Smell Sensitivity and Migraines

Understanding Osmophobia As a Migraine Trigger

Table of Contents
View All
Table of Contents

If you are predisposed to migraines, you are more likely to experience migraines and non-migraine headaches when you are exposed to strong smells. Headaches triggered this way tend to be severe and are often accompanied by nausea.

perfume
JGI/Jamie Grill/Getty Images

It isn't quite clear why some people are more sensitive to noxious smells than others, but osmophobia— a psychological hypersensitivity to smells—is a common part of the migraine experience.

Generally, chemical fumes such as cleaners and gasoline are those most likely to induce a migraine attack. During a migraine, many odors can be bothersome.

What Is Osmophobia?

During a migraine, you may experience an aversion to smells that you regard as unpleasant. This could be due to a physiological cause, a psychological one, or a combination of the two.

When it is psychological, it is referred to as osmophobia.

You may, for example, be disgusted by the smell of raw food, repulsed by the smell of food that is cooking, and repelled by food that doesn't bother you at other times. You might feel that many foods are rotten, or you may detect the persistent smell of food on your hands or in your surroundings.

This can manifest with physiological symptoms such as anxiety and migraine.

The response to the smell may be inconsistent. Certain scents, such as those from polishes and chemical cleaners, may seem exceedingly strong when you are having a migraine but be entirely benign at other times.

Osmophobia is a common psychological feature of a migraine attack, just like photophobia (sensitivity to light) and phonophobia (sensitivity to sound).

The Role of Hyperosmia

In contrast, hyperosmia is when disease, pregnancy, nutritional deficiencies, or an adverse reaction to a medication causes smell hypersensitivity.

Hyperosmia and osmophobia can work together to induce a migraine attack. Because hyperosmia causes smell hypersensitivity, it can induce a psychological response in the form of osmophobia.

Having hyperosmia does not necessarily mean you will get a migraine even if you are prone to them. The same may not be true for osmophobia in which the anxiety induced by a smell serves as a direct trigger for the attack.

Scent hypersensitivity from hyperosmia could be related to the size of the olfactory bulb (the receptor in the brain that processes signals from the nose).

Some studies have suggested that people who get migraines are more likely to have a smaller olfactory bulb than people don't. Others have reported that people with migraines and osmophobia have an even smaller olfactory bulb volume.

Some researchers suggest that diminished blood flow to the olfactory bulb could be the cause of shrinkage of this organ. However, these structural changes are subtle, and measuring your olfactory bulb is not a standard procedure.

Common Odor Triggers

Smells are just as powerful a trigger for migraines as alcohol and sleep deprivation.

There are a variety of odors known to precipitate migraines, the most common of which include:

  • Car exhaust
  • Gasoline
  • Pesticides
  • Perfumes
  • Nail polish
  • Cigarette smoke
  • Cooking smoke
  • Bleach
  • Asphalt
  • Solvents and detergents

Odors are more likely to induce a migraine if you are exposed for more than 15 minutes and if you are in an enclosed space.

Prevention Tips

Awareness and avoidance of your migraine triggers are key to improving your quality of life. There are several steps you can take to thwart scent-induced migraines.

Recognize When You're Triggered

It may be hard to think back on your day and try to align where you were and what you were doing when a migraine started or worsened.

But at least 50% of people who have recurrent migraines experience premonitory symptoms, which occur during the first (prodromal) stage of a migraine.

If you notice symptoms such as moodiness, dizziness, or fatigue, take note of your surroundings and activities in that moment.

  • Do you tend to have migraines while you are in certain locations?
  • Do they occur when you are doing particular things like cooking or cleaning the house?

Then try to see if there is a pattern between this and the onset of your migraines over time.

Control Your Environment

When you are exposed to fumes that could trigger a migraine, leave where you are, open a window, or step outside if you can.

If you work closely with paint thinners, gasoline, or odorous substances that you are sensitive to, consider switching to another workspace where you better able to avoid these smells.

If you discover that a common smell like perfume or detergents is one of your migraine triggers, consider creating a scent-free space with your co-workers or roommate. 

Some people experience a condition known as sick building syndrome, characterized by a variety of symptoms caused by chemicals in an enclosed environment. Good circulation can help prevent migraines and can keep your workplace healthier for everyone.

Did You Know?

In addition to osmophobia, people with migraines have also been known to experience phantosmia (smelling an odor that is not there) and cacosmia (perceiving a mild or pleasant smell as noxious).

A Word From Verywell

Living with migraines requires adapting your mindset and making adjustments when you need to. Sometimes, putting up with certain things—such as odors—can help you avoid a migraine by lowering your stress levels.

12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Chitsaz A, Gborbani A, Dashti M, et al. The prevalence of osmophobia in migranous and episodic tension type headaches. Adv Biomed Res. 2017;6:44. doi:10.4103/2277-9175.204587

  2. Rocha-Filho PAS, Marques KS, Torres RCS, Leal KNR. Migraine, osmophobia, and anxiety. Pain Med. 2016 Apr;17(4):776-80. doi:10.1093/pm/pnv071

  3. Yalin OO, Uluduz D, Ozge A, Sungur MA, Seleker M, Siva A. Phenotypic features of chronic migraine. J Headache Pain. 2016;17:26. doi:10.1186/s10194-016-0616-y

  4. Cleveland Clinic. What’s that smell? What you need to know about hyperosmia.

  5. Marmura MJ, Monteith TS, Anjum W, Coty RL, Hegarty SE, Keith SW. Olfactory function in migraine both during and between attacks. Cephalalgia. 2014 Oct;34(12):977-85. doi:10.1177/0333102414527014

  6. Aktürk T, Tanık N, Serin Hİ, Saçmacı H, İnan LE. Olfactory bulb atrophy in migraine patients. Neurol Sci. 2018 Oct 2;40(1):127-32. doi: 10.1007/s10072-018-3597-6

  7. Doğan A, Bayar Muluk N, Şahan MH, Asal N, Inal M, Ergün U. Olfactory bulbus volume and olfactory sulcus depth in migraine patients: an MRI evaluation. Eur Arch Otorhinolaryngol. 2018 Aug;275(8):2005-11. doi:10.1007/s00405-018-5029-x

  8. Goadsby PJ, Holland PR, Martins-Oliveira M, Hoffmann J, Schankin C, Akerman S. Pathophysiology of migraine: a disorder of sensory processing. Physiol Rev. 2017 Apr;97(2):553-622. doi:10.1152/physrev.00034.2015

  9. Silva-Neto RP, Peres MFP, Valenca MM. Odorant substances that trigger headaches in migraine patients. Cephalalgia. 2014 Jan;34(1):14-21. doi:10.1177/0333102413495969

  10. Laurell K, Artto V, Bendtsen L, et al. Premonitory symptoms in migraine: A cross-sectional study in 2714 persons. Cephalalgia. 2016 Sep;36(10):951-9. doi:10.1177/0333102415620251

  11. Tietjen GE, Khubchandani J, Ghosh S, Bhattachrjee S, Kleinfelder J. Headache symptoms and indoor environmental parameters: results from the EPA BASE study. Ann Indian Acad Neurol. 2012 Aug;15(Suppl 1):S95-9. doi:10.4103/0972-2327.100029

  12. Fornazieri MA, Neto AR, De Rezende Pinna F, et al. Olfactory symptoms reported by migraineurs with and without auras. Headache. 2016 Nov;56(10):1608-16. doi:10.1111/head.12973 

Colleen Doherty, MD

By Colleen Doherty, MD
 Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis.