DEODORANTS - A CLINICAL PROVOCATION STUDY IN FRAGRANCE-SENSITIVE INDIVIDUALS

Deodorants are one of the most marketed types of cosmetics and are fre quently reported as a cause of dermatitis, particularly among fragranc e-sensitive persons. The aim of this study was to investigate the abil ity of deodorants, which had previously caused axillary dermatitis in fragrance-mix-sensitive eczema patients, to provoke reactions on repea ted open application tests on the upper arm and in the axillae, and to relate the findings to the content of fragrance-mix constituents in t hose deodorants. 14 eczema patients performed a 7-day use test with 1 or 2 deodorants that had caused a rash within the last 12 months. 2 ap plications per day were made in the axilla and simultaneously on a 25 cm(2) area on the upper arm. A total of 20 deodorants were tested amon g the 14 patients. Afterwards, the deodorants were subjected to quanti tative chemical analysis identifying constituents of the fragrance mix . 12/20 (60%) deodorants elicited eczema on use testing in the axilla. 8/12 deodorants were positive in the axilla on day (D) 7 and 4 both i n the axilla and on the upper arm. 2 of the 4 developed a reaction in the axilla before it developed on the upper arm. Chemical analysis rev ealed that 18/19 deodorants contained between 1 and 6 of the fragrance -mix constituents, on average 3 being found. The mean concentration of fragrance-mix constituents was generally higher in the deodorants cau sing a positive use test, as compared with those giving a negative rea ction, indicating that the differences between the deodorants in terms of elicitation potential were more related to quantitative aspects of allergen content than of a qualitative nature. It is recommended that deodorants are tested in the axilla in the case of a negative use tes t on the upper arm and a strong clinical suspicion.