Balsam of Peru Allergy

Balsam of Peru allergy

A Balsam of Peru Allergic Contact Dermatitis allergy can be one of the most complicated ACD allergies to understand and manage. I’ve attempted to break Balsam of Peru allergy down here. You can first read great information on the Dermatitis Academy website. It’s a great website managed by patch test pediatric dermatologist Dr. Sharon Jacob. She’s put together a wealth of information there, and we are so lucky to have her practicing in the United States.

Secondly, you’ll find below a summary of a medical journal article I’ve read written by a group of patch test dermatologists. In 2013, this article was written and is the most detailed account of Balsam of Peru allergy I have found. I’ve requested permission to print it here in its entirety, but I’ve done my best to summarize it for you until that permission is given. The article, Balsam of Peru: Past and Future, is copyright 2013 to the American Contact Dermatitis Society.

The most important thing is not to get discouraged. Fighting Balsam of Peru allergy is complex, but it is possible to live a more reaction-free life with careful attention to foods and products. Actually, Balsam of Peru is one of the most commonly diagnosed contact allergens in the US. I am hopeful that with this information, we can live a reaction-free life together! I have read and seen many testimonies of complete remission of this allergy once avoidance is followed. A Balsam of Peru allergy list is listed below and will help you follow a Balsam of Peru Allergy Diet.

*It’s important to note that a Balsam of Peru allergy diet and avoidance of its constituents could be the missing link in treating your allergic contact dermatitis. Many with ACD to Balsam of Peru are unaware that eliminating foods could help their dermatitis. While it is a challenging undertaking, living reaction-free days is a true gift. I hope that by breaking this allergy down for you, you’ll have the tools you need to live more reaction-free days.*

Balsam of Peru is basically tree sap. Myroxylon Pereirae, the medical term for Balsam of Peru, is a thick sap-like fluid secreted from the tree Myroxylon Balsamum Pereirae. It has a potent vanilla/cinnamon odor. BofP (Balsam of Peru) has a mixture of contact allergens, including cinnamein oils (eugenol, cinnamates, and vanillin), benzoic acid derivatives (benzoates), ferulic acid, and coniferin (coniferyl alcohol). These chemicals are often found in spices and flavorings in foods and cosmetics, fragrances, and medicine.

For many of us with Balsam of Peru allergy, simply avoiding fragrance ingredients in products is not enough to live a reaction-free lifestyle and stop Balsam of Peru Allergy Symptoms. We have to live a life avoiding food and drinks that can trigger systemic contact dermatitis – flares due to ingestion of these constituents.

A diet excluding these BofP containing foods is a great tool to use in living a reaction-free lifestyle. An avoidance diet includes excluding foods containing BofP constituents like cinnamates, vanillin, benzoic acid, and eugenol. These are found in citrus fruits, tomatoes, spices, condiments, sweets, and liquor.

Balsam of Peru allergy is a cross-reactor to Fragrance Mix I allergies. If you’re patch test positive to Fragrance Mix I and Balsam of Peru, be cautious to avoid these compounds that show up for both. Fragrance Mix I and Balsam of Peru contain Eugenol, Isoeugenol, and Cinnamic Aldehyde (Benzoates).

Patch testing for specific components of Balsam of Peru can prove helpful as some of us allergic to Balsam of Peru are only allergic to one subgroup (for example, only benzoates or eugenol). Testing for each subgroup could open up a wide range of ingredients you could add back into your daily life. Ask your patch test specialist if individual subgroup testing makes sense for you.

For a copy of the handout many patch test patients receive, you can find it here Balsam of Peru Handout

Balsam of Peru Ingredient Lists

Balsam of Peru is often listed as these ingredients when found in cosmetic or skin and hair products:

•Cinnamic or cinnamylic acid; 3-phenyl- 2-propenoic acid; 3-phenylacrylic acid

• Cinnamal or cinnamic aldehyde; cassia aldehyde; 3-phenyl-2-propenal

• Cinnamic or cinnamyl alcohol; 3-phenyl-2-propenol; 3-phenylallyl alcohol

• Methyl cinnamate or methyl cinnamylate; cinnamic acid methyl ester; methyl 3-phenylpropenoate

• Benzyl cinnamate or cinnamein; cinnamic acid benzyl ester; phenyl- methyl 3-phenyl-2-propenoate

• Vanillin or vanillic aldehyde; vanillaldehyde; 2-methoxy-4-formylphenol

• Eugenol or allylguaiacol; 2-methoxy-4-(2- propenyl)phenol; 2-methoxy-4-allylphenol

• Cinnamyl cinnamate or styracin; 3-phenylallyl cinnamate

• Benzoic alcohol
• Benzyl benzoate and other benzoates • Benzyl acetate
• Benzoic acid
• Benzaldehyde
• Benzyl salicylate
• Cinnamic aldehyde
• Citrus peel
• Coniferyl alcohols
• Coumarin
• Farnesol
• Isoeugenol
• Nerolidol
• Resinous substances
• Tea Tree Oil

Balsam of Peru – Past and Present

The below information is detailed in an American Contact Dermatitis Society article. I have requested it to be shown here in its entirety, but until then, here is my summation.

Eugenol Subgroup

Eugenol/Isoeugenol is found in almost all foods containing BofP, with a few exceptions. Those only allergic to Eugenol may not actually be allergic to citrus fruits, wine, or real vanilla (vanillin).  People allergic to these chemical constituents will want to avoid cinnamon and artificial vanilla (eugenol can be added). Basil and Bay leaves are a significant source of eugenol exposure. Curry can also be a significant source of trouble for this subgroup. Curry can have nutmeg and cinnamon. Avoid cloves, dill, allspice, and mace.

Eugenol Avoid List

• Sweet Food
• Chocolate
• Synthetic Vanilla
• Cola
• Tomato
• Cinnamon
• Cloves
• Nutmeg/Mace
• Dill
• Allspice
• Anise
• Bay Leaves & Basil
• Curry Powder
• Spiced Condiments
• Pickles
• Pate
• Perfumed/Spiced Tea and Tobacco
• Beer
• Gin
• Vermouth
• Whiskey
• Spiced Liquor

Vanillin Subgroup

Vanillin is a phenolic aldehyde. Its functional groups include aldehyde, hydroxyl, and ether. Vanillin is the primary component of the vanilla bean extract and is found in foods that contain vanilla, cloves, and those flavored with vanillin. Some examples include chocolate (vanilla), curry (cloves), vermouth (clove), cola (vanilla), wine (vanillin and pickled items (cloves). Surprisingly tomato, cinnamon, cassia, nutmeg, mace, allspice, bay leaves, basil, and dill do not appear to contain vanillin and may actually be tolerated by a person with a vanillin-only contact dermatitis allergy.

Vanillin Avoid List

• Sweet Food
• Chocolate
• Vanilla
• Synthetic Vanilla
• Cola
• Cloves
• Curry Powder
• Pickles
• Pate
• Perfumed/Spiced Tea and Tobacco
• Wine
• Beer
• Vermouth
• Whiskey
• Asparagus

Cinnamate Subgroup

Cinnamic Acid is obtained from the oil of cinnamon. It is also found in shea butter. Cinnamic acid has a honey-like odor, and its ester, ethyl cinnamate, are flavor components of the essential oil of cinnamon, where cinnamaldehyde is the primary chemical constituent. Those only allergic to the cinnamate subgroup of BofP allergy may only need to avoid the cinnamate avoid list.

Cinnamate Avoid List

• Citrus Peel
• Sweet Food
• Chocolate
• Cola
• Tomato
• Cinnamon
• Casia
• Anise
• Bay Leaves and Basil
• Curry Powder
• Spiced Condiments
• Pickles
• Pate
• Perfumed/Spiced Tea and Tobacco
• Wine
• Beer
• Gin
• Vermouth
• Spiced Liquors

Benzoate Subgroup

Benzoic Acid naturally occurs in vanilla, cinnamon, anise, and cassia (Chinese cinnamon) as well as foods that contain these spices, including, but not limited to, chocolate, cola, spiced condiments, pickles, and vermouth. Also, benzoates naturally occur in milk products, fruits, potatoes, beans, soy, nuts, cereals, and honey.

The challenge is we do not know the exact threshold of benzoates to induce a systemic contact allergy, and the number of benzoates contained naturally in foods is far lower than its preservative, such as sodium benzoate. An exception to this is the fruit in the Vaccinium genus species like cranberry, blueberry, and huckleberry, which naturally have high levels of benzoic acid comparable to preservatives levels.

Eliminating Benzoic Acid for me was a very important step in controlling my Balsam of Peru allergy.

Benzoate Food Avoid List

• Chocolate
• Vanilla
• Cola
• Cinnamon
• Cassia
• Anise
• Spiced Condiments
• Pickles
• Pate
• Vermouth

Ferulic Acid Subgroup

Ferulic Acid is found in many plant’s cell walls, and its derivatives are numerous in vegetables like tomato and asparagus, citrus fruits, apples, and pineapples. It is also a component of wheat and rye.

Ferulic Acid Food Avoid List

• Citrus Peel
• Cola
• Tomato
• Dill
• Pickles
• Pate
• Wine
• Gin
• Vermouth
• Whiskey
• Wheat
• Rye

Coniferin Subgroup

Coniferyl alcohol is found in asparagus, whiskey, and beets and is a fermentation product of brewer’s yeast, so avoiding beer and leavened bakery products may prove helpful.

Coniferin Food Avoid List

• Wine
• Whiskey
• Beets
• Asparagus
• Brewer’s Yeast
• Beer

Avoidance Diet and Controlling Allergy

Avoiding the foods above can go a long way in controlling your Balsam of Peru allergy. It can be the missing link in becoming reaction-free for some. Although this list seems as if you can no longer eat anything, focus on the things you can eat reaction-free. I have gone so far as to eliminate Tea from my diet. Protein without spice and some vegetables are a great way to start. I also always have luck with my Balsam of Peru Avoidance Smoothie.

Keeping a food journal can prove extremely helpful. After following a complete avoidance diet for several months, you may add one food back at a time. Experts believe introducing one food at a time and eaten every day for 3-5 days is the best way to test tolerance. If after a week with the new food you do not react, you may introduce another. Good luck!