Wool and synthetic fibres are the most common causes of allergy and sensitivity to fibres. Cotton, silk and linen are much less likely to cause reactions. Fibres most commonly cause breathing, nasal and skin symptoms, though other allergic symptoms, such as headaches, joint pain and gut pain, are also recorded. Synthetic fibres and polycotton mixes can cause chemical sensitivity as well as allergy, and other symptoms such as mental symptoms are possible.

Standard skin and laboratory tests for allergy are quite reliable at detecting allergy to inhaled fibre particles such as wool and cotton. There are no reliable tests other than avoidance and reintroduction for chemical sensitivity to synthetic fibres.

Allergic and sensitivity reactions to fibres are caused by inhaling particles or vapours as well as by touching the fibres directly. Other people’s clothes, or fibres from furniture or furnishings, or fibres at work, may therefore affect you if you are very sensitive, since particles and fumes will circulate in the air and you will breathe them in. If you get symptoms when you fold laundry, sort clothes or make beds, then inhaling fibres may be the cause, although moulds and house dust mites are possible culprits as well.

If you only get symptoms when you wear, sleep on, or come close to specific fibres, then you will have a clear guide to the source of the trouble. If there is a label, consult it to see what the fabric composition is, and think whether you can see any pattern to your reactions.

There is a relatively cheap and easy way to test at home for allergy or sensitivity to specific fibres – the Pillow Test (overleaf). Washing the cloth with sodium bicarbomate and drying thoroughly before use will minimise the possibility of sensitivity to laundry agents, chemical treatments or moulds interfering with the test.

You will get clearer results from the test if you are able to avoid totally the fibre you are planning to test for at least a day, preferably several days, before you do the test. You can then confirm the Pillow Test by avoiding totally (or as far as is practicable) the fibre that you suspect for a period of a week, and then reintroducing it by wearing or using it again. Monitor any symptoms for the period of avoidance and on reintroduction.

You may not need to replace totally anything you use or wear. It may be sufficient to place a cloth of a material you tolerate over your pillow or over the upper part of your bed clothes, or wear underclothes of a fibre you tolerate next to your skin or around your neck. Try this before replacing anything.

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