Frequency of and trends in fragrance allergy over a 15-year period

Background: The widespread use of fragrance-containing products is probably the most important reason for its high impact in allergic contact dermatitis. Objectives: To describe the frequency of contact allergy to fragrance allergens as tested in the standard series, in relation to age, sex and lesion locations. To determine trends in frequency over the years and to study the association between positive tests observed with the different fragrance-allergy markers as well as between specific fragrance allergens and locations of the lesions. Patients/Methods: 10 128 patients underwent patch testing between January 1990 and December 2005 at the Dermatology department in Leuven. Results: 1463 (14.5%), that is, 380 (26%) males and 1083 (74%) females, reacted positively to at least 1 fragrance-allergy marker in the standard series: 9% to fragrance mix I, 6% to Myroxylon pereirae, and 4.8% to colophonium (often in association), 2.1% to hydroxyisohexyl 3-cyclohexene carboxaldehyde and 2.1% to fragrance mix II, the latter 2 allergens having been introduced more recently. Over the years, fragrance contact allergy has shown a fluctuating trend. Hands and face were the most commonly affected body sites. Moreover, a significant association was found between specific fragrance allergens and certain locations. Conclusions: This study illustrates that fragrance contact allergy is common in patients suffering from contact dermatitis.