Aromatherapy

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Aromatherapy
Intervention
A diffuser and a bottle of essential oil.
MeSH	D019341

Aromatherapy is a form of alternative medicine that uses volatile plant materials, known as essential oils, and other aromatic compounds for the purpose of altering a person's mind, mood, cognitive function or health.

Some essential oils such as tea tree have demonstrated anti-microbial effects, but there is still a lack of clinical evidence demonstrating efficacy against bacterial, fungal, or viral infections. Evidence for the efficacy of aromatherapy in treating medical conditions remains poor, with a particular lack of studies employing rigorous methodology, but some evidence exists that essential oils may have therapeutic potential. Aromatherapy is considered effective because it has pharmacological, physiological, and psychological effects on the body.

History

Many such oils are described by Dioscorides, along with beliefs of the time regarding their healing properties, in his De Materia Medica, written in the first century. Distilled essential oils have been employed as medicines since the invention ofdistillation in the eleventh century, when Avicenna isolated essential oils using steam distillation.

The concept of aromatherapy was first mooted by a small number of European scientists and doctors, in about1907. In 1937, the word first appeared in print in a French book on the subject: Aromathérapie: Les Huiles Essentielles, Hormones Végétales by René-Maurice Gattefossé, 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.

A French surgeon, Jean Valnet, pioneered the medicinal uses of essential oils, which he used as antiseptics in the treatment of wounded soldiers during World War II.

Modes of application

The modes of application of aromatherapy include:

• Aerial diffusion: for environmental fragrancing or aerial disinfection
• Direct inhalation: for respiratory disinfection, decongestion, expectoration as well as psychological effects
• Topical applications: for general massage, baths, compresses, therapeutic skin care

Materials

Some of the materials employed include:

• Essential oils: Fragrant oils extracted from plants chiefly through steam distillation (e.g., eucalyptus oil) or expression (grapefruit oil). However, the term is also occasionally used to describe fragrant oils extracted from plant material by anysolvent extraction. This material includes incense reed diffusers.
• Absolutes: Fragrant oils extracted primarily from flowers or delicate plant tissues through solvent or supercritical fluidextraction (e.g., rose absolute). The term is also used to describe oils extracted from fragrant butters, concretes, and enfleurage pommades using ethanol.
• Carrier oils: Typically oily plant base triacylglycerides that dilute essential oils for use on the skin (e.g., sweet almond oil).
• Herbal distillates or hydrosols: The aqueous by-products of the distillation process (e.g., rosewater). There are many herbs that make herbal distillates and they have culinary uses, medicinal uses and skin care uses. Common herbal distillates are chamomile, rose, and lemon balm.
• Infusions: Aqueous extracts of various plant material (e.g., infusion of chamomile).
• Phytoncides: Various volatile organic compounds from plants that kill microbes Many terpene-based fragrant oils and sulfuric compounds from plants in the genus "Allium" are phytoncides, though the latter are likely less commonly used in aromatherapy due to their disagreeable odors.
• Vaporizer (Volatized) raw herbs: Typically higher oil content plant based materials dried, crushed, and heated to extract and inhale the aromatic oil vapors in a direct inhalation modality.

Theory

Aromatherapy is the treatment or prevention of disease by use of essential oils. Other stated uses include pain and anxiety reduction, enhancement of energy and short-term memory, relaxation, hair loss prevention, and reduction of eczema-induced itching.

Two basic mechanisms are offered to explain the purported effects. One is the influence of aroma on the brain, especially the limbic system through the olfactory system. The other is the direct pharmacological effects of the essential oils.While precise knowledge of the synergy between the body and aromatic oils is often claimed by aromatherapists, the efficacy of aromatherapy remains unproven. However, some preliminary clinical studies of aromatherapy in combination with other techniques show positive effects. Aromatherapy does not cure conditions, but it is suggested that it helps the body to find a natural way to cure itself and improve immune response.

In the English-speaking world, practitioners tend to emphasize the use of oils in massage. Aromatherapy tends to be regarded as a complementary modality at best and a pseudoscientific fraud at worst.

Choice and purchase

Oils with standardized content of components (marked FCC, for Food Chemical Codex) are required^{[by whom?]} to contain a specified amount of certain aroma chemicals that normally occur in the oil.^{[citation needed]} There is no law that the chemicals cannot be added in synthetic form to meet the criteria established by the FCC for that oil. For instance,lemongrass essential oil must contain 75% aldehyde to meet the FCC profile for that oil, but that aldehyde can come from a chemical refinery instead of from lemongrass. To say that FCC oils are "food grade" makes them seem natural when they are not necessarily so.

Undiluted essential oils suitable for aromatherapy are termed 'therapeutic grade', but there are no established and agreed standards for this category. The market for essential oils is dominated by the food, perfume, cosmetics and pharmaceutical industries, so aromatherapists have little choice but to buy the best of whatever oils are available.

Analysis using gas liquid chromatography (GLC) and mass spectrometry (MS) establishes the quality of 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 signaled 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.

Popular uses

• Lemon oil is said to be uplifting and to relieve stress. In a Japanese study, lemon essential oil in vapour form has been found to reduce stress in mice. Research at The Ohio State University indicates that Lemon oil aroma may enhance one's mood, and help with relaxation.
• Thyme oil
• Peppermint oil is often used to deter ants, by applying a few drops on their trail.
• Lavender, Jasmine, Chamomile and Peppermint are used for anti-stress, anti-anxiety and as an anti-depressant.
• Sage oil has been suggested to boost short-term memory performance in many using it as a dietary supplement.

Efficacy

Some benefits that have been linked to aromatherapy, such as relaxation and clarity of mind, may arise from the placebo effect rather than from any actual physiological effect. The consensus among most medical professionals is that while some aromas have demonstrated effects on mood and relaxation and may have related benefits for patients, there is currently insufficient evidence to support the claims made for aromatherapy. Scientific research on the cause and effects of aromatherapy is limited, although in vitro testing has revealed some antibacterial and antiviral effects. There is no evidence of any long-term results from an aromatherapy massage other than the pleasure achieved from a pleasant-smelling massage. A few double blind studies in the field of clinical psychology relating to the treatment of severe dementia have been published. Essential oils have a demonstrated efficacy in dental mouthwash products.

Aromatherapy has been promoted for its ability to fight cancer; however, according to the American Cancer Society, "available scientific evidence does not support claims that aromatherapy is effective in preventing or treating cancer".

Safety concerns

In addition, there are potential safety concerns. Because essential oils are highly concentrated they can irritate the skin when used in undiluted form. Therefore, they are normally diluted with a carrier oil for topical application, such as jojoba oil, olive oil, or coconut oil. Phototoxic reactions may occur with citrus 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). Some of the chemical allergies could even be caused bypesticides, if the original plants are cultivated. Some oils can be toxic to some domestic animals, with cats being particularly prone.

Two common oils, lavender and tea tree, have been implicated in causing gynaecomastia, an abnormal breast tissue growth, in prepubescent boys, although the report which cites this potential issue is based on observations of only three boys (and so is not a scientific study^{[citation needed]}), and two of those boys were significantly above average in weight for their age, thus already prone to gynaecomastia. A child hormone specialist at the University of Cambridge claimed "... these oils can mimic estrogens" and "people should be a little bit careful about using these products." The study has been criticised on many different levels by many authorities. The Aromatherapy Trade Council of the UK has 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 (ATTIA). The New England Journal of Medicine has so far not replied and has not retracted the study.

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.

While some advocate the ingestion of essential oils for therapeutic purposes, licensed aromatherapy professionals do not recommend self prescription due the highly toxic nature of some essential oils. Some very common oils like Eucalyptus are extremely toxic when taken internally. Doses as low as one teaspoon have been reported to cause clinically significant symptoms and severe poisoning can occur after ingestion of 4 to 5 ml. A few reported cases of toxic reactions like liverdamage and seizures have occurred after ingestion of sage, hyssop, thuja, and cedar. Accidental ingestion may happen when oils are not kept out of reach of children.

Oils both ingested and applied to the skin can potentially have negative interaction with conventional medicine. For example, the topical use of methyl salicylate heavy oils like Sweet Birch and Wintergreen may cause hemorrhaging in users taking theanticoagulant Warfarin.

Adulterated oils may also pose problems depending on the type of substance used.

In early 2014, a cat received chemical burns after he spilled the liquid from a reed diffuser.