Prevalence of fragrance contact allergy in the general population of five European countries: a cross-sectional study

Br J Dermatol. 2015 Dec;173(6):1411-9. doi: 10.1111/bjd.14151. Epub 2015 Nov 7.


Background: Contact allergy to fragrances is assessed mostly in clinical populations of patients. Studies in the general population are scarce and vary in their methodology across countries.

Objectives: To determine the prevalence of fragrance contact allergy in the European general population and to assess the clinical relevance of positive patch test reactions to different fragrances.

Methods: In five European countries (Germany, Italy, the Netherlands, Portugal and Sweden) a random sample from the general population aged 18-74 years was drawn. In total, 12 377 subjects were interviewed in this cross-sectional study and a random sample (n = 3119) was patch tested using the TRUE Test and Finn Chamber techniques. Patch test procedures were harmonized by mandatory training before the study and monitoring during the study.

Results: The highest prevalence for contact allergy of 2·6% [95% confidence interval (CI) 2·1-3·2] was found for fragrance mix (FM) I in petrolatum, with a high content of atranol and chloratranol, followed by 1·9% (95% CI 1·5-2·4) for FM II in petrolatum. The conservatively estimated prevalence of fragrance contact allergy was 1·9% (95% CI 1·5-2·5). This is defined as the existence of a positive patch test to FM I or FM II; any of their individual materials; Myroxylon pereirae; sesquiterpene lactones or 3- and 4-hydroxyisohexyl 3-cyclohexene carboxaldehyde that show clinical relevance, defined conservatively as lifetime avoidance of scented products and an itchy skin rash lasting > 3 days in a lifetime. Using the reported lifetime prevalence of any contact dermatitis instead of the lifetime prevalence of any itchy skin rash, the prevalence is 0·8% (95% CI 0·5-1·2). The prevalence rates of contact allergy to fragrances in women are about twice those in men.

Conclusions: This study helps to identify targets for prevention of fragrance allergy.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Allergens / adverse effects
  • Cohort Studies
  • Cross-Sectional Studies
  • Dermatitis, Allergic Contact / epidemiology*
  • Dose-Response Relationship, Drug
  • Europe / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patch Tests
  • Perfume*
  • Prevalence
  • Sex Distribution
  • Young Adult


  • Allergens
  • Perfume