Essential Oils Quick Summary

OHIO STATE UNIVERSITY EXTENSION

Oils requiring dilution for adults: • Black Pepper • Lemon Eucalyptus • Cassia • Lemon Myrtle • Cinnamon • Oregano • Citronella • Thyme • Clove Source: Book Modern Essentials, 11th edition

Common Photo sensitivity Oils: • Citrus oils: bitter orange, grapefruit, lemon, lime and mandarin • Angelica root • Bergamot peel

• Rue leaf https://info.achs.edu/blog/what-is- photosensitivity-with-essential-oils

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ESSENTIALOILS

Lavender Peppermint Eucalyptus Lemongrass Patchouli Ylang-ylang A peek into safe use of essential oils Azzaro said. Popular carrier oils include jojoba, coconut, olive, almond, avocado, ssential oils have soared in popularity. Here is a primer to help you axseed, and argan oils. Eguide your patients in their safe use. Proper dilution is key to safe topical use of essential oils. According to the The basics also past president of the National Tisserand Institute, using an average Essential oils are highly concentrated Association for Holistic Aromatherapy dropper, 30 drops is equal to 1 mL. For 15 aromatic oils of plant origin that are (NAHA), which promotes academic mL of base oil, create a 5% concentration extracted by steam distillation, hydro- standards in aromatherapy education with 22 drops of essential oil; 4% con- diffusion, or pressure.1 They get their and practice standards for the profes- centration with 18 drops of essential oil; fragrances and therapeutic character- sion. According to Azzaro, aromather- 3% concentration with 13 drops of essen- istics from chemical components that apy in the United States consists mostly tial oil; 2% concentration with 9 drops of include monoterpenes, esters, aldehydes, of inhaling essential oils and massag- essential oil; 1% concentration with 4 ketones, alcohols, phenols, and oxides. ing them into the skin—not ingesting drops of essential oil; and a 0.5% con- Plant species may have different che- the oils. Patients can avoid most of the centration with 2 drops. Concentrations movarieties that may produce differ- safety risks associated with essential oils above 2.5% should be used very care- ent clinical effects. These variations of by using them externally only. Still, there fully, preferably in consultation with a subspecies produce essential oils with are dangers. NAHA-approved aromatherapist. different chemical compositions as a “People unfortunately will put [a large result of genetic variation and growth amount of an essential oil] diffuser unit, Skin stuff conditions.2 Aromatherapy is the prac- which diffuses 500 to 1,500 square feet, Some essential oils are known dermal tice of using essential oils for therapeu- in their bedroom, and that could be over- irritants, with severity depending on tic purposes.1 powering for their children or their pets,” concentration. According to NAHA, It is important to use the Latin name Azzaro said. “Or they might only need these should not be used on any in am- of the parent plant when researching it for an hour before bedtime versus let- matory or allergic skin condition and essential oils because multiple essential ting the diffuser run all night long. That should always be properly diluted in oils come from plants in the same genus. can cause an issue where they become vegetable oil. Different parts of the plant make differ- desensitized over time because they’ve Dermal irritants include bay ent oils. For example, in Citrus aurantium, been using lavender every single night (Pimento racemosa), cinnamon bark or neroli is the ower, bitter orange is the to help with sleep.” leaf (Cinnamomum zeylanicum), clove fruit peel, and petitgrain is the leaf. Tisserand Institute, an organization bud (Syzygium aromaticum), citronella To determine the quality of an essen- that “[translates] new research and sci- (Cymbopogon nardus), cumin (Cuminum tial oil product, look on the label for entific findings into comprehensive cyminum), lemongrass (Cymbopogon the Latin name of the parent plant; the educational material about the bene ts citratus), lemon verbena (Lippia citrio- part of the plant from which the oil was of essential oils” and was founded by dora), oregano (Origanum vulgare), tagetes derived; indication that the oil is for leading aromatherapy expert Robert (Tagetes minuta), and thyme chemotype external use only; a warning against its Tisserand, recommends intermittent thymol (Thymus vulgaris). use in undiluted form; a warning to keep diffusion, alternating 30 to 60 minutes of Patients should also be aware that the product away from eyes and mucous diffusion with an equal amount of time some essential oils will make them more membranes; and an expiration date or of no diffusion. sensitive to the sun and ultraviolet rays date of manufacture. The presence of this For massage, “it’s important for phar- like those encountered in a tanning bed. information doesn’t guarantee a product macists to know that essential oils Anyone who has applied photosensitiz- is of good quality, but reputable manu- applied topically need to be diluted in ing essential oils should avoid the sun or facturers should include it. a carrier oil, not put right on the skin,” tanning salon for at least 24 hours. To make further determinations about quality, it is useful to know the batch The National Association for Holistic Aromatherapy (NAHA) recommends avoiding identi er, extraction process, and coun- the following during pregnancy, labor, and breastfeeding: try of origin. Keep essential oils in the ■ Aniseed (Pimpinella anisum) ■ Pennyroyal (Mentha pulegium) refrigerator to slow oxidization, which ■ Basil chemotype estragole ■ Sage (Salvia officinalis) will affect its potency. Oxidized oils will (Ocimum basilicum) ■ Tansy (Tanacetum vulgare) have an altered smell, and viscosity may ■ Birch (Betula lenta) ■ Tarragon (Artemisia dracunculus) change as oils oxidize. ■ Camphor (Cinnamomum camphora) ■ Thuja (Thuja occidentalis) ■ Hyssop (Hyssopus officinalis) ■ Wintergreen (Gaultheria procum- Use caution ■ Mugwort (Artemisia vulgaris) bens) Kelly Holland Azzaro, RA, CCAP, ■ Parsley seed or leaf (Petroselinum ■ Wormwood (Artemisia absinthium) LMT, is an aromatherapist with nearly sativum) 3 decades of experience. Azzaro is

22 PharmacyToday • AUGUST 2019 www.pharmacytoday.org Chamomile Sage Vetiver Fennel Geranium Rosemary Tea tree According to NAHA, photosen- encing pain or anxiety associated with osteoarthritis.5 And post-tonsillectomy sitizing oils include Angelica root medical treatment. Lavender oil is a patients ages 6 to 12 years who under- (Angelica archangelica), bergamot standout—it was associated with lower went inhaled aromatherapy with laven- (Citrus bergamia), cumin (Cuminum anxiety in patients undergoing an intra- der used less acetaminophen in the 3 days cyminum), expressed lemon (Citrus uterine device insertion.3 following their surgery.6 limon), expressed lime (Citrus medica), Patients with cancer who received But caution is imperative when using expressed bitter orange (Citrus auran- inhaled aromatherapy with lavender any essential oil. For example, Azzaro tium), and rue (Ruta graveolens). reported less pain when undergoing noted that wintergreen, while common, needle insertion into an implantable cen- “is contraindicated for people who are Consult the experts tral venous port catheter.4 Aromatherapy on blood-thinning medications or tak- Studies have demonstrated the effective- massage with lavender oil was shown to ing a lot of aspirin because it has methyl ness of essential oils in patients experi- be effective in reducing pain from knee salicylate.” And a study concluded “that concomitant intake of aniseed [essen- Commonly used essential oils and purported effects and warnings1 tial oil] preparations and drugs that act Clary sage (Salvia sclarea): Used as antispasmodic, aphrodisiac, relaxant; used against menstrual cramps, on [the central nervous system] should anxiety, stress, and labor pain. Not recommended in pregnant women until the final stages of pregnancy, as be avoided due to potential herb–drug it may induce contractions. interactions,” although further study was Eucalyptus (Eucalyptus globulus): Used as expectorant, decongestant, energizer, “mind clearer”; used advised.7 against bronchitis, colds, and flu. Not recommended in children younger than 2 years. Eucalyptus oil might decrease how quickly the liver processes some medications. Azzaro urges pharmacists to consult Eucalyptus (Eucalyptus radiata): Used as expectorant and antiviral against colds, flu, and respiratory the resources on NAHA’s website, www. congestion in children. Eucalyptus oil might decrease how quickly the liver processes some medications. naha.org, and to direct patients to the Fennel (Foeniculum vulgare, variant dulce): Used as antimicrobial and digestive aid; used against menstrual site’s “Find an Aromatherapist” tool. irregularities. “When it comes to specifi c health Frankincense (Boswellia frereana): Used as immune strengthener and cell regenerator; used against issues, it’s best that they work with some- inflammatory skin conditions. body who’s trained so they know if there Geranium (Pelargonium asperum syn. graveolens): Used as antimicrobial; used against premenstrual syndrome, hormonal imbalance, and nerve pain. are any problems. Something might be Ginger (Zingiber officinale): Used as digestive aid, emotional and physical warming agent, anti- good for migraines, but it might not be inflammatory, and immune modulator; used against GI upset (flatulence, constipation, and nausea) and good for a speci c person,” she said. GI pain. “With children it’s even more of an issue, Helichrysum (Helichrysum italicum): Used as cell regenerator, anti-inflammatory, wound healer; used although there are some essential oils against bruises and swelling. that can be used with children, as well as Lavender (Lavandula angustifolia): Used as calming agent, wound healer, cell regenerator, skin care agent, antispasmodic; used against anxiety, burns, insect bites, and itchiness. hydrosols, which are much gentler than Lemon (Citrus limon): Used as antiviral, cleanser, uplifting agent, and detoxifier. A 2014 study showed that essential oils.” inhaling lemon essential oil in a carrier oil on a cotton ball relieved pregnancy-related nausea and vomiting.8 Azzaro also recommends hydrosols According to the Tisserand Institute, lemon oil should be used at no greater than 2% concentration to avoid as a safer alternative to essential oils for phototoxicity. older adults, pets, and those with complex Lemongrass (Cymbopogon citratus): Used as cleanser, antiviral, antimicrobial, and insect repellant. Con- health conditions. centration should be low to avoid phototoxicity. The Tisserand Institute at www.tisser- Mandarin (Citrus reticulata): Used as calming agent. Neroli (Citrus aurantium, variant amara): Used as antispasmodic, antidepressant, nourishing agent, and andinstitute.org is another good resource pregnancy and delivery aid; used against anxiety, premenstrual syndrome, and postpartum depression. for both pharmacists and patients. Patchouli (Pogostemon cablin): Used as antidepressant, anti-inflammatory, and nervous system References soothing agent. 1. Manion C, et al. Am J Health Syst Pharmacy. Peppermint (Mentha piperita): Used as analgesic, energizer, antispasmodic; useful against nausea and 2017;74(9):e153–62 migraines. Not recommended for use in children younger than 31 months, for undiluted topical use, or for 2. www.cancer.gov/about-cancer/treatment/ oral use other than the enteric-coated dosage form. cam/hp/aromatherapy-pdq Roman chamomile (Chamaemelum nobile): Used as antispasmodic, sedative, anti-inflammatory, 3. Shahnazi M, et al. J Caring Sci. 2012; 1(4): comforting and soothing agent for children; used against menstrual cramps, anxiety, stress, and insomnia. 255–61 Rose (Rosa damascena): Used as cell regenerator, emotional nourisher, aphrodisiac; used against stress, 4. Yayla EM, et al. Cancer Nurs. 2019; 42(1): anxiety, and premenstrual syndrome. 35–41 Rosemary (Rosmarinus officinalis): Used as expectorant, energizer, breath expander and deepener, “mind 5. Nasiri A, et al. Complement Ther Clin Pract. clearer,” circulatory stimulant; used against congestion, bronchitis, flu, and colds. 2016;25:75–80 Tea tree (Melaleuca alternifolia): Used as antimicrobial, immune system enhancer, antibacterial, 6. Soltani R, et al. Int J Pediatr Otorhinolaryn- antifungal, and antiviral. Some studies have shown promise as a treatment or deterrent for lice, but more gol. 2013;77(9):157981 evidence is needed. 7. Samojlik I, et al. Fitoterapia. 2012;83(8): Vetiver (Vetiveria zizanioides): Used as cooling agent, grounding agent, astringent, calming agent; used 1466–73 against poor circulation and varicose veins. 8. Yavari Kia P, et al. Iran Red Crescent Med J. Ylang-ylang (Cananga odorata): Used as aphrodisiac, antispasmodic, antidepressant, and 2014;16(3):e14360 nourishing agent. Rachel Balick, reporter