A recent CBS News piece has renewed attention on a frequently overlooked trigger for migraine: artificial scents. Perfumes, scented candles, plug-in air fresheners and fragranced cleaning products can provoke severe headaches and full-blown migraine attacks in susceptible people, exacerbating a condition that already ranks among the world’s leading causes of disability.

Neurologists and environmental health researchers say the smell of synthetic fragrances can activate the olfactory and trigeminal nerve pathways and set off neurovascular changes associated with migraine. For those who live with recurrent attacks, exposure in public places — offices, schools, buses, medical clinics and multiunit housing — can mean missed work, lost wages and social isolation. Migraine affects about 12 percent of U.S. adults, disproportionately affecting women and people of prime working age, and even intermittent exposures to potent fragrances can have outsized impacts on daily functioning.

Public health experts emphasize that the problem is not purely individual. Fragrance chemicals often contain volatile organic compounds that can irritate the respiratory system and interact with other pollutants, and fragranced consumer products are ubiquitous in commercial and institutional settings. Many workplaces have no policies addressing scent exposure, leaving employees who suffer from chemical sensitivities or migraine with few formal protections. Occupational sectors with lower-wage workers, including retail, hospitality and cleaning services, are more likely to expose staff to scented products while offering little control over the environment, compounding health inequities.

Current disability and workplace laws could be interpreted to cover scent-triggered migraines, but in practice, obtaining reasonable accommodations — scent-free spaces, schedule flexibility, or remote work — is inconsistent and often depends on employer goodwill. Federal workplace safety guidance does not set limits on fragranced products, and regulations governing indoor air quality rarely name scent as a specific hazard. At the same time, newer migraine therapies such as CGRP inhibitors offer relief for some patients, but high cost and insurance barriers mean many who would benefit remain under-treated.

Community-level interventions are practical and low-cost. Fragrance-free policies in hospitals, schools and municipal buildings, improved ventilation standards, and substitution of fragranced cleaning supplies with unscented alternatives can reduce exposures without dramatic expense. Public signage and education campaigns also can normalize scent-free norms and reduce stigma toward people seeking accommodations.

Addressing scent-triggered migraine requires integrating clinical care with environmental policy and equity-focused labor protections. Clinicians can screen patients for fragrance sensitivity and advocate for workplace or school accommodations, but meaningful change will also depend on employers, building managers and public agencies acknowledging scent exposure as a public health issue.

As discourse around indoor air quality and chemical exposures expands, policymakers face a choice: treat synthetic fragrances as a minor comfort item or recognize them as a source of preventable harm for millions. For those with migraine, the difference between a scent-free commute and a hallway full of air fresheners can be the difference between working a full day and being sidelined by a disabling attack — a disparity that public health and labor policy can and should address.