Saturday 19 October 2019

Dear Dr Nina: Scented candles give me migraines - could I have multiple chemical sensitivity?

Strong smells can cause a reaction in some people
Strong smells can cause a reaction in some people

Nina Byrnes

Q I have a severe reaction to strong perfume or scented candles. If I am in a room with a strongly scented candle, it aggravates my sinuses and can bring on a migraine if I am there long enough. I have done some reading on the internet and have come across something called multiple chemical sensitivity. Can you explain this and could I have it?

Dr Nina replies: We all know that exposure to high levels of chemicals and irritants can be toxic but for some people, small chemical doses may cause symptoms. Multiple chemical sensitivity (MCS) manifests as a result of exposure to individual or various environmental contaminants, usually of a chemical basis. Those with the condition are believed to be sensitive to exposure to these chemical at concentrations below the level at which they may be considered toxic for the general population.

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Although this condition has been described since the 1940s, the medical community has had differing opinions on defining the condition and its diagnosis. Some in the medical community have suggested it has a predominately psychological rather than physical basis. In more recent years, opinions are changing somewhat, particularly among those who work in environmental health.

Some 85pc to 90pc of those with MCS are women. Most cases occur in those aged 30 to 50.

Symptoms of MCS include headaches, rashes, shortness of breath, asthma-type symptoms, muscle and joint aches and pains, fatigue, poor concentration or memory loss and confusion. Severity ranges from mild to life-altering with those with severe cases avoiding social activities, work or other areas where they feel they may be exposed.

Allergy, toxic exposure (effectively low-dose poisoning) or neurobiologic sensitisation (increased sensitivity with prolonged exposure) have been proposed as causative factors. Stress also seems to be a trigger in many with up to 50pc of those affected meeting the diagnostic criteria for depression and/or anxiety. Given that there is little consensus on the cause, diagnosis, symptoms and treatment of MCS it is hard to categorise.

Given that your symptoms seem to be perfume or scent-related it may be worth exploring the allergy theory as your first port of call. Rhinitis-type symptoms and asthma can be triggered by both in some people.

Allergic rhinitis causes a sensation of blocked nose, congestion and can cause headaches along with the usual symptoms of sneezing, itchy eyes and nasal drip. Other symptoms may include reduced taste, red eyes, mouth breathing, snoring, reduced sleep and fatigue. Most associate rhinitis with summer grasses and pollens but symptoms can occur due to perfumes, tannins and other possible food or chemical allergens.

Rhinitis occurs in about 20pc of the population. It affects all ages.

Treatment for any irritant symptoms, whether MCS or rhinitis, involves primarily reducing exposure to the triggers. If this is impossible (such as community exposure to perfumes) then using a daily nasal rinse may help.

If allergy type treatments are not working and your quality of life is severely impacted, referral onwards to an immunologist may be appropriate.

⬤ If you have any queries, email

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