How to instruct patients sensitive to fragrances

Patients who are sensitive to fragrances should either use fragrance-free cosmetics or undergo a repeat open application test to the cosmetic or perfume to determine sensitivity. Unusual reactions include systemic contact dermatitis due to balsam of Peru, benzyl alcohol, and menthol. Some responses involve pigmented eruptions due to phototoxic or photoallergic agents in perfumes and incense. Other reactions include consort dermatitis and reactions to toothpastes, gum and perfumes in paper products, sanitary napkins, ostomy pastes, and detergents.