Many patients I see come in complaining of skin irritation or a rash. My first question is: what kind of detergent do you use? My follow-up question is: do you use fabric softener? I even ask if they send their clothes off for dry cleaning.
Increased exposure to ingredients in fragrances during the last century appears to have increased the number of people sensitive to these additives.
Namali Corea and the co-authors of "Fragrance Allergy: Assessing the Risk from Washed Fabrics" in the journal Contact Dermatitis
When a chemical you are allergic to comes in contact with your skin, your immune system overreacts and produces a rash. Poison ivy and metals such as nickel, among many other substances, can produce this reaction, called irritant contact dermatitis. Symptoms include:
• hives, red bumps, or welts on the skin • itching • rash • blisters • burning • swelling • redness • cracked or peeling skin
Irritant Contact Dermatitis
Although the symptoms are similar, irritant contact dermatitis differs from allergic contact dermatitis in an important way. Irritant contact dermatitis is caused by contact with an irritant you are sensitive, but not allergic to.
The American College of Allergy, Asthma and Immunology says that irritant contact dermatitis is usually not caused by an allergen. Rather, a skin irritant such as detergent, soap, or plant oil can trigger it.
Fragrances and Scented Laundry Detergent
Namali Corea and the co-authors of "Fragrance Allergy: Assessing the Risk from Washed Fabrics" in the journal Contact Dermatitis observed that increased exposure to ingredients in fragrances during the last century appears to have increased the number of people sensitive to these additives. The Environmental Health Association of Nova Scotia warns that clothes, sheets, and pillowcases can hold detergent residue that can cause skin irritation.
However, Corea et al, found that the risk of developing allergic contact dermatitis from fragrances in fabrics is extremely low. This is consistent with my observation that irritant contact dermatitis is more common than allergic contact dermatitis.
Alternatives to Scented Detergents
Commercial products I recommend for my patients include:
• Seventh Generation Natural Detergent Free & Clear Powder • Arm & Hammer Essentials Laundry Detergent • Tide Free & Gentle Laundry Detergent
Beware of detergents marked "hypoallergenic" or "unscented." They may still contain trace amounts of chemical fragrances. The label must read fragrance-free.
About the Author
Boyan Hadjiev, MD, has been a practicing physician for five years. He is double board certified in Internal Medicine, (2003), and Allergy and Immunology, (2005).
Dr. Hadjiev graduated from University of Michigan with a BA in biology and an MD from Cleveland Clinic-Case Western Reserve School of Medicine.
Is This an Emergency?
- Atopic Dermatitis vs. Contact Dermatitis. (n.d.). American College of Allergy, Asthma & Immunology. Retrieved September 28, 2012
- Contact Dermatitis. (n.d.). American College of Allergy, Asthma & Immunology. Retrieved September 28, 2012
- Corea, N.V. et al. (2006, July). Fragrance allergy: assessing the risk from washed fabrics. Contact Dermatitis, 55(1), 48-53. Retrieved September 28, 2012
- Guide to less Toxic Products: Laundry Detergent. (n.d.). Environmental Health Association of Nova Scotia. Retrieved September 28, 2012
- Johansen, J.D. (2003). Fragrance Contact Allergy: A Clinical Review. American Journal of Clinical Dermatology, 4(11), 789-798. Retrieved September 28, 2012
- Skin Allergies. (n.d.). American College of Allergy, Asthma & Immunology. Retrieved September 28, 2012