When a rose may not smell so sweet

Is it possible that there are more chemicals being used in perfumes and sprays that are hurting more people than 10 or 20 years ago?

"That is definitely accurate," said Dr. Merritt Fajt, an allergist who is a nationally known physician at the University of Pittsburgh Asthma Institute at UP Medical Center and an assistant professor of medicine at Pitt.

"One reason that fragrant sensitivities are on the rise is that the use of fragrances is becoming a lot more prominent in this world and now there are about 500 different fragrances and even more if you combine the different fragrances."

Allegheny Health Network allergist Dr. Deborah Gentile agreed that there are now "four or five hundred types of these chemicals." The newer chemicals are used in fragrances, perfumes and air fresheners.

"Some of these chemicals may cause breathing problems, irritation in the nose or chest, headaches, stomachaches," Gentile added. "You can treat them, using allergy medications like antihistamines."

Liz Sandhagen, 48, of Whitehall, Pa., said she reacts to a list of allergens that includes household cleaners, scented candles, perfume and smoke.

"I don't go places where there might be smoke, and nobody comes to the house and smokes. There are no perfumes or colognes in our house, either," she said. Sandhagen is treated monthly with a shot of Xolair. She said the allergy care she has received over 25 years has helped reduce the number of hospital stays she has needed for other medical problems.

The growing popularity of fragrances has caused at least one person to have a terrible allergic reaction that has no treatment available yet. He's Brandon Silk, 16, of Bethlehem, Pa. He has been terribly allergic to the Axe body spray that others his age have been wearing since he was in the fifth grade.

"One day [in the fifth grade] he went into anaphylactic shock," said his mother, Rosa, who wrote a story to raise awareness about his problem. "He stayed for days in the hospital as doctors tried to figure out what was the cause. … They came to the conclusion that it was something airborne that he must have been exposed to."

Eventually he came home from the hospital, but the problem continued. "Every time he went to school he was sick with headaches, trouble breathing, welts on his face and arms, blurred vision, stomach pains to the point where he had to be homebound for weeks at a time before he could go back to school," Brandon's mother said.

The physicians never were able to determine what was causing Brandon's symptoms, but he figured it out himself. He walked into a school hall, felt the familiar allergic reaction starting and at the same time recognized a scent. It was Axe body spray.

In a recent interview with the Pittsburgh Post-Gazette, Brandon's mother said that one doctor got the list of Axe's fragrance ingredients. But his work was of no help. That doctor "indicated there is no testing for the chemicals," she said. She said she was not given the list, that the doctor was not allowed to pass it along because Axe's content is considered proprietary information, or a trade secret.

"We will try to figure out what can we test on it and then go forward with a test for all of them," Rosa Silk said. "I feel that she would be able to find some sort of solution for Brandon."

Brandon's case is far more difficult than even that of the most highly allergic patients, said UPMC's Fajt, who has not seen the young man as a patient.

"The majority of patients we see with a true fragrance or perfume allergy get a dermatitis skin rash," she said. "I would say that [Brandon] appears to be an extremely unique case."

Fajt added, "The new types of allergies are difficult to diagnose objectively because our traditional tests for allergies focus on environmental allergens — trees, grasses — so the traditional tests, blood or skin, have been developed to detect those type of agents. For a dermatitis rash that can result from a perfume sensitivity, skin testing — known as patch testing — can be done. But they take up to three days to get results."

So while Brandon waits for Redlich to find a way to treat him, other allergy patients may benefit if they get allergy shots for a long enough time.

Others, like another of Fajt's patients, 80-year-old Dorothy Brown, are happy to no longer be bothered by at least some of their allergies. For years, Brown was considered allergic to ragweed, trees, mold, cats and dogs.