Fragrance Sensitivity is on the Rise. Here’s What That Means, and What to Do if You’re Affected.

For a growing number of people, perfume and other fragranced products trigger nausea, headaches or other unpleasant symptoms. This can be tricky to deal with since fragrances are nearly everywhere—stores, workplaces, churches, public restrooms and more.

“Fragrance” in the ingredients list of household and personal care products is shorthand for a complex mix of chemicals. Companies generally aren’t required to disclose the details because they’re regarded as trade secrets.

Even if you don’t notice symptoms when exposed to these scents, the negative health effects of synthetic fragrances can build over the long term. They pollute the earth, too. Everyone should make an effort to limit their exposure to them.

Fragrance sensitivity is growing      

If you’re sensitive to fragrances, you’re not alone. On average, 32% of adults report adverse effects from exposure to fragrances, according to recent surveys of nationally representative samples across four countries, including the United States.

Fragrances can be especially problematic for the estimated 13% of Americans with multiple chemical sensitivity (MCS), also called environmental illness (EI) or toxicant-induced loss of tolerance (TILT). The prevalence of MCS has increased by more than 300% in the United States over the past decade.

Those who are sensitive to fragrance may react to the slightest whiff of scents. They may trigger any number of troubling symptoms, such as:

• Anxiety
• Asthma attacks
• Breathing problems
• Coughing
• Difficulty thinking
• Dizziness
• Eye irritation
• Fainting
• Fatigue
• Headaches or migraines
• Hoarseness
• Irregular heartbeat
• Mood swings
• Muscle or joint pain
• Nasal congestion
• Nausea
• Skin rashes

Fragrance sensitivity shouldn’t be confused with fragrance allergy, which most commonly triggers a skin rash or asthma symptoms. Fragrance allergies may be detected by standard allergy tests, but fragrance sensitivity generally can’t be diagnosed this way.

A scientifically validated questionnaire called the Quick Environmental Exposure and Sensitivity Inventory (QEESI) can help identify if you have chemical sensitivity/intolerance, including to fragrances. You can share it with a knowledgeable doctor, which you can locate though the Academy of Environmental Medicine.

What causes fragrance sensitivity? 

Several factors may be involved in the development of MCS and hypersensitivity to fragrances. Some individuals seem to be more susceptible to this than others, such as due to genetics or environmental factors.

According to Claudia Miller, MD, a consultant for the Hoffman TILT Program in San Antonio, an intolerance to fragrances and other chemicals may result from a major toxin exposure, such as a chemical spill. Or, it may result from a series of smaller exposures to toxins over time, such as from pesticides, cleaning products, diesel fuel, personal care products, new building materials and mold.

As a result, fragrances (and other chemicals) that people once tolerated now make them feel ill, even in trace amounts. The underlying reasons for this aren’t completely clear.

“According to our published hypothesis, we believe that chemical sensitivities are due to malfunctions in the unconscious brain, specifically the amygdala and insula,” says Ashok Gupta, founder and director of The Gupta Program Brain Retraining.

The amygdala is part of the limbic system. One of its functions is to help protect the body from potential threats by triggering the fight or flight response. The insula takes in sensory information, such as exposure to fragrances, and prompts responses from the nervous system and immune system.

“Fragrance sensitivity or MCS is essentially the brain learning to respond to chemicals as if they are life-threatening or dangerous,” Gupta says. “When the brain first encounters the initial chemical, a conditioned traumatic response trains the brain to continually react to even small amounts of that chemical in the future.”

The problem often extends beyond fragrances. “Once the brain is hyper-stimulated and in emergency response mode, neurologically it is more prone to being conditioned to react to new stimuli,” Gupta says. “A sensitive brain is a cautious brain, and it will respond to new chemicals to err on the side of caution.”

As a result, many people with MCS find themselves reacting to an ever-growing list of chemical substances, as well as foods, supplements and medication. But it is beyond their conscious control.

COVID-19 and distorted perfume smells

Scientific studies and anecdotal reports from some people dealing with lingering symptoms of COVID-19 have noted that perfume smells “unpleasant” or “disgusting” and triggers nausea. They also typically have an array of other smell distortions. This is called parosmia.

In a survey of 434 people in the United Kingdom who had lost their sense of smell at the onset of COVID-19, 43% reported parosmia six months later. On average, their distorted sense of smell started 2.5 months after they initially lost their sense of smell.

What happens to distort sense of smell after COVID-19 isn’t certain. Some scientists say it’s due to the SARS-CoV-2 virus damaging the olfactory system and new nerves rewiring in a trial-and-error fashion.

Gupta says COVID-related fragrance distortion (and other long-hauler symptoms like fatigue) might be due to the same potential for conditioning in the unconscious brain as in MCS.

“COVID-19 seems to have quite an impact on the brain and body, and the brain may go into a state of hypersensitivity, due to the life-threatening nature of COVID-19,” Gupta says. “In that state, it can be prone to learning new defense responses and sensitivities, leading to MCS.”

A related theory is that COVID long-haulers may have overactive mast cells, a type of immune system cell that is spurred into action by SARS-CoV-2. Mast cells are also involved in allergic responses and can stimulate the limbic system of the brain, potentially resulting in a distorted sense of smell.

Harmful for you and the earth          

The chemicals in synthetic fragrances aren’t good for anyone. Manufacturers commonly use man-made fragrances instead of natural ones because the synthetic fragrances are more stable. Most synthetic fragrance compounds are made from petroleum.

Some fragrance ingredients are carcinogens, endocrine (hormone) disruptors, allergens, respiratory irritants, chemicals toxic to the brain and environmental toxins.

Fragrances are a major source of indoor air pollutants. People commonly inhale them or absorb them through the skin. As a result, the chemicals are commonly found in the blood and urine of people, as well as in women’s breast milk.

Fragrance also pollutes the outdoor air, such as through the fumes emitted from dryer vents. Terpenes, which are a commonly used class of fragrance chemicals, can react with ozone, yielding formaldehyde and other hazardous pollutants.

The chemicals also end up in the soil, lakes and oceans, accumulating in wildlife and seafood. Some fragrance chemicals contaminate our drinking water.

Three common types of fragrance compounds used in personal care and household products and some of their potential harms are:

• Phthalates — These are used to slow the evaporation of fragrance, so scents last longer. The chemicals may disrupt hormonal signaling and have been linked to obesity, breast cancer, lower bone density, decreased fertility and asthma. Exposing children to phthalates (including while in the womb) is linked with attention and behavior problems.
• Synthetic musks — These fragrances are endocrine disruptors, which can interfere with hormonal signaling and normal biological processes, such as fertility. Many synthetic musks have estrogen-like activity, which may increase risk of cancer, such as breast cancer.
• Chemical sensitizers — These are chemicals that can trigger a substantial number of people exposed to them to develop an allergy to them through repeated exposure. They are commonly used for the scents they impart.

Unfortunately, fragrance chemicals have become pervasive in modern society. Unless you’re actively working to avoid them, you’re likely getting a lot of exposures you don’t realize.

Where fragrances hide

People with fragrance sensitivities learn to avoid them in the products they use. Still, this doesn’t protect them from scents present on other people or used in public buildings.

Some sources of chemical fragrances include:

• deodorant/antiperspirant
• makeup
• lotion and other skin products
• hair products (shampoo, styling products)
• shaving lotions and aftershave
• fingernail polish remover
• body spray, perfume and cologne
• hand sanitizer
• sunscreen
• cleaning supplies
• laundry products
• soap and detergent
• carpet deodorizers
• candles
• plug-in or spray air fresheners
• potpourri and reed diffusers
• some garbage bags

Avoiding fragrance in products requires checking ingredient lists for “fragrance,” “parfum” or “perfume.” These words are umbrella terms for the long list of chemicals that make up fragrances.

People with fragrance sensitivity may or may not be able to tolerate essential oils, which are generally listed on product labels by the ingredient name rather than as a fragrance. The quality of the essential oil may be a factor in how people react. High quality, pure essential oils may be better tolerated.

What to do about fragrance sensitivity

Even if you’re not sensitive to fragrance, someone around you might be—though they may be too polite to say so.

If someone asks you to avoid using fragranced products, do your best to help. Don’t assume they won’t notice. Those sensitive to fragrances tend to develop an acute sense of smell. If you have any trace of fragrance on you, it can be very difficult for a sensitive person to be near you or ride in a car with you.

To help control fragrance-related symptoms, as well as help protect the health of yourself and others:

• Buy fragrance-free products — Look for personal care products (such as bar soap, liquid hand soap, deodorant, cosmetics, shampoo, conditioner, lotion and sunscreen) and household cleaning products (such as laundry detergent, dish soap and cleaning products) that are fragrance-free. Besides people with MCS and fragrance allergies, some people with COVID-related parosmia find fragrance-free products helpful.
• Research products and ingredients — One helpful resource is the Skin Deep Database from the Environmental Working Group. It includes a smartphone app you can easily use when you’re shopping.
• Check “unscented” product ingredients — These sometimes contain a masking fragrance to cover up the inherent odor of the product. This fragrance may be listed in the ingredients under its chemical name. Unless you research the chemical, you won’t know it’s a fragrance.
• Retrain your brain — Two science-based programs to “rewire” the brain to help overcome conditions such as fragrance sensitivity and MCS are The Gupta Program Brain Retraining and the Dynamic Neural Retraining System. Some COVID long-haulers have also used these programs, not only for parosmia but also for other chronic COVID symptoms. Alternately, some individuals with COVID-related parosmia use olfactory training therapy.
• Detoxify — Several methods, such as toxin binders and infrared saunas, are available to support your body’s detoxification from the buildup of the chemicals used in fragrances and other products. A skilled functional medicine practitioner can guide you.
• Advocate for fragrance-free policies — Encourage your workplace, school, health care facilities and other public places to enact fragrance-free policies. Sample policy documents are available online, such as from the American Lung Association.
• Let smelly stores know — If there are some heavily fragranced stores where you can’t shop, contact the stores and let them know why you don’t shop there. You may also mention your concern for the health and wellbeing of the employees who work there and have to breathe the chemical fragrances for hours on end.

Not everyone will readily get on board with your fragrance-free efforts. However, it may be a more popular movement than you might think.

Surveys from nationally representative samples of people in four countries, including the United States, found that at least twice as many people prefer fragrance-free environments. That includes the majority of people who aren’t even fragrance-sensitive. So, don’t be afraid to voice your needs.