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Animal-assisted therapies

Description

Therapies involving animals are particularly beneficial for people with learning or physical disabilities, as well as the elderly and those in long-term residential healthcare settings. While it is acknowledged that animals have been used for relaxation purposes, e.g. swimming with dolphins, these activities have not been included here as they are generally considered to be self-prescribed recreational activities as opposed to specific clinical interventions.

Equine-assisted therapy/therapeutic riding

Description

Therapeutic riding involves the provision of horse-riding lessons for people who are disabled or less mobile than others, under the supervision of a specially trained physiotherapist. The physiotherapist undertakes an initial assessment of the rider, including manual handling requirements, facilitates the planning of the riding programme and may work with the rider during lessons. The physiotherapist then works closely with the riding instructor to ensure that the therapy is appropriate for the individual’s capabilities. Recreational riding is offered by the Riding for the Disabled Association, both for riders who will never be able to ride independently and for those who intend to train for international equestrian events for the disabled. While not a designated therapy per se, the experience enables riders to develop balance, muscle strength and confidence often giving them a dramatic new perspective on life and the world, particularly for wheelchair users.

Evidence:

Therapeutic riding has been shown to assist in the development of muscular strength, coordination and balance and to encourage self confidence.

Safety:

No evidence was found on therapeutic riding as a clinical modality or regarding its relative safety. Conversely, no evidence was found on any specific contraindications. Clients should be supervised at all times by professional physiotherapists and riding instructors.

Bibliography

Candler C. Sensory integration and therapeutic riding at Summer Camp: an occupational performance outcomes. Physical Occupational Therapy Pediatrics. 2003;23(3):51-64.

Daly M. Rehabilitation in the therapeutic riding arena. Rehabilitation Nurse. 2000;25(5):167-168.

Hammer A, Nilsagard Y, Forsberg A, et al. Evaluation of therapeutic riding (Sweden) hippotherapy (United States). A single-subject experimental design study replicated in eleven patients with multiple sclerosis. Physiotherapy Theory and Practice. 2005;21(1):51-77.

Land G, Errington-Povalac E, Paul S. The effects of therapeutic riding on sitting posture in individuals with disabilities. Journal of Chronic Fatigue Syndrome. 2002;10(1):1-12.

Liptak GS. Complementary and alternative therapies for cerebral palsy. Mental Retardation and Developmental Disabilities Research Reviews. 2005;11(2):156-163.

Snider L, Korner-Bitensky N, Kammenn C, et al. Horseback riding as therapy for children with cerebral palsy: is there evidence of it effectiveness? Physical Occupational Therapy Pediatrics. 2007;27(2):5-23.

Winchester P, Kendall K, Peters H, et al. The effect of therapeutic horseback riding on gross motor function and gait speed in children who are developmentally delayed. Physical Occupational Therapy Pediatrics. 2002;22(3–4):37-50.

Resources

Riding for the Disabled: www.riding-for-disabled.org.uk

Hippotherapy

Description

Hippotherapy differs from therapeutic riding in that it is a specific physiotherapy treatment on horseback, for adults and children with varying degrees of physical, cognitive or emotional disability. The person sits passively on the horse’s back without the conventional saddle, allowing for three-dimensional movement of the horse, thus helping to elicit automatic reactions from the rider as they accommodate to the horse’s gait. The physiotherapist applies neurodevelopmental and sensory integration techniques to develop balance and posture, which programmes or re-programmes the mind via a feedback loop, allowing more normal movement to be developed. It also engenders self confidence, flexibility and muscle strength. When the person is unable to accommodate to the horse’s movement, back riding is used in which a physiotherapist qualified in neurodevelopment and riding sits on the horse behind the person and facilitates techniques to encourage postural control. It is a labour-intensive therapy involving the therapist, a riding master who controls the horse and a side helper and is, consequently, expensive.

Evidence:

Hippotherapy has been shown to develop muscular strength, coordination and balance and encourage self confidence.

Safety:

No evidence was found regarding safety or specific contraindications.

Bibliography

Benda W, McGibbon N, Grant K. Improvements in muscle symmetry in children with cerebral palsy after equine assisted therapy (hippotherapy). Journal of Alternative Complementary Medicine. 2003;9(6):817-825.

Gehrts K. Examining the effectiveness of hippotherapy with cerebral palsy (Part 3). NZ Physiotherapy Krankengymnastik. 2006;59(10):1086-1093.

Hammer A, Nilsagard Y, Forsberg A, et al. Evaluation of therapeutic riding (Sweden) hippotherapy (United States). A single-subject experimental design study replicated in eleven patients with multiple sclerosis. Physiotherapy Theory and Practice. 2005;21(1):51-77.

Sterba J. Does horseback riding or therapist-directed hippotherapy rehabilitate children with cerebral palsy? Developments Medical Child Neurology. 2007;49(1):68-73.

Resources

Chartered Society of Physiotherapists: www.csp.org.uk

Riding for the Disabled: www.riding-for-disabled.org.uk

Pet therapy

Description

Pet therapy was originally endorsed by Florence Nightingale who observed that pets were often excellent companions for the sick. It has since developed into a widely used therapy involving a range of interventions including: facilitating animals to visit people in hospital or convalescent homes, especially those who are away from home for long periods of time, the use of pets as part of a therapy programme and the training of dogs to facilitate independence in people who are disabled.

Evidence:

Stroking, watching or interacting with animals has been shown to reduce blood pressure, reduce anxiety and promote interaction and communication and elevate mood.

Safety:

Careful choice of animal is needed, caution with people who are allergic to animal dander or who are animal phobic or immunosuppressed.

Bibliography

Malesle M. Hospice care. Pet therapy. Hospice Health Network. 2004;78(11):24.

Roenke L, Mulligan S. The therapeutic value of the human-animal connection. Occupational Therapy Healthcare. 1998;11(2):27-43.

Resources

Pet Therapy: www.petsastherapy.org

Anthroposophical medicine

Description

Anthroposophical medicine was developed by the Austrian philosopher, Rudolph Steiner, the name derived from the Greek anthropos (human) and sophia (wisdom). It is based on the concept of body, mind and spirit/ego and encompasses the life-force/etheric body and the soul/astral body. Health equates to maintenance of equilibrium between the four parts, in conjunction with earth, water, fire and air and is dependent on the balance between catabolism (breakdown and use of energy) and anabolism (building and storing of energy). Anthroposophical medicine also recognizes three interconnected dynamic systems: the nervous system (spinal column, brain and nerves, responsible for thought and cognition), metabolic system (responsible for assimilation of nutrition, metabolism and movement of the limbs) and the rhythmic system (responsible for respiratory and circulatory systems, i.e. the rhythms of the body). The nervous and metabolic systems are polar opposites, while the rhythmic system maintains the balance between the two. Illness is viewed as a transformation, as part of the person’s destiny; failure to acknowledge this results in interference with the body/soul connection.

Anthroposophical medicine is normally practised by specially trained doctors and nurses and advocates a biodynamic, lacto-vegetarian diet, with unrefined carbohydrates. Foods are analogous with the human body; plant roots equate to the brain; stems/leaves equate to the rhythmic system; flowers/fruit equate to the metabolic system. Massage, hydrotherapy, eurhythmy, art, music therapy, homeopathic and herbal remedies are used as well as some conventional interventions. Consideration is given to seasonal and cosmic influences, i.e. solar, lunar and planetary influences, with treatments prescribed both for physical effects and as a catalyst in promoting the person’s life-force.

Evidence:

There appears to be no real scientific evidence for anthroposophical medicine as a concept, although individual aspects have been evaluated. It is therefore necessary to have a basic knowledge of the elements of the therapy in order to conduct professional literature searches on both its effectiveness and safety. Therapeutic eurythmy may be useful for children with attention deficit hyperactivity disorder (ADHD). Herbal remedies used in anthroposophical medicine, such as Iscador (mistletoe) have been found to regulate cardiorespiratory function during night-time sleep and may prolong survival time in oncology patients.

Safety:

As this is an integrated medical system safety issues relate to the individual components and the professional accountability of the practitioners.

Bibliography

Arman M, Backman M. A longitudinal study on women’s experiences of life with breast cancer in anthroposophical (complementary) and conventional care. European Journal of Cancer Care. 2000;16(5):440-450.

Cysarz D, Heckmann C, Bettermann H, et al. Effects of an anthroposophical remedy on cardiorespiratory regulation. Alternative Therapies in Health and Medicine. 2002;8(6):78-83.

Ernst E. Anthroposophical medicine: a systematic review of randomised clinical trials. Wiener klinische Wochenschrift. 2004;116(4):128-130.

Fliostrup H, Swartz J, Bergstgrom A, et al. Allergic disease and sensitization in Steiner school children. Journal of Allergy and Clinical Immunology. 2006;117(1):59-66.

Grossarth-Maticek R, Kiene H, Baumgartner SM, et al. Use of Iscador, an extract of European mistletoe (Viscum album), in cancer treatment: prospective nonrandomized and randomized matched-pair studies nested within a cohort study. Alternative Therapies in Health and Medicine. 2001;7(3):57-66. 68–72

Hamre H, Becker-Witt C, Glockman A, et al. Anthroposophical therapies in chronic disease: the Anthroposophical Medicine Outcomes Study (AMOS). European Journal of Medical Research. 2004;9(7):351-360.

Hamre H, Fischer M, Heger M, et al. Anthroposophical vs. conventional therapy of acute respiratory and ear infections: a prospective outcomes study. Wiener klinische Wochenschrift. 2005;117(7–8):256-268.

Heusser P, Berger-Brauna S, Ziegler R. Palliative in-patient cancer treatment in an anthroposophical hospital: 1. Treatment patterns and compliance with anthroposophical medicine. Forschende Komplementärmedizin und Klassische Naturheilkunde. 2006;13(2):94-100.

Majorek M, Tüchelmann T, Heusser P. Therapeutic eurhythmy-movement therapy for children with attention deficit hyperactivity disorder (ADHD): a pilot study. Complementary Therapies in Nursing and Midwifery. 2004;10(1):46-53.

Van der Bie G, Huber M. Foundations of anthroposophical medicine: A training manual. Edinburgh: Floris Books; 2003.

Resources

Anthroposophy Organization: www.anthroposophy.org

Weleda Weleda: www.weleda.co.uk

Aromatherapy

Description

Aromatherapy is the therapeutic use of concentrated essential oils administered via the skin in massage, creams, gels and in water, via the respiratory tract in inhalations and vaporizers via mucous membranes, including rectally and vaginally, plus, occasionally gastrointestinally (aromatology). Therapeutic effects are thought to result from a combination of the chemical constituents, methods of administration and the effects of the aromas. The French chemist, Rene-Maurice Gattefosse (1881–1950) first used the term ‘aromatherapie’ and promoted essential oils as medical interventions after he burnt his hand in an accident and found that lavender oil relieved the pain and aided healing. The French surgeon Dr Jean Valnet (1920–1975) subsequently used essential oils effectively to treat wounded soldiers during the First World War and continued his research, teaching and practice almost until his death.

Essential oils are extracted most commonly by steam distillation, although other methods such as expression (for citrus essences) and solvent extraction (which produces an absolute) are also used. They contain hundreds of constituents with different therapeutic properties, grouped primarily into: alcohols (antiseptic, antiviral), aldehydes (antiseptic, sedative), coumarins (anticoagulant, hypotensive, phototoxic), esters (antifungal, antispasmodic, sedative), ketones (expectorant, mucolytic, analgesic, possibly emmenagogic), oxides (expectorant), terpenes – sub-divided into monoterpenes (antibacterial antiviral, analgesic), sesquiterpenes (antiinfective, antiinflammatory, antispasmodic) and diterpenes (antiinfective, expectorant), as well as phenols (antibacterial, stimulants) and some other constituents.

Evidence

There is both clinical and non-clinical evidence that essential oils are antibacterial, antiviral and antifungal and trials have demonstrated their effectiveness in combating methicillin resistant staphylococcus aureus (MRSA) and other major infections. Clinical studies have demonstrated the value of aromatherapy for labour and other types of pain, reducing blood pressure, anxiety, depression and insomnia but whether this is due to the essential oil chemistry or the method of administration has not yet been adequately verified. Many of the aromatherapy trials have investigated the concept of aromatherapy as a treatment modality, irrespective of the individual oils used. The number of studies on specific essential oils varies, with some, such as tea tree, having vast amounts of evidence, while others which are less well known or less commonly used, have very little, if any, literature to support them. References to clinical research, as well as some case reports, have been included here, where available; readers interested in non-clinical investigations of specific oils are referred to the Journal of Essential Oil Research as one particularly good resource.

Safety:

Essential oils should be stored in dark bottles at a cool temperature, to avoid deterioration and be kept away from children. Some oils such as citrus oils will deteriorate more quickly than others and have a shelf-life of about 3–6 months; they should be stored in the refrigerator. In the UK, oils are not normally ingested as it is not possible to determine the site and rate of absorption, nor can the majority of UK aromatherapists obtain indemnity insurance cover for administration by mouth (although French doctors prescribe oils orally). Oils should not normally be applied neat to the skin, as dermal sensitivity may occur, but should be diluted in a carrier oil, such as grapeseed or sweet almond (although some individuals may also be sensitive to certain carrier oils, particularly sweet almond). Blended oils should be discarded after about 4 weeks as oxidation (deterioration) may chemically alter the oil and its therapeutic properties.

Some oils should be avoided by people with abnormalities of blood pressure, as certain essential oils are hypotensive, while others are hypertensive. If used in large doses, certain oils, notably the citrus oils, may cause photosensitivity in susceptible people and in those taking drugs with similar side-effects. There are many essential oils which should not be used by pregnant or lactating women, as the effects on the fetus and the mother’s systemic condition are unknown; it is advisable to avoid all essential oils in pregnancy unless recommended by a suitably trained practitioner. Many oils should be used with caution in small children under 12 years of age and should never be used on babies under 3 months, as the antibacterial properties may adversely affect ongoing maturation of the immune system.

Dosages should range from 0.5–1% for children; 1–2% during pregnancy, labour and lactation and for patients compromised by illness or debilitating conditions; the normal dose for healthy adults is up to 3% ( a total of 3 drops of essential oil in each 5 mL of carrier/base oil). Care should be taken if the individual is prescribed any medication since the metabolism of essential oils is precisely the same as for pharmacological drugs and there is a theoretical possibility of drug–oil interactions.

Bibliography

Bastard J, Tiran D. Aromatherapy and massage for antenatal anxiety: its effect on the fetus. Complementary Therapies in Clinical Practice. 2006;12(1):48-54.

Burns E, Zobbi V, Panzeri D, et al. Aromatherapy in childbirth: a pilot randomised controlled trial. British Journal of Obstetrics and Gynaecology. 2007;114(7):838-844.

Hadfield N. The role of aromatherapy massage in reducing anxiety in patients with malignant brain tumours. International Journal of Palliative Nursing. 2001;7(6):279-285.

Hur MH, Oh H, Lee MS, et al. Effects of aromatherapy massage on blood pressure and lipid profile in Korean climacteric women. International Journal of Neuroscience. 2007;117(9):1281-1287.

Fellowes D, Barnes K, Wilkinson S. Aromatherapy and massage for symptom relief in patients with cancer. Cochrane Database of Systematic Reviews. (2):2004. CD002287

Kim JT, Ren CJ, Fielding GA, et al. Treatment with lavender aromatherapy in the post-anesthesia care unit reduces opioid requirements of morbidly obese patients undergoing laparoscopic adjustable gastric banding. Obstetric Surgery. 2007;17(7):920-925.

Kyle G. Evaluating the effectiveness of aromatherapy in reducing levels of anxiety in palliative care patients: results of a pilot study. Complementary Therapies in Clinical Practice. 2006;12(2):148-155.

Lee CO. Clinical aromatherapy Part II: Safe guidelines for integration into clinical practice. Clinical Journal of Oncology Nursing. 2003;7(5):597-598.

Lin PW, Chan WC, Ng BF, et al. Efficacy of aromatherapy (Lavandula angustifolia) as an intervention for agitated behaviours in Chinese older persons with dementia: a cross-over randomized trial. International Journal of Geriatric Psychiatry. 2007;22(5):405-410.

Lis-Balchin M. Possible health and safety problems in the use of novel plant essential oils and extracts in aromatherapy. Journal of the Royal Society of Health. 1999;4:240-243.

Lis-Balchin M. Aromatherapy science: a guide for healthcare professionals. London: Pharmaceutical Press; 2006.

Tiran D. Clinical Aromatherapy for Pregnancy and Childbirth, 2nd edn. Edinburgh: Churchill Livingstone; 2004.

Wilkinson SM, Love SB, Westcombe AM, et al. Effectiveness of aromatherapy massage in the management of anxiety and depression in patients with cancer: a multicenter randomized controlled trial. Journal of Clinical Oncology. 2007;25(5):532-539.

Resources

Aromatherapy Organisations Council: http://www.aocuk.net

Selected essential oils

Basil (Ocimum basilicum)

Traditional uses:

antibacterial, antifungal, stimulant, expectorant.

Principal constituents:

linalool, 1, 8 cineol, eugenol, pinene, camphor, methyl chavicol, β-caryophyllene.

Evidence:

There is some evidence of the antiinfective properties of basil oil.

Safety:

Mildly toxic, not for oral administration, has previously been thought to be carcinogenic. Not to be used in pregnancy or for children.

Bibliography

Misner BD. A novel aromatic oil compound inhibits microbial overgrowth on feet: a case study. Journal of the International Society of Sports Nutrition. 2007;4:3.

Benzoin (Styrax benzoin)

Traditional uses:

respiratory tract infection, skin lesions, warming and soothing.

Principal constituents:

benzoic acid, vanillin, aldehydes.

Evidence:

No evidence of therapeutic properties was found, although there are case reports on the potential adverse dermal effects.

Safety:

May cause dermal irritation. Not for oral administration. Appears safe in therapeutic doses.

Bibliography

Scardamaglia L, Nixon R, Fewings J. Compound tincture of benzoin: a common contact allergen? Australasian Journal of Dermatology. 2003;44(3):180-184.

Bergamot (Citrus bergamia)

Traditional uses:

urinary and respiratory tract infections, antimicrobial, mood enhancer.

Principal constituents:

linalyl acetate, limonene and linalool α- and β-terpinene.

Evidence:

Most studies have focused on the antibacterial and antimicrobial effects of a number of essential oils, including bergamot.

Safety:

Non-toxic in therapeutic dosages, not for oral administration. May increase photosensitivity in susceptible people: avoid direct sunlight/sunbed use for at least 2 h after administration May also cause dermal irritation. Safe in pregnancy and for children over 12 months. Shelf-life of 3–6 months when stored in refrigerator.

Bibliography

Fisher K, Phillips CA. The effect of lemon orange and bergamot essential oils and their components on the survival of Campylobacter jejuni, Escherichia coli O157, Listeria monocytogenes, Bacillus cereus and Staphylococcus aureus in vitro and in food systems. Journal of Applied Microbiology. 2006;101(6):1232-1240.

Kejlová K, Jírová D, Bendová H, et al. Phototoxicity of bergamot oil assessed by in vitro techniques in combination with human patch tests. Toxicology in Vitro. 2007;21(7):1298-1303.

Sanguinetti M, Posteraro B, Romano L, et al. In vitro activity of Citrus bergamia (bergamot) oil against clinical isolates of dermatophytes. Journal of Antimicrobial Chemotherapy. 2007;59(2):305-308.

Black pepper (Piper nigrum)

Traditional uses:

digestive disorders, antispasmodic, tonic, stimulant, warming.

Principal constituents:

piperine, pinene, limonene, terpinolene, caryophyllene, cadinene.

Evidence:

Single studies have demonstrated a possible role in smoking cessation and in its stimulating effect on the olfactory system.

Safety:

Safe in pregnancy and labour in low doses, not safe for children. Best avoided in those who are hyper-pyrexial, due to its warming properties.

Bibliography

Ebihara T, Ebihara S, Maruyama M, et al. A randomized trial of olfactory stimulation using black pepper oil in older people with swallowing dysfunction. Journal of the American Geriatrics Society. 2006;54(9):1401-1406.

Rose JE, Behm FM. Inhalation of vapor from black pepper extract reduces smoking withdrawal symptoms. Drug and Alcohol Dependence. 1994;34(3):225-229.

Cedarwood (Cedrus atlanticus)

Traditional uses:

insect repellent, antiseptic, bronchial and urinary tract infections, catarrhal.

Principal constituents:

cedrol, cadinene sesquiterpenes terpenic hydrocarbons.

Evidence:

No specific evidence found.

Safety:

Safe in therapeutic dosages for healthy people. Probably not safe in pregnancy, but appears relatively safe for children over 6 months. Not for oral administration.

Bibliography

Hay IC, Jamieson Mormerod AD. Randomized trial of aromatherapy Successful treatment for alopecia areata. Archives of Dermatology. 1998;134:1349-1352.

Chamomile – Roman (Anthemis nobilis)/German/Hungarian (Matricaria recutita)/Moroccan (Principal)

Traditional uses:

antispasmodic, antiinflammatory, antiseptic, sedative, wound healing.

Principal constituents:

coumarins, esters, terpenes, alcohol and ketone; chamazulene, which is formed during the extraction process and causes the oil to turn blue. Roman chamomile has high percentage of esters (antiinflammatory, antispasmodic, antifungal, calming and sedative); German chamomile oil contains more antiinflammatory chamazulene, produced when the essential oil is extracted from the plant. (Constituents vary between varieties.)

Evidence:

Any evidence should be set in context since most studies and case reports relate to effects of the whole plant, rather than just the extracted essential oil. However, experiential evidence suggests that chamomile has a sedating effect.

Safety:

Exceeding the recommended amount can result in a stimulating rather than sedating effect. May interact with warfarin if used in large doses. Roman chamomile should not be used in pregnancy until the third trimester due to higher proportion of camphor.

Bibliography

Segal R, Pilote L. Warfarin interaction with Matricaria chamomilla. Canadian Medical Association Journal. 2006;174:1281-1282.

Melzer J, Rosch W, Reichling J, et al. Meta-analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast). Alimentary Pharmacology and Therapeutics. 2004;20:1279-1287.

Nayak BS, Raju SS, Rao AV. Wound healing activity of Matricaria recutita L – extract. Journal of Wound Care. 2007;16(7):298-302.

Storr M, Sibaev A, Weiser D, et al. Herbal extracts modulate the amplitude and frequency of slow waves in circular smooth muscle of mouse small intestine. Digestion. 2004;70:257-264.

Cinnamon (Cinnamomum zeylanicum)

Traditional uses:

respiratory tract infections.

Principal constituents:

α-pinene, cinnamaldehyde, eugenol, caryophyllene.

Evidence:

May possibly have an anti-diabetic effect.

Safety:

Non-toxic in therapeutic dosages. Not for oral administration. May cause dermal irritation in susceptible people, in the form of contact dermatitis. Probably not safe during pregnancy, but appears safe for children over 6 months.

Bibliography

Kanerva L, Estlander T, Jolanki R. Occupational allergic contact dermatitis from spices. Contact Dermatitis. 1996;35:157-162.

Verspohl EJ, Bauer K, Neddermann E. Antidiabetic effect of Cinnamomum cassia and Cinnamomum zeylanicum in vivo and in vitro. Phytotherapy Research. 2005;19:203-206.

Clary sage (Salvia sclarea)

Traditional uses:

euphoric, antispasmodic, muscle relaxant, childbirth.

Principal constituents:

linalyl acetate, sclareol, linalool, salvene caryophyllene, composition may vary.

Evidence:

Although no studies have been undertaken specifically on clary sage in isolation, there does appear to be the suggestion that this essential oil has an effect on smooth muscle, such as the uterus.

Safety:

Non-toxic in therapeutic dosages when used appropriately. Not for oral administration. May potentiate the effects of alcohol. Completely contraindicated in pregnancy; may enhance uterine action in labour, but advise women not to use it to initiate uterine contractions towards term unless on the advice of a midwife. May cause menorrhagia and even inter-menstrual bleeding – caution with clients and therapists who are menstruating heavily. May cause transient hypotension.

Bibliography

Burns E, Blamey C, Ersser SJ, et al. The use of aromatherapy in intrapartum midwifery practice an observational study. Complementary Therapies in Nursing and Midwifery. 2000;6(1):33-34.

Han SH, Hur MH, Buckle J, et al. Effect of aromatherapy on symptoms of dysmenorrhea in college students: a randomized placebo-controlled clinical trial. Journal of Alternative and Complementary Medicine. 2006;12(6):535-541.

Lis-Balchin M, Hart S. A preliminary study of the effect of essential oils on skeletal and smooth muscle in vitro. Journal of Ethnopharmacology. 1997;58(3):183-187.

Cypress (Cupressus sempervirens)

Traditional uses:

astringent, antispasmodic, for asthma, oedema, may aid weight loss, stimulating.

Principal constituents:

D-pinene, D-camphene, cymene, sabinol, camphor.

Evidence:

Appears to be effective in reducing fluid retention.

Safety:

Non-toxic in therapeutic dosages, safe in pregnancy and for children, not for oral administration, may cause dermal irritation.

Bibliography

Kim HJ. Effect of aromatherapy massage on abdominal fat and body image in post-menopausal women. Taehan Kanho Hakhoe Chi. 2007;37(4):603-612.

Lim WC, Seo JM, Lee CI, et al. Stimulative and sedative effects of essential oils upon inhalation in mice. Archives of Pharmacal Research. 2005;28(7):770-774.

Eucalyptus (Eucalyptus globules, E. radiate, E. citriodora)

Traditional uses:

decongestant, mucolytic, antibacterial, local analgesic, CNS stimulant, deodorizing.

Principal constituents:

(may vary between genera) eucalyptol, ethyl alcohol, amyl alcohol aldehydes, camphene, pinene, menthone.

Evidence:

Shown to have strong antiinfective properties; also an effective expectorant.

Safety:

Not for oral use. Appears safe in pregnancy and for children over the age of 6 months, in therapeutic doses.

Bibliography

Liapi C, Anifantis G, Chinou I, et al. Antinociceptive properties of 1,8-cineole and beta-pinene, from the essential oil of Eucalyptus camaldulensis leaves, in rodents. Planta Medica. 2007;73(12):1247-1254.

Sartorelli P, Marquioreto AD, Amaral-Baroli A, et al. Chemical composition and antimicrobial activity of the essential oils from two species of Eucalyptus. Phytotherapy Research. 2007;21(3):231-233.

Silva J, Abebe W, Sousa SM, et al. Analgesic and antiinflammatory effects of essential oils of eucalyptus. Journal of Ethnopharmacology. 2003;89:277-283.

Warnke PH, Sherry E, Russo PA, et al. Antibacterial essential oils in malodorous cancer patients: clinical observations in 30 patients. Phytomedicine. 2006;13(7):463-467.

Frankincense (Boswellia carteri)

Traditional uses:

respiratory tract infections, asthma, urinary tract infections, used to calm and relax, aid to meditation, antiinflammatory, used for diarrhoea.

Principal constituents:

α-pinene, α-thujene, dipentene, cymene, farnesol, borneol, olibanol, limonene, linalool (may differ between oils from different locations).

Evidence:

Any evidence suggesting either an antiinfective analgesic effect is from studies in which several essential oils have been used in combination, thus it is difficult to ascertain whether the effects are specifically related to frankincense; experiential evidence seems to reflect the calming and pain-relieving properties with which frankincense has long been credited. It also appears to have a good expectorant effect and has been used in some commercial preparations for this purpose.

Safety:

Safe in pregnancy and in children over the age of 6 months. Not for oral use.

Bibliography

Borrelli F, Capasso F, Capasso R, et al. Effect of Boswellia serrata on intestinal motility in rodents: inhibition of diarrhoea without constipation. British Journal of Pharmacology, 4. 2006: 553-560.

Buckle J. Use of aromatherapy as a complementary treatment for chronic pain. Alternative Therapies in Health and Medicine. 1999;5:42-51.

Clarke JO, Mullin GE. A review of complementary and alternative approaches to immunomodulation. Nutrition in Clinical Practice. 2008;23(1):49-62.

Geranium (Pelargonium graveolens)

Traditional uses:

antidepressant, antiseptic, astringent, used for menopausal problems, antibacterial, antimicrobial, antiinflammatory.

Principal constituents:

citronellol, geraniol, linalool, citral, geranyl acetate, valerianic acid.

Evidence:

several reputable studies reflect the antibacterial and antimicrobial effects of geranium oil.

Safety:

Non-toxic in normal doses, not for oral ingestion. Safe in pregnancy. May cause dermal irritation.

Bibliography

Maruyama N, Ishibashi H, Hu W, et al. Suppression of carrageenan- and collagen II-induced inflammation in mice by geranium oil. Mediators of Inflammation. 2006;2006(3):62537.

Prabuseenivasan S, Jayakumar M, Ignacimuthu S. In vitro antibacterial activity of some plant essential oils. BMC Complementary and Alternative Medicine. 2006;6:39.

Rosato A, Vitali C, De Laurentis N, et al. Antibacterial effect of some essential oils administered alone or in combination with norfloxacin. Phytomedicine. 2007;14(11):727-732.

Schelz Z, Molnar J, Hohmann J. Antimicrobial and antiplasmid activities of essential oils. Fitoterapia. 2006;77(4):279-285.

Ginger (Zingiber officinalis)

Traditional uses:

warming, antispasmodic, used for stomach cramps and diarrhoea, may enhance uterine action, antibacterial, antiviral, stimulating. Antiemetic, although most research has investigated the herbal remedy rather than the essential oil. Possible role in converting breech-presenting fetus to cephalic.

Principal constituents:

zingiberene, camphene, limonene, d-phellandrene, 1,8-cineole, geranial, geraniol, curcumene, linalool, citrale.

Evidence:

Numerous studies confirm the antibacterial effects of ginger. Any apparent evidence on the use of ginger oil as an antiemetic need to be put in context as the majority of research has been undertaken using ginger root as a herbal remedy, rather than the extracted essential oil. A single study suggests that ginger has an effect on the smooth muscle of the uterus, possibly indicating a role in obstetrics.

Safety:

Not to be used by those with coagulation disorders or on anticoagulant medication (including NSAIs). Not always appropriate as an antiemetic in pregnancy, may cause heart burn. Non-toxic, safe in therapeutic dosages, essential oil not for oral consumption.

Bibliography

Calvert I. Ginger: an essential oil for shortening labour? Practising Midwife. 2005;8(1):30-34.

Koch C, Reichling J, Schneele J, et al. Inhibitory effect of essential oils against herpes simplex virus type 2. Phytomedicine. 2008;15(1–2):71-78.

Lim WC, Seo JM, Lee CI, et al. Stimulative and sedative effects of essential oils upon inhalation in mice. Archives of Pharmacol Research. 2005;28(7):770-774.

Norajit K, Laohakunjit N, Kerdchoechuen O. Antibacterial effect of five Zingiberaceae essential oils. Molecules. 2007;12(8):2047-2060.

Riyazi A, Hensel A, Bauer K, et al. The effect of the volatile oil from ginger rhizomes (Zingiber officinale), its fractions and isolated compounds on the 5-HT3 receptor complex and the serotoninergic system of the rat ileum. Planta Medica. 2007;73(4):355-362.

Zhou HL, Deng YM, Xie QM. The modulatory effects of the volatile oil of ginger on the cellular immune response in vitro and in vivo in mice. Journal of Ethnopharmacology. 2006;105(1–2):301-305.

Grapefruit (Citrus paradisi)

Traditional uses:

diuretic, detoxifier, lymphatic stimulant for fluid retention, weight loss, cellulite, acne, antiseptic, antibacterial, analgesic.

Principal constituents:

limonene, citral, geraniol, neral, cadinene and paradisol.

Evidence:

Some trials on the antibacterial properties of essential oils have included grapefruit. It is possible that the effect of the aroma of grapefruit on the olfactory mechanism can be stimulating.

Safety:

Non-toxic in therapeutic dosages. Safe for children; safe in pregnancy after the first trimester. Not for oral administration. May cause dermal irritation, may increase susceptibility to photosensitivity. Shelf-life of 3–6 months when stored in refrigerator.

Bibliography

Edwards-Jones V, Buck R, Shawcross SG, et al. The effect of essential oils on methicillin-resistant Staphylococcus aureus using a dressing model. Burns. 2004;30(8):772-777.

Niijima A, Nagai K. Effect of olfactory stimulation with flavor of grapefruit oil and lemon oil on the activity of sympathetic branch in the white adipose tissue of the epididymis. Experimental Biology and Medicine. 2003;228(10):1190-1192.

Shen J, Niijima A, Tanida M, et al. Mechanism of changes induced in plasma glycerol by scent stimulation with grapefruit and lavender essential oils. Neuroscience Letters. 2007;416(3):241-246.

Jasmine (Jasminum officinalis)

Traditional uses:

uterine tonic to relieve pain and strengthen contractions, antidepressant, aphrodisiac.

Principal constituents:

benzyl benzoate, benzyl acetate, 1,8-cineole, methyl anthranilate, farnesene, cis-jasmone, indol, linalool and linalyl acetate.

Evidence:

Several German studies have suggested the effects of a number of essential oils on human concentration, including jasmine.

Safety:

Non-toxic in therapeutic dosages. Should be avoided during pregnancy but is acceptable in labour and the puerperium. Safe for children over 6 months. Not for oral administration.

Bibliography

Imberger J, Heuberger E, Mahrhofer C, et al. The influence of essential oils on human attention and alertness. Chemical Senses. 2001;26(3):239-245.

Lis-Balchin M, Hart S, Wan Hang Lo B. Jasmine absolute (Jasminum grandiflora L.) and its mode of action on guinea-pig ileum in vitro. Phytotherapy Research. 2002;16(5):437-439.

Lavender (Lavandula angustifolia/augustifolia/officinalis, true lavender)

Traditional uses:

sedative, relaxant, antispasmodic, antibacterial, antimicrobial, anti-hypertensive, may reduce anxiety, analgesic, good for pain in labour, may aid wound healing.

Principal constituents:

lavandulol, lavandulyl acetate, camphor, geranyl, geraniol, linalool, 1,8-cineole, limonene. (Vary between genera.)

Evidence:

Lavender oil appears to have calming and analgesic properties, as well as reducing blood pressure and improving circulation.

Safety:

Non-toxic in therapeutic dosages. Safe for children over the age of 6 months. Lavandula angustifolia appears safe after the first trimester of pregnancy, caution with other varieties of lavender which may contain higher levels of potentially emmenagogic constituents. Oxidized lavender may cause dermal irritation. Continual use in pre-pubertal boys have been shown to cause gynaecomastia. Not for oral administration.

Bibliography

Burns E, Blamey C, Ersser SJ, et al. The use of aromatherapy in intrapartum midwifery practice: an observational study. Complementary Therapies in Nursing and Midwifery. 2000;6(1):33-34.

Cline M, Taylor JE, Flores J, et al. Investigation of the anxiolytic effects of linalool, a lavender extract, in the male Sprague-Dawley rat. Arthroscopy Association of North America Journal. 2008;76(1):47-52.

Hay IC, Jamieson M, Ormerod AD. Randomized trial of aromatherapy: successful treatment for alopecia areata. Archives of Dermatology. 1998;134:1349-1352.

Kim JT, Ren CJ, Fielding GA, et al. Treatment with lavender aromatherapy in the post-anesthesia care unit reduces opioid requirements of morbidly obese patients undergoing laparoscopic adjustable gastric banding. Obesity Surgery. 2007;17(7):920-925.

Kurtz JL. Prepubertal gynecomastia linked to lavender and tea tree oils. New England Journal of Medicine. 2007;356(24):2542-2543.

Shiina Y, Funabashi N, Lee K, et al. Relaxation effects of lavender aromatherapy improve coronary flow velocity reserve in healthy men evaluated by transthoracic Doppler echocardiography. International Journal of Cardiology. 7, 2007. Aug [Epub ahead of print]

Sköld M, Hagvall L, Karlberg AT. Autoxidation of linalyl acetate, the main component of lavender oil, creates potent contact allergens. Contact Dermatitis. 2008;58(1):9-14.

Woollard AC, Tatham KC, Barker S. The influence of essential oils on the process of wound healing: a review of the current evidence. Journal of Wound Care. 2007;16(6):255-257.

Lemon (Citrus limonum)

Traditional uses:

immunostimulant, antipyretic, circulatory stimulant, hypotensive.

Principal constituents:

citral, limonene, pinene, geraniol, neral, myrcene.

Evidence:

May be effective in reducing stress; studies on the antiinfective properties of essential oils in general have frequently included lemon oil.

Safety:

Non-toxic in therapeutic dosages. Safe for children over 6 months. Not for oral administration. Safe in pregnancy. May cause severe dermal irritation in susceptible people. Shelf-life of 3–6 months when stored in refrigerator.

Bibliography

Fukumoto S, Sawasaki E, Okuyama S, et al. Flavor components of monoterpenes in citrus essential oils enhance the release of monoamines from rat brain slices. Nutritional Neuroscience. 2006;9(1–2):73-80.

Komiya M, Takeuchi T, Harada E. Lemon oil vapor causes an anti-stress effect via modulating the 5-HT and DA activities in mice. Behavioural Brain Research. 2006;172(2):240-249.

Lemongrass (Cymbopogon citrates)

Traditional uses:

antiseptic, antibacterial, analgesic for headaches.

Principal constituents:

citral, geraniol, farnesol, nerol, geraniol, citronellol, limonene and myrcene.

Evidence:

Appears to have antiinfective effects.

Safety:

Non-toxic in therapeutic dosages, safe for children over 6 months, not for oral administration, not recommended for massage in pregnancy.

Bibliography

Duarte MC, Leme EE, Delarmelina C, et al. Activity of essential oils from Brazilian medicinal plants on Escherichia coli. Journal of Ethnopharmacology. 2007;111(2):197-201.

Imura M, Misao H, Ushijima H. The psychological effects of aromatherapy-massage in healthy postpartum mothers. Journal of Midwifery and Women’s Health. 2006;51(2):e21-e27.

Tampieri MP, Galuppi R, Macchioni F, et al. The inhibition of Candida albicans by selected essential oils and their major components. Mycopathologia. 2005;159(3):339-345.

Marjoram sweet (Origanum marjorana)

Traditional uses:

for respiratory tract infections, hypotensor, analgesic (headache, sciatica) intestinal problems constipation and diarrhoea and as a sedative.

Principal constituents:

1,8-cineole, linalool, limonene, carvacrol, thymol, terpinene, pinene, caryophyllene, geraniol, terpinolene.

Evidence:

In common with many other essential oils, the majority of research has focused on the possible antiinfective properties of marjoram, particularly its antibacterial action.

Safety:

Safe in therapeutic dosages, safe in pregnancy but caution in dermal application, may cause skin irritation, caution in children, not for oral administration.

Bibliography

Kim MJ, Nam ES, Paik SI. The effects of aromatherapy on pain, depression and life satisfaction of arthritis patients. Taehan Kanho Hakhoe Chi. 2005;35(1):186-194.

Oussalah M, Caillet S, Lacroix M. Mechanism of action of Spanish oregano, Chinese cinnamon and savory essential oils against cell membranes and walls of Escherichia coli O157:H7 and Listeria monocytogenes. Journal of Food Protection. 2006;69(5):1046-1055.

Ozcan MM, Sagdiç O, Ozkan G. Inhibitory effects of spice essential oils on the growth of Bacillus species. Journal of Medicinal Food. 2006;9(3):418-421.

Neroli (Citrus aurantium)

Traditional uses:

antidepressant, antispasmodic and sedative, antibacterial, antifungal; anti-hypertensive, premenstrual tension, menopausal symptoms, colic, diarrhoea.

Principal constituents:

linalool, linalyl acetate, nerol, geraniol, citral, limonene.

Evidence:

Very little contemporary evidence could be found. Older studies suggest a possible hypotensive effect; whether this is due to the chemical constituents or to the impact of the odour on the limbic system has not yet been satisfactorily demonstrated.

Safety:

Safe in therapeutic dosages. May cause dermal irritation. Safe for children over 6 months. Safe in pregnancy.

Bibliography

Campenni CE, Crawley EJ, Meier ME. Role of suggestion in odor-induced mood change. Psychological Reports. 2004;94(3 Pt 2):1127-1136.

Nutmeg (Myristica fragrans)

Traditional uses:

warming and toning.

Principal constituents:

camphene, myrcene, 1,8-cineole, terpinen-4-ol, sabinene, borneol, geraniol, linalool, eugenol, myristicin, safrole.

Evidence:

Most available literature on evidence relates to the herbal medicine format of nutmeg, although it is the constituents of the volatile essential oils to which the adverse effects are attributed. However, much of the evidence concerns the oral consumption of nutmeg as a medicinal product, i.e. in amounts greater than the general culinary additive.

Safety:

Not for oral administration. Can cause hallucinations, delirium, visual disturbances, ataxia and, ultimately, death. Potentially carcinogenic. Thought to be a cardiovascular stimulant. Totally contraindicated in pregnancy, although it may have a possible use, in extremely low doses, in labour. Contraindicated in children. Should not be used concurrently with morphine derivative drugs including codeine, pethidine, etc. May cause allergic dermatitis when applied to the skin.

Bibliography

Lis-Balchin M, Hart S. A preliminary study of the effect of essential oils on skeletal and smooth muscle in vitro. Journal of Ethnopharmacology. 1997;58(3):183-187.

Sangalli BC, Chiang W. Toxicology of nutmeg abuse. Journal of Toxicology. Clinical Toxicology. 2000;38(6):671-678.

Orange (sweet) (Citrus aurantium)

Traditional uses:

antidepressant, antispasmodic, mild sedative, dyspepsia, colic, constipation.

Principal constituents:

limonene, myrecene, pinene, sabanene, 1,8-cineole.

Evidence:

May reduce anxiety, particularly when used in combination with other oils. Orange oil has been shown to have antiinfective effects, in similarity with other essential oils. Caution may be required when using this oil to combat traumatic effects, as the familiarity of the aroma and the impact of odour memory may trigger psychosomatic symptoms after the event.

Safety:

Safe in therapeutic dosages. Safe for children over 6 months, safe in pregnancy, not for oral administration. Mildly irritant to skin. Avoid if sensitive to oranges. Shelf-life of 3–6 months when stored in a refrigerator.

Bibliography

Arias BA, Ramón-Laca L. Pharmacological properties of citrus oils and their ancient and medieval uses in the Mediterranean region. Journal of Ethnopharmacology. 2005;97(1):89-95.

Friedman M, Henika PR, Mandrell RE. Bactericidal activities of plant essential oils and some of their isolated constituents against Campylobacter jejuni, Escherichia coli, Listeria monocytogenes and Salmonella enterica. Journal of Food Protection. 2002;65(10):1545-1560.

Lehrner J, Marwinski G, Lehr S, et al. Ambient odors of orange and lavender reduce anxiety and improve mood in a dental office. Physiology and Behavior. 2005;86(1–2):92-95.

Patchouli (Pogostemon patchouli)

Traditional uses:

antiinflammatory, stimulant, tonic, antiseptic and febrifuge; used for depression, anxiety and stress-related conditions.

Principal constituents:

patchouline, eugenol, cadinene, α-guaiene, caryophyllene, pogostol, carvone; similar in structure to azulene found in chamomile.

Evidence:

May have antibacterial effects.

Safety:

Safe in therapeutic dosages, safe in pregnancy and children over 6 months, not for oral administration.

Bibliography

Edwards-Jones V, Buck R, Shawcross SG, et al. The effect of essential oils on methicillin-resistant Staphylococcus aureus using a dressing model. Burns. 2004;30(8):772-777.

Peppermint (Mentha piperata)

Traditional uses:

digestive problems, respiratory tract infections, antiemetic and for headaches and migraine.

Principal constituents:

menthol, limonene.

Evidence:

Peppermint is the only essential oil to be approved and included in the British Pharmacopoeia and has long been used for its carminative properties.

Safety:

Safe in therapeutic doses. Safe in pregnancy (but caution with dermal application). Safe in children over 6 months. Cardiac stimulant – caution in cardiac pathology. Skin irritant. Should not be used concurrently with homeopathic remedies as the strong aroma may inactivate the homeopathy.

Bibliography

Forbes MA, Schmid MM. Use of OTC essential oils to clear plantar warts. Nurse Practitioner. 31(3), 2006. 53–55, 57

Hur MH, Park J, Maddock-Jennings W, et al. Reduction of mouth malodour and volatile sulphur compounds in intensive care patients using an essential oil mouthwash. Phytotherapy Research. 2007;21(7):641-643.

Kim MA, Sakong JK, Kim EJ, et al. Effect of aromatherapy massage for the relief of constipation in the elderly. Taehan Kanho Hakhoe Chi. 2005;35(1):56-64.

Lim WC, Seo JM, Lee CI, et al. Stimulative and sedative effects of essential oils upon inhalation in mice. Archives of Pharmacol Research. 2005;28(7):770-774.

Norrish MI, Dwyer KL. Preliminary investigation of the effect of peppermint oil on an objective measure of daytime sleepiness. International Journal of Psychophysiology. 2005;55(3):291-298.

Rafii F, Shahverdi AR. Comparison of essential oils from three plants for enhancement of antimicrobial activity of nitrofurantoin against enterobacteria. Chemotherapy. 2007;53(1):21-25.

Rose (Rosa centifolia, Rosa damascene)

Traditional uses:

female disorders, useful in labour, antidepressant, particularly postnatal depression and generally for emotional imbalance, purported aphrodisiac.

Principal constituents:

citronellol, geraniol, nerol, linalool, phenylethyl alcohol. (Constituents may vary between species, some have high levels of ketones.)

Evidence:

Very little specific clinical research could be found, although general studies on the antibacterial effects of aromatherapy have often included rose oil.

Safety:

Safe in therapeutic dosages. Avoid until the latter part of pregnancy due to varying levels of ketones. Safe in children over 6 months. Not for oral administration. Ensure purity to avoid adulterated oils.

Bibliography

Basim E, Basim H. Antibacterial activity of Rosa damascena essential oil. Fitoterapia. 2003;74(4):394-396.

Boskabady MH, Kiani S, Rakhshandah H. Relaxant effects of Rosa damascena on guinea pig tracheal chains and its possible mechanism(s). Journal of Ethnopharmacology. 2006;106(3):377-382.

Haze S, Sakai K, Gozu Y. Effects of fragrance inhalation on sympathetic activity in normal adults. Japanese Journal of Pharmacology. 2002;90(3):247-253.

Rosemary (Rosmarinus officinalis)

Traditional uses:

antiseptic, CNS stimulant, useful for improving memory and concentration, for mental strain and exhaustion, an antispasmodic useful for dyspepsia, expectorant, used for respiratory infections and congestion, skin conditions such as seborrhoea and dandruff.

Principal constituents:

1,8-cineole, myrcene, pinene, limonene, borneol, linalool, ρ-cymene and camphor, camphene.

Evidence:

Appears to be strongly antibacterial. May have an impact on mood and concentration, particularly when inhaled.

Safety:

May cause epileptiform fits. Not for oral administration. Use with caution, in late pregnancy only. Not advised for children.

Bibliography

Atsumi T, Tonosaki K. Smelling lavender and rosemary increases free radical scavenging activity and decreases cortisol level in saliva. Psychiatry Research. 2007;150(1):89-96.

Fu Y, Zu Y, Chen L, et al. Antimicrobial activity of clove and rosemary essential oils alone and in combination. Phytotherapy Research. 2007;21(10):989-994.

Gedney JJ, Glover TL, Fillingim RB. Sensory and affective pain discrimination after inhalation of essential oils. Psychosomatic Medicine. 2004;66(4):599-606.

Luqman S, Dwivedi GR, Darokar MP, et al. Potential of rosemary oil to be used in drug-resistant infections. Alternative Therapies in Health and Medicine. 2007;13(5):54-59.

Moss M, Cook J, Wesnes K, et al. Aromas of rosemary and lavender essential oils differentially affect cognition and mood in healthy adults. International Journal of Neuroscience. 2003;113(1):15-38.

Prabuseenivasan S, Jayakumar M, Ignacimuthu S. In vitro antibacterial activity of some plant essential oils. BMC Complementary and Alternative Medicine. 2006;6:39.

Rosewood (Aniba rosaeodora)

Traditional uses:

general tonic and relaxant, immunostimulant, analgesic, acne, colds and fever, urogenital conditions, fatigue.

Principal constituents:

linalool, α-terpineol, 1,8-cineole, nerol, geraniol.

Evidence:

No specific clinical research was found, although rosewood has been implicated, with other essential oils, in causing contact dermatitis.

Safety:

Safe in therapeutic dosages, safe in pregnancy, caution with children, not for oral administration, may cause dermal irritation.

Bibliography

Schaller M, Korting HC. Allergic airborne contact dermatitis from essential oils used in aromatherapy. Clinical and Experimental Dermatology. 1995;20(2):143-145.

Sandalwood (Santalum album)

Traditional uses:

urinary tract infections, neuralgia, antiviral, antifungal, skin conditions, respiratory tract infections, decongestant and as a sedative.

Principal constituents:

pinene, santalic acid, santalele farnesol, bisabolols, terasantalic acid.

Evidence:

Shown to have antiinfective properties. May also impact on mood and concentration.

Safety:

Safe in therapeutic dosages. Safe in pregnancy and for children over 6 months. Not for oral administration. Ensure the oil is ethically sourced where possible.

Bibliography

Benencia F, Courrèges MC. Antiviral activity of sandalwood oil against herpes simplex viruses-1 and -2. Phytomedicine. 1999;6(2):119-123.

Heuberger E, Hongratanaworakit T, Buchbauer G. East Indian Sandalwood and alpha-santalol odor increase physiological and self-rated arousal in humans. Planta Medica. 2006;72(9):792-800.

Schnitzler P, Koch C, Reichling J. Susceptibility of drug-resistant clinical herpes simplex virus type 1 strains to essential oils of ginger, thyme, hyssop and sandalwood. Antimicrobial Agents and Chemotherapy. 2007;51(5):1859-1862.

Tea tree/ti tree (Melaleuca alternifolia)

Traditional uses:

antibacterial, antiviral, antifungal, antimicrobial.

Principal constituents:

α-terpinene, pinene, limonene, sabinene, aromadendrene, terpinene, 1,8-cineole, y-terpene, p-cymene (terpinen-4-ol amounts may vary).

Evidence:

Several randomized controlled studies have demonstrated the effects of tea tree oil against specific pathogens, including Candidiasis (thrush), herpes and, more recently, against MRSA.

Safety:

Safe in therapeutic dosages. Safe in pregnancy but one study suggesting that tea tree may relax smooth muscle may mean it is best avoided in labour. Not safe for children due to high risk of skin irritation. May cause severe dermal irritation in susceptible people, caution in mucosal application (e.g. vaginal). Not for oral administration except diluted as a mouth wash. In common with lavender, prolonged use in boys has shown a risk of pre-pubertal gynaecomastia.

Bibliography

Carson CF, Smith DW, Lampacher GJ, et al. Use of deception to achieve double-blinding in a clinical trial of Melaleuca alternifolia (tea tree) oil for the treatment of recurrent herpes labialis. Contemporary Clinical Trials. 2008;29(1):9-12.

Enshaieh S, Jooya A, Siadat AH, et al. The efficacy of 5% topical tea tree oil gel in mild to moderate acne vulgaris: a randomized, double-blind placebo-controlled study. Indian Journal of Dermatology, Venereology and Leprology. 2007;73(1):22-25.

Henley DV, Lipson N, Korach KS, et al. Prepubertal gynecomastia linked to lavender and tea tree oils. New England Journal of Medicine. 2007;356(5):479-485.

Hur MH, Park J, Maddock-Jennings W, et al. Reduction of mouth malodour and volatile sulphur compounds in intensive care patients using an essential oil mouthwash. Phytotherapy Research. 2007;21(7):641-643.

Kurtz JL. Prepubertal gynecomastia linked to lavender and tea tree oils. New England Journal of Medicine. 2007;356(24):2542-2543.

Mondello F, De Bernardis F, Girolamo A, et al. In vivo activity of terpinen-4-ol, the main bioactive component of Melaleuca alternifolia Cheel (tea tree) oil against azole-susceptible and -resistant human pathogenic Candida species. BMC Infectious Diseases. 2006;6:158.

Park H, Jang CH, Cho YB, et al. Antibacterial effect of tea-tree oil on methicillin-resistant Staphylococcus aureus biofilm formation of the tympanostomy tube: an in vitro study. In Vivo. 2007;21(6):1027-1030.

Reichling J, Landvatter U, Wagner H, et al. In vitro studies on release and human skin permeation of Australian tea tree oil (TTO) from topical formulations. European Journal of Pharmaceutics and Biopharmaceutics. 2006;64(2):222-228.

Rutherford T, Nixon R, Tam M, et al. Allergy to tea tree oil: retrospective review of 41 cases with positive patch tests over 4.5 years. Australasian Journal of Dermatology. 2007;48(2):83-87.

Terzi V, Morcia C, Faccioli P, et al. In vitro antifungal activity of the tea tree (Melaleuca alternifolia) essential oil and its major components against plant pathogens. Letters in Applied Microbiology. 2007;44(6):613-618.

Williams JD, Nixon RL, Lee A. Recurrent allergic contact dermatitis due to allergen transfer by sunglasses. Contact Dermatitis. 2007;57(2):120-121.

Woollard AC, Tatham KC, Barker S. The influence of essential oils on the process of wound healing: a review of the current evidence. Journal of Wound Care. 2007;16(6):255-257.

Thyme (Thymus vulgaris)

Traditional uses:

as a digestive stimulant for gastric infections, colds and sore throats and respiratory tract infections.

Principal constituents:

thymol, carvacrol, geraniol, geranyl acetate, β-caryophyllene, α-pinene, ρ-cymene, 1,8-cineole, terpinolene.

Evidence:

Strongly antiinfective.

Safety:

Safe in therapeutic dosages. Avoid in pregnancy. Not safe for children. Not for oral administration. May cause dermal and mucous membrane irritation; may cause allergic reactions.

Bibliography

Fabio A, Cermelli C, Fabio G, et al. Screening of the antibacterial effects of a variety of essential oils on microorganisms responsible for respiratory infections. Phytotherapy Research. 2007;21(4):374-377.

Schnitzler P, Koch C, Reichling J. Susceptibility of drug-resistant clinical herpes simplex virus type 1 strains to essential oils of ginger, thyme, hyssop and sandalwood. Antimicrobial Agents and Chemotherapy. 2007;51(5):1859-1862.

Tullio V, Nostro A, Mandras N, et al. Antifungal activity of essential oils against filamentous fungi determined by broth microdilution and vapour contact methods. Journal of Applied Microbiology, 6. 2007: 1544-1550.

Ylang ylang (Cananga odorata)

Traditional uses:

antidepressant, anti-anxiety, soothing and sedative. May reduce blood pressure.

Principal constituents:

linalool, geraniol, farnesol, benzyl salicylate, eugenol, β-caryophyllene, methyl benzoate.

Evidence:

Studies appear to confirm the relaxation and calming effects of ylang ylang.

Safety:

Safe in therapeutic dosages. Safe in pregnancy. Safe for children over 6 months. Not for oral administration. Check purity to avoid adulterated oil.

Bibliography

Hongratanaworakit T, Buchbauer G. Relaxing effect of ylang ylang oil on humans after transdermal absorption. Phytotherapy Research. 2006;20(9):758-763.

Imberger J, Heuberger E, Mahrhofer C, et al. The influence of essential oils on human attention and alertness. Chemical Senses, 3. 2001: 239-245.

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