title: Is it really fragrance-free?
abstract: BACKGROUND
  Fragrance allergy is the most common cause of cosmetic contact dermatitis. Many occult sources of fragrance exist. Those which cause the most concern are some "fragrance-free" products that contain fragrance raw ingredients. Thus, the very patients requiring fragrance-free items may be exposed to potential perfume allergens or cross-reactors in seemingly safe products. Additionally, medications dermatologists recommend, both prescription and over-the-counter, sometimes contain fragrance.
  
  
  OBJECTIVE
  This report describes a patient with chronic hand dermatitis sensitized to multiple fragrance ingredients including rose oil, present in the "fragrance-free" soap she used. Additionally, the tar soaks recommended to her also contained fragrance.
  
  
  CONCLUSIONS
  It is no longer sufficient to recommend the use of products labeled fragrance-free to fragrance-sensitive patients. These patients must be educated to read labels and look for plant extracts that are potential perfume sensitizers and cross-reactors. Rose oil, which has been felt to be a rare sensitizer, may be a more common allergen than previously recognized, perhaps because of its existence in a popular "fragrance-free" soap and, conceivably, in many "all-natural" products. Further testing with rose oil should be conducted in the future. Finally, manufacturers need to be more forthright in the labeling of their products.
authors.affiliation: Department of Medical and Surgical Dermatology, New England Medical Center Hospital, Boston, MA 02111, USA.
authors.forename: P L
authors.initials: PL
authors.lastname: Scheinman
mesh_terms: D000368:Aged; D000485:Allergens / Q000009:adverse effects; D003358:Cosmetics / Q000009:adverse effects*; D003877:Dermatitis, Contact / Q000209:etiology*; D005260:Female; D006229:Hand Dermatoses / Q000139:chemically induced*; D006795:Household Products / Q000009:adverse effects*; D006801:Humans; D010328:Patch Tests; D010476:Perfume / Q000009:adverse effects*; D012915:Soaps / Q000009:adverse effects
chemical_list: D000485:Allergens; D003358:Cosmetics; D010476:Perfume; D012915:Soaps