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Aromatherapy is based on the usage of aromatic materials including essential oils and other
aroma compound An aroma compound, also known as an odorant, aroma, fragrance or flavoring, is a chemical compound that has a smell or odor. For an individual chemical or class of chemical compounds to impart a smell or fragrance, it must be sufficiently vol ...
s, with claims for improving psychological and physical well-being. It is offered as a
complementary therapy Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability, or evidence from clinical trials. Complementary medicine (CM), complementary and alte ...
or as a form of
alternative medicine Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability, or evidence from clinical trials. Complementary medicine (CM), complementary and alt ...
, the first meaning alongside standard treatments, the second instead of conventional, evidence-based treatments. Aromatherapists, people who specialize in the practice of aromatherapy, utilize blends of supposedly therapeutic essential oils that can be used as topical application, massage, inhalation or water immersion. There is no good medical evidence that aromatherapy can either prevent, treat or cure any disease. Placebo-controlled trials are difficult to design as the point of aromatherapy is the smell of the products. There is disputed evidence that it may be effective in combating postoperative nausea and vomiting.


History

The use of essential oils for therapeutic, spiritual, hygienic and ritualistic purposes goes back to ancient civilizations including the Indians, Chinese, Egyptians, Greeks, and Romans who used them in cosmetics, perfumes and drugs. Oils were used for aesthetic pleasure and in the beauty industry. They were a luxury item and a means of payment. It was believed the essential oils increased the shelf life of wine and improved the taste of food. Oils are described by Dioscorides, along with beliefs of the time regarding their healing properties, in his ''
De Materia Medica (Latin name for the Greek work , , both meaning "On Medical Material") is a pharmacopoeia of medicinal plants and the medicines that can be obtained from them. The five-volume work was written between 50 and 70 CE by Pedanius Dioscorides, a ...
'', written in the first century. Distilled cedarwood oil was used by the ancient Egyptians, and the process of
distilling Distillation, or classical distillation, is the process of separating the components or substances from a liquid mixture by using selective boiling and condensation, usually inside an apparatus known as a still. Dry distillation is the heatin ...
essential oils like rose essence was refined by the 11th century Persian scholar Ibn Sina.
Hildegard of Bingen Hildegard of Bingen (german: Hildegard von Bingen; la, Hildegardis Bingensis; 17 September 1179), also known as Saint Hildegard and the Sibyl of the Rhine, was a German Benedictine abbess and polymath active as a writer, composer, philosopher ...
used distilled lavender oil for medicinal treatments in the 12th century, and by the 15th century, oils were commonly distilled from various plant sources. In the era of modern medicine, the naming of this treatment first appeared in print in 1937 in a French book on the subject: ''Aromathérapie: Les Huiles Essentielles, Hormones Végétales'' by , a chemist. An English version was published in 1993. In 1910, Gattefossé burned a hand very badly and later claimed he treated it effectively with
lavender oil Lavender oil is an essential oil obtained by distillation from the flower spikes of certain species of lavender. There are over 400 types of lavender worldwide with different scents and qualities. Two forms of lavender oil are distinguished, ' ...
. A French surgeon, , pioneered the medicinal uses of essential oils, which he used as
antiseptic An antiseptic (from Greek ἀντί ''anti'', "against" and σηπτικός ''sēptikos'', "putrefactive") is an antimicrobial substance or compound that is applied to living tissue/skin to reduce the possibility of infection, sepsis, or putre ...
s in the treatment of wounded soldiers during World War II.


Choice and purchase

Aromatherapy products, and essential oils, in particular, may be regulated differently depending on their intended use. A product that is marketed with a therapeutic use in the US is regulated by the US Food & Drug Administration (FDA); a product with a cosmetic use is not (unless information shows that "it is unsafe when consumers use it according to directions on the label, or in the customary or expected way, or if it is not labeled properly".) The US
Federal Trade Commission The Federal Trade Commission (FTC) is an independent agency of the United States government whose principal mission is the enforcement of civil (non-criminal) antitrust law and the promotion of consumer protection. The FTC shares jurisdiction ov ...
(FTC) regulates any aromatherapy advertising claims. There are no standards for determining the quality of essential oils in the United States; while the term "therapeutic grade" is in use, it does not have a regulatory meaning. Analysis using
gas chromatography Gas chromatography (GC) is a common type of chromatography used in analytical chemistry for separating and analyzing compounds that can be vaporized without decomposition. Typical uses of GC include testing the purity of a particular substance, ...
and mass spectrometry has been used to identify bioactive compounds in essential oils. These techniques are able to measure the levels of components to a few parts per billion. This does not make it possible to determine whether each component is natural or whether a poor oil has been "improved" by the addition of synthetic aromachemicals but the latter is often signalled by the minor impurities present. For example, linalool made in plants will be accompanied by a small amount of hydro-linalool whilst synthetic linalool has traces of dihydro-linalool.


Effectiveness

There is no good medical evidence that aromatherapy can prevent or cure any disease. However, for cancer patients, aromatherapy tests showed mixed results in lowering anxiety and depression symptoms. In 2015, the Australian Government's Department of Health published the results of a review of alternative therapies that sought to determine if any were suitable for being covered by health insurance; aromatherapy was one of 17 therapies evaluated for which no clear evidence of effectiveness was found. * Evidence for the efficacy of aromatherapy in treating medical conditions is poor, with a particular lack of studies employing rigorous methodology. A number of systematic reviews have studied the clinical effectiveness of aromatherapy in respect to pain management in labor, the treatment of
post-operative nausea and vomiting Postoperative nausea and vomiting (PONV) is the phenomenon of nausea, vomiting, or retching experienced by a patient in the postanesthesia care unit (PACU) or within 24 hours following a surgical procedure. PONV affects about 10% of the population ...
, managing challenging behaviors in people suffering from dementia and symptom relief in cancer. However, some studies have come to the conclusion that while it does improve the patient's mood, there is no conclusive evidence on how it works with pain management. Studies have been inconclusive because no straightforward evidence exists. All of these reviews report a lack of evidence on the effectiveness of aromatherapy.


Safety concerns

Aromatherapy carries a number of risks of
adverse effects An adverse effect is an undesired harmful effect resulting from a medication or other intervention, such as surgery. An adverse effect may be termed a "side effect", when judged to be secondary to a main or therapeutic effect. The term complica ...
and with this in consideration, combined with the lack of evidence of its therapeutic benefit, makes the practice of questionable worth. Many studies exploring the concerns that essential oils are highly concentrated and can irritate the skin when used in undiluted form often referred to as neat application. Therefore, they are normally diluted with a carrier oil for topical application such as jojoba oil, olive oil, sweet almond oil or
coconut oil frameless , right , alt = A cracked coconut and a bottle of coconut oil Coconut oil (or coconut butter) is an edible oil derived from the wick, meat, and milk of the coconut palm fruit. Coconut oil is a white solid fat; in warmer climates du ...
. Phototoxic reactions may occur with many cold pressed
citrus ''Citrus'' is a genus of flowering trees and shrubs in the rue family, Rutaceae. Plants in the genus produce citrus fruits, including important crops such as oranges, lemons, grapefruits, pomelos, and limes. The genus ''Citrus'' is nativ ...
peel oils such as lemon or lime. Also, many essential oils have chemical components that are sensitisers (meaning that they will, after a number of uses, cause reactions on the skin and more so in the rest of the body). Chemical composition of essential oils could be affected by herbicides if the original plants are cultivated versus wild-harvested. Some oils can be toxic to some domestic animals, with cats being particularly prone. Most oils can be toxic to humans as well. A report of three cases documented gynecomastia in prepubertal boys who were exposed to topical lavender and tea tree oils. The Aromatherapy Trade Council of the UK issued a rebuttal. The Australian Tea Tree Association, a group that promotes the interests of Australian tea tree oil producers, exporters and manufacturers issued a letter that questioned the study and called on the '' New England Journal of Medicine'' for a retraction. Another article published by a different research group also documented three cases of gynecomastia in prepubertal boys who were exposed to topical lavender oil. A recent research, made by
NIEHS The National Institute of Environmental Health Sciences (NIEHS) conducts research into the effects of the environment on human disease, as one of the 27 institutes and centers of the National Institutes of Health (NIH). It is located in the Rese ...
scientists and published on Endocrine Society's ''
Journal of Clinical Endocrinology and Metabolism ''The Journal of Clinical Endocrinology and Metabolism'' is a peer-reviewed medical journal in the field of endocrinology and metabolism. The current editor-in-chief is Paul Stewart. References External links * Publications establishe ...
'', concluded that persistent exposure to lavender products is associated with premature breast development in girls and "that chemicals in lavender oil and tea tree oil are potential
endocrine disruptors Endocrine disruptors, sometimes also referred to as hormonally active agents, endocrine disrupting chemicals, or endocrine disrupting compounds are chemicals that can interfere with endocrine (or hormonal) systems. These disruptions can cause ca ...
with varying effects on receptors for two hormones — estrogen and
androgen An androgen (from Greek ''andr-'', the stem of the word meaning "man") is any natural or synthetic steroid hormone that regulates the development and maintenance of male characteristics in vertebrates by binding to androgen receptors. This incl ...
". Essential oils can be extremely toxic when ingested or absorbed internally. Doses as low as 2 ml have been reported to cause clinically significant symptoms and severe poisoning can occur after ingestion of as little as 4 ml. A few reported cases of toxic reactions like liver damage and seizures have occurred after ingestion of sage, hyssop, thuja and cedar oils. Accidental ingestion may happen when oils are not kept out of reach of children. As with any bioactive substance, an essential oil that may be safe for the general public could still pose hazards for pregnant and lactating women. Oils both ingested and applied to the skin can potentially have negative interactions with conventional medicine. For example, the topical use of
methyl salicylate Methyl salicylate (oil of wintergreen or wintergreen oil) is an organic compound with the formula C8H8O3. It is the methyl ester of salicylic acid. It is a colorless, viscous liquid with a sweet, fruity odor reminiscent of root beer, but often a ...
-heavy oils like
wintergreen Wintergreen is a group of aromatic plants. The term "wintergreen" once commonly referred to plants that remain green (continue photosynthesis) throughout the winter. The term "evergreen" is now more commonly used for this characteristic. Mos ...
may cause bleeding in users taking the
anticoagulant Anticoagulants, commonly known as blood thinners, are chemical substances that prevent or reduce coagulation of blood, prolonging the clotting time. Some of them occur naturally in blood-eating animals such as leeches and mosquitoes, where the ...
warfarin. In late 2021, an aromatherapy spray was recalled after it was found to be contaminated with ''
Burkholderia pseudomallei ''Burkholderia pseudomallei'' (also known as ''Pseudomonas pseudomallei'') is a Gram-negative, bipolar, aerobic, motile rod-shaped bacterium. It is a soil-dwelling bacterium endemic in tropical and subtropical regions worldwide, particularly in ...
'', the bacteria that causes
melioidosis Melioidosis is an infectious disease caused by a gram-negative bacterium called ''Burkholderia pseudomallei''. Most people exposed to ''B. pseudomallei'' experience no symptoms; however, those who do experience symptoms have signs and symptoms ...
, which led to four cases of the disease and two deaths.


See also

*
Aromachologist Aromachology is the study of the influence of odors on human behavior and to examine the relationship between feelings and emotions. Those who practice aromachology are aromachologists. Aromachologists analyze emotions such as relaxation, exhilarat ...
*
List of unproven and disproven cancer treatments This is a non-exhaustive list of alternative treatments that have been promoted to treat or prevent cancer in humans but which lack scientific and medical evidence of effectiveness. In many cases, there is scientific evidence that the alleged tr ...


References


External links


Aromatherapy and Essential Oils
– health professional
patient
PDQ (Physician Data Query) summaries from the National Cancer Institute * {{Authority control Herbalism Mind–body interventions Fringe science Alternative medicine