Deodorant allergy in armpit: understanding contact dermatitis

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If your armpit is itchy, red, flaky, or bumpy, you may be having an allergic reaction to your deodorant. The various ingredients in deodorant, which help mask the smell of sweat, can be a common cause of contact dermatitis.

Contact dermatitis, a form of eczema, occurs when the skin becomes irritated or inflamed after coming into contact with a substance that causes an allergic reaction.

Common allergens in deodorant

“There are many allergens that can be found in deodorants,” says Dr. Ari Zelig, allergist and immunologist at Charleston ENT and Allergy in Charleston, South Carolina.

Fragrances are the most common allergen in deodorant.1 A Danish study found that deodorants are the leading cause of fragrance allergies, especially in men.2

Fragrances can be especially ubiquitous in cosmetic products such as deodorant. In a scientific review of studies, researchers found that fragrance was a prominent ingredient in cosmetic products.3 Additionally, the fragrance in these products contained a combination of three to four allergens in the same product, making exposure difficult to avoid.3

Although fragrance is a common allergen in deodorant, there are other ingredients that can cause problems. “Propylene glycol is an ingredient commonly found in deodorant, and some people are sensitive to it, which can lead to contact dermatitis,” says Dr. Michael Nevid, a pediatric allergist and immunologist at National Jewish Health in Denver, Colorado. Propylene glycol is usually used in deodorant to give it a firm texture and allow it to roll on the skin.

Dr. Nevid also pointed out that essential oils, lanolin and parabens are other common allergens found in deodorant. These ingredients are also known to cause contact reactions. Finding products without any of these ingredients can be a real challenge. A 2008 study assessed all deodorants available at Walgreens pharmacies in Chicago, Illinois. Of the 107 products available, only eight were free of fragrances or other commonly allergenic ingredients.1

There are two main types of contact dermatitis: irritant and allergic. Irritant contact dermatitis is the most common type of contact dermatitis. It occurs when a substance damages or inflames the skin. It usually occurs at the first sign of contact between the skin and an irritating substance. Irritant contact dermatitis can be easier to identify because symptoms usually occur immediately and cause a stinging sensation or discomfort.

Allergic contact dermatitis is a delayed allergic reaction that appears as a rash a day or two after the skin is exposed to the allergen. It is caused by the body mounting an inflammatory response to a specific ingredient. With repeated use, your immune system recognizes the substance as an allergen and causes an itchy skin reaction.

There are a few things to consider when determining whether deodorant causes contact dermatitis.

First, think about when the symptoms appeared. Irritant contact reactions are characterized by a stinging sensation or discomfort when applying your deodorant to the skin. If this happens to you, it may be time to look for a new product.

Because allergic contact reactions are delayed, they may be more difficult to pinpoint. But there are indicators.

Dr. Zelig explained that contact dermatitis “presents as a flaky, itchy rash under the armpits where deodorant is applied.”

Taking a break from deodorant is another way to determine if it is causing a reaction. “We tell patients to stop using deodorant for a few weeks and see if it improves,” says Dr. Nevid.

“The ultimate test for contact dermatitis is patch testing,” says Dr. Nevid. In a patch test, a potential allergen is placed on a patient’s back and then covered with an adhesive patch. Dr. Nevid explained that the patches are removed after 48 hours. Patients are then asked to return to the clinic 72 to 96 hours later to assess whether or not an allergic reaction has occurred.

“There is an option to bring your own skin care products and also test them with a patch,” said Dr. Nevid. It is recommended that you take your own products to your doctor for testing.3 Because there are thousands of chemicals used in perfumes, it is not possible to try them all in a single patch test. As a result, an allergy may be missed if your doctor does not stock the specific ingredients used in your products.

How to assess an armpit rash if you have atopic dermatitis

If you have atopic dermatitis, you are often very sensitive to skin care products with fragrances. If you have a rash under your armpit, it can be difficult to determine whether the reaction is from your deodorant or something else.

Dr. Nevid explained that in people with atopic dermatitis, a rash in the armpit can be the result of other types of rashes or infections, not just deodorant. “It could be that the patient’s atopic dermatitis just happens to be in that spot, without the deodorant,” he said.

Sweat can also be the cause. Many people with atopic dermatitis experience irritation when the salts in sweat come into contact with their skin.

One step to help decipher whether you have contact dermatitis from deodorant or if you are suffering from atopic dermatitis is to stop using the deodorant for a few weeks to see if it goes away.

The best way to treat deodorant contact dermatitis is to stop using the deodorant that is causing the allergic reaction. Once you have identified the ingredients causing the reaction, the most important step is to avoid using them in the future.

“The overall message with contact dermatitis is to avoid triggers,” said Dr. Nevid. “It is the ultimate treatment.”

Identifying triggers is not always easy. And eliminating deodorant altogether may not be possible. In these cases, other treatments are available. “If it’s unavoidable or you’re having trouble figuring out what that trigger is, you can use topical corticosteroids or topical calcineurin inhibitors, similar to how we treat atopic dermatitis,” said Dr. Nevid. “But ultimately the hope is to find those triggers and remove them.”

Choosing the right deodorant if you have eczema

Whether you have atopic dermatitis or are prone to contact dermatitis, finding the right deodorant is crucial to preventing eczema flare-ups.

“In general, patients with eczema should use hypoallergenic, unscented skin care products, and this includes deodorants,” says Dr. Zelig.

When shopping for a deodorant, read labels carefully to avoid your triggers. Even products marked ‘unscented’ can contain masking fragrances, so it’s essential to carefully examine all ingredients listed.

“Discussing the possibility of patch testing with your allergist or dermatologist is also highly recommended to help identify and avoid your triggers,” says Dr. Zelig.

Dr. Zelig explained that once allergens have been identified, “your allergist or dermatologist can help you create a list of safe products.”

The good news is that although it may take some time to diagnose, deodorant-induced breakouts are relatively easy to treat. Once you find a product that works for you, uncomfortable underarm rashes can be a thing of the past.


Look for the seal

To find eczema-friendly skin care products, including moisturizers and cleansers, visit the National Eczema Association’s Seal of Acceptance™ Product Directory. Deodorant products will be added to the product list in fall 2024.


References

1. Zirwas MJ, Moennich J. Antiperspirant and deodorant allergy: diagnosis and management. J Clin Aesthet Dermatol. 2008;1(3):38-43. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3013594/

2. Heisterberg MV, Menné T, Andersen KE, et al. Deodorants are the leading cause of allergic contact dermatitis to fragrance ingredients. Contact dermatitis. 2011;64(5):258-64. https://pubmed.ncbi.nlm.nih.gov/21480912/

3. Johansen JD. Odor contact allergy: a clinical review. Ben J Clin Dermatol. 2003;4(11):789-98. https://pubmed.ncbi.nlm.nih.gov/14572300/