Abstract
BACKGROUND: Fragrance allergy is difficult to define, with thousands of known fragrance-related compounds. Whether certain botanicals should be considered 'fragrance' and whether fragrance-allergic patients should avoid these ingredients remains unclear, with minimal published data on the topic. OBJECTIVES: This study aimed to evaluate whether there is cross-reactivity between fragrance and various botanicals commonly found in personal-care products, such as aloe, coconut oil and shea butter, among others. METHODS: A cohort of fragrance-allergic patients was identified using data from 2038 patients patch-tested at a tertiary referral centre from 2020-2024. Cross-reactivity rates to botanicals commonly found in personal-care products were calculated, and statistical significance was determined using Fisher's exact test. Cross-reactivity was defined as > 10% reaction incidence. RESULTS: In patients with fragrance allergy, there was no significant cross-reactivity to any of the investigated botanical compounds. CONCLUSIONS: The low concomitant rates of reaction between fragrance and the investigated substances suggest that patients allergic to fragrance do not need to avoid certain common botanicals. Many products contain these compounds, including ones marked as 'fragrance-free'. Dermatologists can safely reassure fragrance-allergic patients of the safety of many botanicals commonly used in personal-care products.