Contact allergy to the 26 specific fragrance ingredients to be declared on cosmetic products in accordance with the EU cosmetics directive.

Fragrance ingredients are a frequent cause of allergic contact dermatitis. The EU Cosmetics Directive states that 26 specific fragrance ingredients, known to cause allergic contact dermatitis, must be declared on the ingredient lists of cosmetic products. To investigate frequencies of sensitization to the 26 individual fragrances and evaluate their importance as screening markers of fragrance allergy. This was a retrospective study based on data from the Department of Dermato-Allergology, Copenhagen University Hospital Gentofte. Eczema patients (n = 1508) were patch tested (January 2008 to July 2010) with the 26 fragrance ingredients. Sensitization to the 26 fragrances was identified in 115 (7.6%) subjects. The most frequent allergens were Evernia furfuracea (n = 50), Evernia prunastri (n = 31), and hydroxyisohexyl 3-cyclohexene carboxaldehyde (n = 24). Including fragrance mix I, fragrance mix II and Myroxylon pereirae, 196 (13.0%) had a fragrance allergy. Testing with the 26 fragrances additionally identified 23 subjects who would otherwise have gone undetected. The majority (75.7%) of positive reactions to the 26 fragrances were of clinical relevance. Sensitization to the 26 individual fragrance ingredients was identified in 7.6% of the subjects patch tested. Most reactions were of clinical relevance. Fragrance-allergic subjects would be missed if testing with the individual fragrance ingredients was not performed.