Allergy or is it an irritant?

Dear Bloggers,

My wife came home this week with hardly any voice left due to the fact that someone sprayed some kind of perfume. The doctor gives her prednisone for a week and this will do the magic. But it is crap that you have to use these kind of heavy drugs when this could be prevented on the work floor.

Just ask yourself the following question: 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 said that 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.

Hmmmm.....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,"

The immune system's response to allergen exposure can be divided into two phases. The first is immediate hypersensitivity or the early phase reaction, that occurs within 15 minutes of exposure to the allergen. The second, or late phase reaction, occurs 4-6 hours after the disappearance of the first phase symptoms and can last for days or even weeks. During the early phase reaction chemical mediators released by mast cells including histamine, prostaglandins, leukotrienes and thromboxane produce local tissue responses characteristic of an allergic reaction.

In the respiratory tract for example, these include sneezing, oedema and mucus secretion, with vasodilatation in the nose, leading to nasal blockage, and bronchoconstriction in the lung, leading to wheezing. During the late phase reaction in the lung, cellular infiltration, fibrin deposition and tissue destruction resulting from the sustained allergic response lead to increased bronchial reactivity, oedema and further inflammatory cell recruitment. These observations suggest that IgE is instrumental in the immune system's response to allergens by virtue of its ability to trigger mast cell mediator release, leading directly to both the early and late phase reactions.

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.

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 can be recommended for anyone who has experienced allergy symptoms due to fragrance sensitivities.

"Any product with a scent can be irritating to patients," I am suggesting that 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," every case is unique. "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.

The Old Sailor,