Fragrances or pleasant aromas are an integral part of our everyday lives.
From the perfumes we use to the spices we eat, there is a fragrant component
in everything. Fragrances, though meant to have a positive effect, do
have their negative outcome in individuals who are allergic to them.
This is known as fragrance sensitivity.
The North American Contact Dermatitis Group (NACDG) classifies fragrances
as the fourth most common allergen, accounting for 11.7% of all contact
dermatitis cases. NACDG also marks fragrances as the most common cosmetic
ingredient to cause allergic contact dermatitis (ACD).
Among fragrances, balsam of Peru, or scientifically myroxylon pereirae,
is one of the most widespread allergens. It occurs naturally and the NACDG
rates it as the third most prevalent allergen. The International Fragrance
Association recommends its repression as a fragrance component.
Initially balsam of Peru was also a vital means of testing for fragrance
allergy before the implementation of an easier method with a fragrance
mix developed in the 1970s. In fact, it could effectively identify an
estimated 50% of cases sensitive to fragrance.
Sources of Balsam of Peru allergens
As a fragrance, balsam of Peru is found in personal use and cosmetics
products such as:
- Bath essence
- Body sprays and deodorants
- Domestic items
- Aromatic skin or hair products
However, sensitivity to balsam of Peru is not restricted to fragrance
alone; it can also be triggered from the following direct food sources:
Other than these obvious sources, there are some important implicit sources
as well. They are:
- Though fragrances are primarily used as pleasant aroma, it also
often works to camouflage a distasteful scent. These are called ‘masking
fragrances’ and found in products labeled ‘unscented’.
are some fragrance elements that act as preservatives or emollients.
Balsam of Peru, benzylaldehyde, benzvl alcohol and bisbalol are some
of the conventional covert fragrances.
How to avoid Balsam of Peru allergy
Those who suffer from balsam of Peru allergy need to be actively counseled
on how to avoid fragrances. There are two ways to go about it:
1. Avoidance of balsam of Peru products (used as a fragrance ingredient
or to mask fragrances): Balsam of Peru used as a fragrance is an obvious
form and can be avoided by active label reading for product ingredient
information. The Cosmetic, Toiletry, and Fragrance Association furnishes
information on product making and contents distinctive to various preparations.
However, for knowing about fragrance masking a patient needs to be sufficiently
educated about the category of products that are marked as unscented.
As explained earlier, these are products that can consist of fragrances
used to mask unpleasant odors. Hence, allergic individuals should know
that they should look out and use only those products that are labeled
as ‘fragrance free’. This of course entails the comprehensive
declaration of product ingredients despite their purpose. However, this
is still far from an industry convention.
2. Balsam of Peru avoidance diet: Fragrance allergy is related
to systemic contact dermatitis that results from the exposure to an allergen
means of drug/chemical/food ingestion, inhalation, injection or percutaneous
penetration (intramuscularly, intravenously, orally, rectally, or
It causes the following conditions:
- Generalized or resistant palmar dermatitis
- Plantar or anogenital
Persons allergic to balsam of Peru are often systemically allergic
to some spices and foods that form a part of our diet. They can
safeguard against allergy by a dietary avoidance of balsams. These
go on a four-week long trial of an avoidance diet and note the
results. If there is noteworthy relief then the patient should avoid
food ingredients on a long-term basis. Thereafter, one food item
(at a time) can be tried out after sometime to find out specific ones
There are three categories of patients who should strictly limit
balsam-based foods. They are:
- Patients who has been suffering from chronic dermatitis for
at least a year and with no respite even after avoidance
of skin contact
- Those with dermatitis that equally
affects the hands and feet, the anogenital area and the skin creases.
who have reported a positive patch test to balsam of Peru and/or fragrance
Last but not least, here is the list of foods that a
patient with balsam of Peru allergy should avoid:
- Spices: These include cinnamon, cloves, vanilla,
curry, allspice, anise, ginger and Jamaican
food seasonings for
chili sauce, barbecue sauce, chutney and liver
paste. Chili found in pizzas and other Italian and Mexican
fares that are
- Citrus products: Preparations that contain citrus
fruits such as oranges, lemons, grapefruit, bitter oranges,
tangerines and mandarin oranges. These
include marmalades, juices and bakery items.
- Flavoring substances: Flavors
like those added to Danish pastries and various forms of bakery
items, candy and chewing gum.
- Drinks: Wine, beer, gin, and vermouth
(a wine flavored with herbs). Cola and spiced soft drinks.
and pickled vegetables.
- Beverages: Aromatic or flavored tea.
- Tobacco: Mostly mentholated
- Cough medication: This includes some cough drugs
- Milk products: Ice cream and chocolate.
- Tomatoes and tomato-based