Aromatherapy
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Aromatherapy is a practice based on the use of aromatic materials, including essential oils and other
aroma compound An aroma compound, also known as an odorant, aroma, fragrance, flavoring or flavor, 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 sufficien ...
s, with claims for improving psychological
well-being Well-being is what is Intrinsic value (ethics), ultimately good for a person. Also called "welfare" and "quality of life", it is a measure of how well life is going for someone. It is a central goal of many individual and societal endeavors. ...
. It is used as a complementary therapy or as a form of
alternative medicine Alternative medicine refers to practices that aim to achieve the healing effects of conventional medicine, but that typically lack biological plausibility, testability, repeatability, or supporting evidence of effectiveness. Such practices are ...
, and typically is used via inhalation and not by ingestion. Fragrances used in aromatherapy are not approved as prescription drugs in the United States. Although there is insufficient medical evidence that aromatherapy can prevent, treat or cure any disease, aromatherapy is used by some people with diseases, such as cancer, to provide general well-being and relief from pain, nausea or stress. People may use blends of essential oils as a topical application, massage, inhalation, or water immersion. Essential oils comprise hundreds to thousands of aromatic constituents, like terpinoids and phenylpropanoids, and to sufficiently research the
pharmacological Pharmacology is the science of drugs and medications, including a substance's origin, composition, pharmacokinetics, pharmacodynamics, therapeutic use, and toxicology. More specifically, it is the study of the interactions that occur between ...
effects of essential oil constituents, each isolated constituent in the selected essential oil would have to be studied.


History

Oils and the belief that they had healing properties, along with other beliefs of the time, are described by
Dioscorides Pedanius Dioscorides (, ; 40–90 AD), "the father of pharmacognosy", was a Greek physician, pharmacologist, botanist, and author of (in the original , , both meaning "On Materia medica, Medical Material") , a 5-volume Greek encyclopedic phar ...
in his '' De Materia Medica'', written in the 1st century A.D. Distilled cedarwood oil was used by the ancient Egyptians, and the process of distilling essential oils like rose essence was refined by the 11th century Persian scholar Ibn Sina. Hildegard of Bingen 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 name "aromatherapy" first appeared in print in 1937 in a French book on the subject: by René-Maurice Gattefossé, a chemist. An English version was published in 1993. Jean Valnet, a French surgeon, pioneered the supposed medicinal uses of essential oils, which he used as
antiseptic An antiseptic ( and ) is an antimicrobial substance or compound that is applied to living tissue to reduce the possibility of sepsis, infection, or putrefaction. Antiseptics are generally distinguished from ''antibiotics'' by the latter's abil ...
s in the treatment of wounded soldiers during
World War II World War II or the Second World War (1 September 1939 – 2 September 1945) was a World war, global conflict between two coalitions: the Allies of World War II, Allies and the Axis powers. World War II by country, Nearly all of the wo ...
.


Choice and purchase

Aromatherapy products, and essential oils in particular, may be regulated differently depending on their intended use. Products that are marketed with a therapeutic use in the US are regulated by the US Food and Drug Administration (FDA); products with a cosmetic use must meet safety requirements, regardless of their source. 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) United States antitrust law, antitrust law and the promotion of consumer protection. It ...
(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 Separation process, separating and analyzing compounds that can be vaporized without Chemical decomposition, decomposition. Typical uses of GC include t ...
and
mass spectrometry Mass spectrometry (MS) is an analytical technique that is used to measure the mass-to-charge ratio of ions. The results are presented as a ''mass spectrum'', a plot of intensity as a function of the mass-to-charge ratio. Mass spectrometry is used ...
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.


Effectiveness

There is no clinical evidence that aromatherapy can prevent or cure any disease, although it may be useful for managing symptoms. Evidence for the efficacy of aromatherapy in treating medical conditions is poor, with a particular lack of studies employing rigorous methodology. 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 Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among ma ...
; no clear evidence for the effectiveness of aromatherapy was found. * Several
systematic review A systematic review is a scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from published studies on ...
s have studied the clinical effectiveness of aromatherapy in respect to pain management in labor, the treatment of post-operative nausea and vomiting, managing challenging behaviors in people suffering from
dementia Dementia is a syndrome associated with many neurodegenerative diseases, characterized by a general decline in cognitive abilities that affects a person's ability to perform activities of daily living, everyday activities. This typically invo ...
, and symptom relief in
cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...
. According to the US
National Cancer Institute The National Cancer Institute (NCI) coordinates the United States National Cancer Program and is part of the National Institutes of Health (NIH), which is one of eleven agencies that are part of the U.S. Department of Health and Human Services. ...
, no studies of aromatherapy in cancer treatment have been published in a peer-reviewed scientific journal. Results are mixed for other studies. Some showed improved sleep, anxiety, mood, nausea, and pain, while others showed no change in symptoms.


Safety concerns

Aromatherapy carries several risks of adverse effects; combined with the lack of evidence of its therapeutic benefit, the practice is of questionable worth. Many studies have explored 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 Olive oil is a vegetable oil obtained by pressing whole olives (the fruit of ''Olea europaea'', a traditional Tree fruit, tree crop of the Mediterranean Basin) and extracting the oil. It is commonly used in cooking for frying foods, as a cond ...
, sweet almond oil or coconut oil. Phototoxic reactions may occur with many cold-pressed
citrus ''Citrus'' is a genus of flowering trees and shrubs in the family Rutaceae. Plants in the genus produce citrus fruits, including important crops such as oranges, mandarins, lemons, grapefruits, pomelos, and limes. ''Citrus'' is nativ ...
peel oils such as lemon or lime. Many essential oils have chemical components that are sensitisers (meaning that they will, after several uses, cause reactions on the skin and more so in the rest of the body). All cosmetic products and ingredients must meet the same safety requirements, regardless of their source. Chemical composition of essential oils could be affected by
herbicide Herbicides (, ), also commonly known as weed killers, are substances used to control undesired plants, also known as weeds.EPA. February 201Pesticides Industry. Sales and Usage 2006 and 2007: Market Estimates. Summary in press releasMain page f ...
s 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 on three different cases documented gynecomastia in prepubertal boys who were exposed to topical lavender and
tea tree oil Tea tree oil, also known as melaleuca oil, is an essential oil with a fresh, camphoraceous odour and a colour that ranges from pale yellow to nearly colourless and clear. It is derived from the leaves of the tea tree, '' Melaleuca alternif ...
s. The Aromatherapy Trade Council of the UK issued a rebuttal. Another article published by a different research group also documented three cases of gynecomastia in prepubertal boys who were exposed to topical lavender oil. Persistent exposure to lavender products may be associated with premature breast development in girls and "that chemicals in lavender oil and
tea tree oil Tea tree oil, also known as melaleuca oil, is an essential oil with a fresh, camphoraceous odour and a colour that ranges from pale yellow to nearly colourless and clear. It is derived from the leaves of the tea tree, '' Melaleuca alternif ...
are potential endocrine disruptors with varying effects on receptors for two hormones –
estrogen Estrogen (also spelled oestrogen in British English; see spelling differences) is a category of sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three ...
and
androgen An androgen (from Greek ''andr-'', the stem of the word meaning ) is any natural or synthetic steroid hormone that regulates the development and maintenance of male characteristics in vertebrates by binding to androgen receptors. This includes ...
". Essential oils can be 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 The liver is a major metabolic organ (anatomy), organ exclusively found in vertebrates, which performs many essential biological Function (biology), functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of var ...
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 Pregnancy is the time during which one or more offspring gestation, gestates inside a woman's uterus. A multiple birth, multiple pregnancy involves more than one offspring, such as with twins. Conception (biology), Conception usually occurs ...
and lactating people. 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 (in which it ...
–heavy oils like wintergreen may cause bleeding in users taking the
anticoagulant An anticoagulant, commonly known as a blood thinner, is a chemical substance that prevents or reduces the coagulation of blood, prolonging the clotting time. Some occur naturally in blood-eating animals, such as leeches and mosquitoes, which ...
warfarin Warfarin, sold under the brand name Coumadin among others. It is used as an anticoagulant, anticoagulant medication. It is commonly used to prevent deep vein thrombosis and pulmonary embolism, and to protect against stroke in people who ha ...
. In late 2021, an aromatherapy spray was recalled after it was found to be contaminated with '' Burkholderia pseudomallei'', the bacterial agent that causes melioidosis, which led to four cases of the disease and two deaths.


See also

* Aromachologist * List of unproven and disproven cancer treatments


References

{{Authority control Herbalism Mind–body interventions Fringe science Alternative medicine