MD, PhD, FMedSci, FSB, FRCP, FRCPEd

AROMATHERAPY is one of the most popular alternative therapies. The experience is usually pleasant enough, but what are the risks? None!!! At least this is what the therapists would claim. But is this true? Perhaps not. According to a recent press-release, the risks might be considerable.

Officials with the Tennessee Poison Control Center (TPC) are warning that they are seeing an increasing number of toxic exposures, mostly involving children, to essential oils used in aromatherapy. The TPC says the number of essential oil exposures doubled between 2011 and 2015, and 80 percent of those cases involved children. The primary route of poisoning is by ingestion, but also occurs with excessive or inappropriate application to the skin. Children are at risk because their skin easily absorbs oils and because they may try to ingest essential oils from the container.

“Tea tree oil is commonly cited, and most of those cases are accidental ingestions by children.” said Justin Loden, PharmD, certified specialist in Poison Information (CSPI) at TPC. Most essential oils have a pleasant smell but bitter taste, so children easily choke on them and aspirate the oil to their lungs, Loden said.

Several essential oils such as camphor, clove, lavender, eucalyptus, thyme, tea tree, and wintergreen oils are highly toxic. All of the oils produce oral and throat irritation, nausea, and vomiting when ingested. Most essential oils either produce central nervous system (CNS) stimulation, which results in agitation, hallucinations, delirium, and seizures or CNS depression, which results in lethargy and coma. Other toxic effects include painless chemical burns, hypotension, acute respiratory distress syndrome, acute liver failure, severe metabolic acidosis, and cerebral edema depending on which essential oil is in question.

Tennessee Poison Center Tips for using essential oils

  • Safely using and storing essential oils is extremely important
  • Use essential oil products ONLY for their intended purpose.
  • Use only the amount stated on the label/guide.
  • Do not swallow an essential oil unless the label says to do so.
  • Do not use a product on the skin unless the label says to do so.
  • Do not leave the product out (i.e. as a pesticide) unless the label says to do so.
  • If you have bottles of essential oils at home, keep them locked up, out of sight and reach of children and pet at all times. Children act fast, so do poisons.

Many will think that this is alarmist – but I don’t. In fact, in 2012, I published a systematic review aimed at critically evaluating the evidence regarding the adverse effects associated with aromatherapy. No, it was not funded by ‘BIG PHARMA’ but by THE ROYAL COLLEGE OF PHYSICIANS, LONDON.

Five electronic databases were searched to identify all relevant case reports and case series. Forty two primary reports met our inclusion criteria. In total, 71 patients experienced adverse effects of aromatherapy. Adverse effects ranged from mild to severe and included one fatality. The most common adverse effect was dermatitis. Lavender, peppermint, tea tree oil and ylang-ylang were the most common essential oils responsible for adverse effects.

At the time, we concluded that aromatherapy has the potential to cause adverse effects some of which are serious. Their frequency remains unknown. Lack of sufficiently convincing evidence regarding the effectiveness of aromatherapy combined with its potential to cause adverse effects questions the usefulness of this modality in any condition.

I might add – before the therapists start making comments – that, yes, aromatherapy is still dimensions safer than many conventional treatments. But remember: the value of a therapy is not determined by its safety but by the risk/benefit balance! And what are the proven benefits of aromatherapy, I ask you.

14 Responses to Aromatherapy: pleasant enough, but what are the risks?

  • I’ve used aromatherapy clinically, with great benefit.

    I very much doubt there’s any direct pharmacological effect, but getting the patient to associate with a particular smell when they are feeling well can induce – like M. Proust’s cup of tea – that same feeling of wellness when presented during periods of pain or distress.

    No need to rub anything on, though. The name of the thing is AROMA-therapy.

  • ‘Therapy’ is defined as “Treatment intended to relieve or heal a disorder” (Oxford Dictionary).
    It would be helful if Glyn Hughes would share with us what disorder he suffered from, what the ‘clinical benefit’ was, and how he measured the benefit.

    How does he know he did not simply experience a nice feeling from nice aromas?
    Nothing wrong with that, but unless there is evidence to the contrary, that is not ‘therapy’.

    Folks who market aromas whilst claiming therapeutic effect are surely intending to deceive the public.
    The more correct, and honest, term would be ‘Aromapleasantry’.
    I’d welcome some!

  • I don’t really get the “don’t leave out as a pesticide unless specifically indicated on the bottle” advice. Clove oil does work to disrupt ants for instance. I’m not sure if some clove oil is marketed for that and some is not, but if so there’s not a giant difference in the chemical makeup of the two bottles. And also certainly many products are sold labeled for purposes for which they absolutely do not work. Many pesticides shouldn’t just be left out for children or pets to get into. It’s useful to know that clove oil (or whatever oil) isn’t completely safe in every way and to keep children, pets, and yourself away from touching it if necessary, but “don’t use it unless it’s labeled for that purpose” doesn’t really make sense.

  • Why must aroma therapy consist of good smells? Why not zoo smells or dumpster essence on on a summer day? Medicine does not tend to taste good so why should aroma therapy concoctions?

    Mr. Rawlins has it right about “aromapleasantry”. Too bad I can not bottle the air from my grandmother’s kitchen. I’d become a millionaire.

    • Not everyone finds aromatherapy pleasant.
      I have found that I may be oversensitive or even allergic to at least some aromatherapy odors. After half an hour in a practicing relative’s home my eyes and throat become irritated and watery. I have even felt these symptoms when came for a visit. The smells of the popular frankincense and tea tree oil seem especially noxious to me.

      For some reason many midwives dabble in this nonsense (and acupuncture!). I have heard stories of parents who were talked into shaving smelling potions spread about in the middle of labour and found it uncomfortable and even irritating but were too glad everything was happily over and answered positively to the gullible midwife’s leading questions about it afterwards.

      • ‘Aromapleasantry’ describes the intention of the practice in general, not (necessarily), the outcome for any particular patient.

        ‘Aromatherapy’ implies the intention is to treat a specific disease or condition.
        As there is no plausible evidence aromas have any effect on any disease process, use of the term ‘therapy’ is misleading and practitioners who use the term might intend taking advantage of gullible and vulnerable patients, and even intend to defraud.

    • In fairness, I attended an aromatherapy ‘party’ once – like a tupperware or sex toy party but with essential oils, the object being for the seller of the oils to make a few quid – and some of them smelt truly revolting. The selling point for these evil-smelling ones were that they were ‘marvellous for lumbago’ (or whatever). Nobody was taken in by this nonsense – we were all there for the pleasant ones that would make our homes smell nice.

      I would add that the seller seemed very responsible on the safety aspect pointing out that they should be kept out of reach of children and should not be applied directly to the skin or even to bathwater unless in a ‘carrier’ i.e. almond oil.

      I’ve been a convert ever since and highly recommend using them in a vaporiser to keep your house delightfully fragrant.

  • I’ll add:

    1. The therapists have the greatest exposure to these oils therefore the known toxicity of essential oils used in aromatherapy does indeed qualify as an occupational hazard: “An occupational hazard is a hazard experienced in the workplace. Occupational hazards can encompass many types of hazards, including chemical hazards, biological hazards (biohazards), psychosocial hazards, and physical hazards.” — Wikipedia. I have not yet seen a proper report on the adverse effects experienced by aromatherapists: I guess it is likely to be under-reported by both self-employed and employee aromatherapists.

    2. Children’s skin is much more absorbent than adult skin; and the ratio of skin surface area to body mass is much greater for a small child than that of an average-sized adult. These two factors alone should be enough to preclude exposing children to toxic massage oils.

    3. Children, by definition, cannot give their informed consent to ‘treatments’ provided by sCAM practitioners.

  • A child safety expert told my daughter’s childcare parents group that the most dangerous substance we had in our houses was probably the eucalyptus oil used in steamers for colds and croup! It’s terribly corrosive to the throat etc.

    Aspirating corrosive oil into the lungs could produce a horrific injury.

Leave a Reply

Your email address will not be published. Required fields are marked *

Please answer the following: *

Gravityscan Badge

Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted.


Click here for a comprehensive list of recent comments.

Categories