists, make an appointment with an otorhinolaryngologist. Most problems with scent recognition are within the purview of this physician.

What diseases cause loss of smell?

Violation of the sense of smells and tastes can be accompanied by:

How long does anosmia last with covid?

The duration of anosmia in coronavirus depends on the location of the lesion of the olfactory analyzer. If the olfactory receptors are affected, the sensitivity to odors returns within a month and a half. If the problem occurs at the level of the cerebral cortex, recovery takes six to twelve months. The strength of immunity, concomitant diseases, bad habits also matter.

What should I do if my sense of smell has not recovered after suffering COVID-19?

It is necessary to contact an ENT doctor for rehabilitation after a coronavirus infection. The otorhinolaryngologist will prescribe an effective drug or hardware therapy. To make an appointment with a specialist at the Family Doctor clinic at a time convenient for you, call the unified contact center in Moscow at +7 (495) 775 75 66, use the online appointment service, or contact the clinic’s registry.

At home, olfactory gymnastics helps to restore sensitivity to odors.

For this, aromatic oils are used. Standard set: rose, fir or eucalyptus, carnation, lemon. You should inhale each fragrance in turn for half a minute, up to eight times a day.

Scientists from all over the world are studying COVID-19. Gradually, new information appears, effective treatment regimens for the disease and its consequences, including anosmia and ageusia, are being drawn up. Doctors are the first to receive important information. Remember: anosmia is curable, you just need to see a doctor in a timely manner.

Publications on the topic of the month “How to overcome postcoid syndrome”:

Variations of genes responsible for the perception of smell discovered

Icelandic scientists have carried out the largest genome-wide search for associations of genes responsible for smell in humans. The study found variations in genetic sequences that affect people’s ability to recognize fish, licorice and cinnamon odors. The article was published in the journal Current Biology.

Previously, it was known that human olfactory receptors are encoded by 855 genes, but it is believed that about half of them do not function.Icelandic scientists conducted a large-scale study on a genome-wide search for associations of genes associated with smell, in which nine thousand people took part. The authors found variations in genetic sequences that affect how people perceive and describe certain pungent odors, such as fish, licorice, and cinnamon.

In the course of the experiment, the participants were asked to familiarize themselves with the smells and give them a name, and in addition, to evaluate the intensity and pleasantness of the aroma. Scientists have discovered variations in some of the olfactory genes.For example, alleles of the TAAR5 olfactory receptor gene affect the perception of smell in fish containing trimethylamine, a compound found in rotten and fermented fish. In experiments, people with a particular variant of this gene were more likely not to smell the usually foul odor, or to use neutral or positive non-seafood descriptions for it, such as “potato,” “caramel,” or “rose.”

Two other genes, variations of which have been investigated, affect the ability to detect the smells of licorice and cinnamon.Carriers of one of the alleles of the gene responsible for sensitivity to trans-anethole, which is found in licorice, spices, anise seeds and fennel, find the smell of licorice more intense and pleasant, and in addition, it is better defined. A similar situation is observed with the perception of the smell of cinnamon for the gene responsible for sensitivity to trans-cinnamaldehyde.

The authors plan to continue research on the perception of smell, and also use the same olfactory tests to study the loss of smell after infection with coronavirus.

Treatment of olfactory disorders | Clinic of new technologies

Smell is able to evoke love, joy, inspiration, trigger the mechanism of memories, warn of danger and even change the rate of the metabolic process.

What are the risks of a decrease in our sense of smell? If its functions are violated, the quality of life suffers – how much joy the aroma of fresh baked goods brings, the fragrance of flowers or the smell of a coniferous forest. Losing sensitivity to odors, we lose our appetite, orient ourselves poorly and even endanger ourselves, not noticing the smell of gas or flammable substances in the air in time.Scientists have proven that impaired olfactory function leads to decreased performance.

Violation of the sense of smell can be quantitative (decrease or absence of smell), and qualitative – the feeling of non-existent odors, unpleasant odors, the inability to recognize the smell. Also, there may be a rapid fatigability of the olfactory analyzer – in this case, a person smells only for a short time.

The good news is that you can restore your sense of smell through exercise.The earlier a patient with a violation of the sense of smell turns to a specialist, the more likely it is to restore the function of smell. To do this, you must first undergo modern diagnostics, after which it will be possible to establish the causes of the problem, as well as prescribe treatment or additional examinations.

Therapeutic treatment

In our clinic, we use a qualitative and quantitative test developed by scientists from Germany to study the olfactory analyzer, which is not only diagnostic, but also therapeutic.The test consists of three stages. At the first stage, the threshold of smell is determined (the minimum amount of an odorous substance required in order to begin to smell). The second stage is the stage of discrimination (differentiation), out of the three proposed options, the patient must determine the one that smells different from the other two. At the third stage (identification, or recognition), the patient needs to identify the smell from the four options suggested by the doctor. The need to go through each of the stages is determined by the doctor after an endoscopic examination and a conversation with the patient.As a result, it will be possible to judge the degree of a decrease in the sense of smell (normosmia-hyposmia-anosmia), its causes, and choose either an additional examination or a method of treatment. With the help of a qualitative and quantitative study of the test, the ENT doctor determines the degree of impairment of the sense of smell, and the need for additional research methods of the olfactory analyzer. It may be necessary to refer the patient for a consultation with a neurologist or endocrinologist.

If, after talking with the patient and endoscopic examination in the nasal cavity, the ENT doctor does not identify the cause of the violation of smell, then such a disorder is called perceptual.Considering the ability of cells in the peripheral part of the olfactory analyzer to regenerate, i.e. to division and recovery, the patient can be offered a method of training for the treatment of perceptual disorders of smell – stage 3 of the test.

Operative treatment

If, after talking with the patient and endoscopic examination in the nasal cavity, the ENT doctor identifies the reasons for the violation of the sense of smell: curvature of the nasal septum, the presence of polyps in the nasal cavity, individual anatomical features, as a result of which there is a difficulty in the flow of air with odorous substances into the olfactory area, after diagnosis the sense of smell, the patient can be offered an operative method of treatment.Surgical treatment should be gentle, using endoscopic equipment, since the olfactory cells are located in a small area of ​​the nasal mucosa. The task of the surgeon is to restore the access of odoriferous substances to this area and not damage the existing cells. After surgical treatment, it is necessary to repeat the olfactory test to confirm the effectiveness of

90,000 Smell recovery after coronavirus infection

Three quarters of patients with coronavirus infection experience impairment of smell (hyposmia or anosmia) and taste.In 10% of those who had been ill, the ability to adequately distinguish odors did not recover for more than six months. This is a serious problem, and leading scientists are working on its solution.

Why is there a change in smell and taste after covid?

Doctors are often faced with diseases in which the patient does not distinguish between odors. Here are some examples.

• Parkinson’s disease. The patient is worried about tremor of the limbs, gait disturbance, muscle stiffness. It is with these symptoms that he goes to the doctor.But 5 years before the onset of movement disorders, patients may notice that their sense of smell decreases.
• Tumors. The sensation of odors disappears when the brain is damaged, if the olfactory bulb is affected – a special area where the olfactory neurons are located.
• Cystic fibrosis. Hereditary disease. Anosmia appears in the first two years.
• Receptors stop fully forming a nerve impulse.
• ARVI, allergic rhinitis, polyps in the nasal cavity.Hyposmia is associated with swelling of the nasal mucosa. It is he who blocks sensitive hairs.

SARS-CoV-2 works differently. A special protein binds to receptors in the cells of the olfactory neuroepithelium, helping the coronavirus to get inside. Then the pathogen travels along the nerve fibers to the brain to the olfactory bulb. As a result, the olfactory tract from the initial receptors to the analyzer can be affected.

Is it possible to bring back the sense of smell and taste?

In parallel with a decrease in the sense of smell, a violation of taste perception occurs.This is a logical process. The aroma of food caught by a person enhances the taste, makes it richer. When a person does not perceive the smell of food, he cannot fully appreciate its taste. With the restoration of olfactory sensitivity, gustatory perception returns.
The ability to distinguish between odors and tastes can be restored. The earlier treatment is started, the easier it is to do this. It looks like a stroke situation. After a vascular catastrophe in the brain, it is necessary to help the person as soon as possible, to start restoring motor activity at the earliest possible date.
In case of coronavirus infection, it is the same – the sooner rehabilitation begins, the better the prognosis. Olfactory neurons have the ability to regenerate, renewing themselves approximately every 40 days. In order for them to work faster, they need to be actively engaged.

Why do not everyone who has had a coronavirus infection lose their sense of smell?

Anosmia usually develops on days 4–6 of illness. On days 10-14, most people recover and the ability to distinguish aromas returns. But for some, the defect remains.You need to understand that any disease cannot proceed in the same way in different people. There are no two identical organisms, respectively, and diseases will proceed differently.

Other significant factors:

• Viral load is the number of microbes that have entered the body. The more, the more severe the disease progresses.
• The virulence of a virus is the strength of its destructive (damaging) effect. Different types and subtypes of coronaviruses are different. Do not forget that viruses mutate and change.
• Immune memory. The more SARS a person has suffered in his life, the easier it is to get sick with coronavirus, the less the risk of complications.
• Concomitant human diseases: diabetes mellitus, obesity, severe forms of hypertension, respiratory failure. And if these diseases are combined, the coronavirus infection is even more severe.

What needs to be done to restore the sense of smell?

Irritate receptors and restore the pathway chain.Make nerve cells work, remember their functions. Coffee, lemon balm, mint, garlic are well suited for this. Aromatherapy is used with essential oils: cloves, citrus fruits, eucalyptus. You need to inhale the aromas 5–6 times a day. With swelling of the mucous membrane, irrigation of the nasal cavity with saline solutions will help. It is allowed to use special sprays, even hormonal ones. They should be prescribed by an otorhinolaryngologist, because there are contraindications.
A neurologist can prescribe drugs that improve the trophism of nervous tissue, including olfactory receptors, and also recommend reflexology.

Reflexology. What’s this? How can you restore your sense of smell with it?

Reflexology physicians refer to physiotherapy. It improves blood supply, innervation, lymph drainage, improves well-being. Reflexology can help restore the sense of smell. This is not a new treatment, it has been used before. Reflexology is good for treating allergic rhinitis and even infectious ones.
Acupuncture – setting needles, can be combined with moxibustion. Internal organs on the surface of the skin have their own projections, which are called wonderful meridians.The doctor acts on biologically active points of a certain zone, as a result of which there is an improvement in microcirculation, lymph flow, elimination of edema, and improvement of smell. By restoring the circulation of energy according to the ancient Chinese teachings, we restore health.

Information for you has been prepared by: Neurologist Lyudmila Vasilievna Lebedeva, reflexologist. Conducts a reception in the building of the clinic on Novoslobodskaya.

VIDEOS with the participation of a neurologist Lebedeva L.V.

A plot with the participation of our neurologist, reflexologist Lyudmila Vasilievna Lebedeva on the NTV channel in the News program, under the heading “Special Report” from 27.