Contact Dermatitis, 1998, 39, 161–165 Copyright C Munksgaard 1998 Printed in Denmark . All rights reserved ISSN 0105-1873 Deodorants: a clinical provocation study in fragrance-sensitive individuals J. D. J 1 , S. C. R 2 , M. B 3 , K. E. A 4 ,P.F 5 , B. D 5 , J. P. L 6 , I. W 7 T. M ´ 1 1 Department of Dermatology, Gentofte Hospital, University of Copenhagen, Denmark 2 Department of Environmental Chemistry, National Environmental Research Institute, Roskilde, Denmark 3 Department of Occupational and Environmental Dermatology, University Hospital, Malmo ¨, Sweden 4 Department of Dermatology, Odense University Hospital, Denmark 5 Hautklink, Sta ¨dtische Kliniken and University of Witten/Herdecke, Dortmund, Germany 6 Laboratorie de Dermatochimie, Universite ´ Louis Pasteur, Strasbourg 7 St. John’s Institute of Dermatology, London, UK Deodorants are one of the most marketed types of cosmetics and are frequently reported as a cause of dermatitis, particularly among fragrance-sensitive persons. The aim of this study was to investigate the ability of deodorants, which had previously caused axillary dermatitis in fragrance- mix-sensitive eczema patients, to provoke reactions on repeated open application tests on the upper arm and in the axillae, and to relate the findings to the content of fragrance-mix constituents in those 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 applications 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 among the 14 patients. Afterwards, the deodorants were subjected to quantitative 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 in 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 revealed 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 causing a positive use test, as compared with those giving a negative reaction, 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 test on the upper arm and a strong clinical suspicion. Key words: deodorant; allergic contact dermatitis; fragrances; use test; regional differences; axilla; chemical analysis. C Munksgaard, 1998. Accepted for publication 18 May 1998 In 1888, the first deodorant, MUM-Creme, was launched, with zinc oxide as an active ingredient (1). By the early 1900s, aluminium chloride had been reported to be an effective agent against sweating (2) and industrial production of antiper- spirants and deodorants started. Most of the adult population in the developed world today uses anti- perspirants or deodorants, giving a sales volume beyond $1 billion in US and £150 million in UK (1). Antiperspirants actively reduce the amount of axillary perspiration, but frequently also contain fragrances to give the products a special character. In deodorant products, fragrances and anti- microbial agents act together to reduce axillary odour. Thus, both deodorants and antiperspirants are important sources of fragrance exposure. Fra- grance-sensitized eczema patients often have a his- tory of rashes from scented products (3, 4). It seems that particular deodorants, antiperspirants and colognes are involved in the onset of skin problems in these patients (4). Detailed infor-