Increase in Allergic Contact Dermatitis in Recent Years

A study of 1600 adults in 1987 showed that 12% reacted adversely to cosmetics and toiletries, 4.3% of which were used for their odor (i.e., they contained high levels of fragrances). Respiratory problems worsened with prolonged fragrance exposure (e.g., at cosmetic/perfumery counters) and even in churches. In another study, 32% of the women tested had adverse reactions and 80% of these had positive skin tests for fragrances (deGroot and Frosch, 1987). Problems with essential oils have also been increasing. For example, contact dermatitis and allergic contact dermatitis (ACD) caused by tea tree oil has been reported, which was previously considered to be safe (Carson and Riley, 1995). It is unclear whether eucalyptol was responsible for the allergenic response (Southwell, 1997); out of seven patients sensitized to tea tree oil, six reacted to limonene, five to a-terpinene and aromadendrene, two to terpinen-4-ol, and one to p-cymene and a-phellandrene (Knight and Hausen, 1994).

Many studies on ACD have been done in different parts of the world (deGroot and Frosch, 1987) and recently more studies have appeared:

• Japan (Sugiura et al., 2000): The patch test with lavender oil was found to be positive in increased numbers and above that of other essential oils in 10 years.

• Denmark (Johansen et al., 2000): There was an 11% increase in the patch test in the last year and of 1537 patients, 29% were allergic to scents.

• Hungary (Katona and Egyud, 2001): Increased sensitivity to balsams and fragrances was noted.

• Switzerland (Kohl et al., 2002): ACD incidence has increased over the years and recently 36% of 819 patch tests were positive to cosmetics.

• Belgium (Kohl et al., 2002): Increased incidence of ACD has been noted.

Occupational increases have also been observed. Two aromatherapists developed ACD: one to citrus, neroli, lavender, frankincense, and rosewood and the other to geraniol, ylang ylang, and angelica (Keane et al., 2000). Allergic airborne contact dermatitis from the essential oils used in aromatherapy was also reported (Schaller and Korting, 1995). ACD occurred in an aromatherapist due to French marigold essential oil, Tagetes (Bilsland and Strong, 1990). A physiotherapist developed ACD to eugenol, cloves, and cinnamon (Sanchez-Perez and Garcia Diez, 1999).

There is also the growing problem that patients with eczema are frequently treated by aromather-apists using massage with essential oils. A possible allergic response to a variety of essential oils was found in children with atopic eczema, who were massaged with or without the oils. At first, both massages proved beneficial, though not significantly different; but on reapplying the essential oil massage after a month's break, there was a notable adverse effect on the eczema, which could suggest sensitization (Anderson et al., 2000).

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