Skin treatments using essential oils
Skin problems may often indicate deeper conditions such as toxins in the blood, hormonal imbalance, nervous or emotional problems (Lawless 1995) and improper diet (Ryman1991). Essential oils may be particularly effective on skin problems since they work on a variety of levels. They may act to restore a better frame of mind, to calm emotions or to remove a variety of toxins. The antimicrobial action of essential oils is also helpful is dealing with problems of the skin. Some skin conditions that seem especially amenable to the use of essential oils are eczema, herpes and fungal infections (Buckle 2003).
To investigate the efficacy of essential oils on a variety of skin-related problems, I researched methodologies of several aromatherapists with long-term experience and looked for similiarities in treatment as well as basic essential oil components such as terpenes or alcohols that might be commonly used to treat conditions even if particular essential oils varied. These were compared with clinical trials that tested the effectiveness of treatments on selected skin conditions. For the following discussion there are two tables, Table 1 includes traditionally recommended essential oil treatments and the essential oil components. Table 2 includes the essential oils used in clinical trials along with their main components.
Skin health and appearance
This is the most general category and is also the one most affected by other problems such as diet, mental condition and hygiene habits. In this case, traditional aromatherapy treatments may include a mixture of anti-microbial, oil control, uplifting, and nourishing treatments. Both Ryman (1991) and Schnaubelt (1999) recommend general improvements to the diet and cleansing of the system to assist in skin health. I include discussions of acne, hair loss and eczema in this category.
Acne is generally caused by a build up of oils on the skin. Skin with acne benefits from calendula, chamomile, juniper, lavender, mint, myrrh, myrtle, neroli, palmarosa, patchouli, petitgrain and tea tree (Ryman 1991). Care should also be used with carriers oils; they should not be heavy or greasy so that they exacerbate the problem. Schnaubelt (1999) recommends peppermint internally, perhaps as a tea rather than the essential oils, to stimulate release of toxins by the liver and then thyme linalool. Lavender, Melaleuca, and tea tree oils on the skin will help clean the skin and stimulate the formation of new, healthy skin. This treatment should be supplemented with a good diet and avoidance of dairy and pesticide or hormone treated foods.
Hair loss (alopecia) may be due to aging, a variety of physical conditions, and autoimmune diseases such as alopecia areata. Recommendations for all types of alopecia include clary sage (Ryman 1991), thyme, rosemary, lavender, carrot and sage (Worwood 1991). Most of these essential oils contain esters that are cell regenerating and that relax the nervous system (Watson). They are also gentle. In a specific clinical study of alopecia areata 86 patients were divided into two groups. The control group massaged their scalps with carrier oils while the active group used thyme, rosemary, lavender and cedarwood in a carrier oil. There was a significant improvement (44% of patients in active group vs. 15% in control) based on evaluation by blind observers using photographs (Hay et al. 1998). The practitioners chose the essential oils based on anecdotal evidence for 100 years and through their practice. A trained aromatherapist was part of the study team and this study probably provided the best clinical trial to aromatherapy practices.
For eczema, practitioners recommend benzoin, cedarwood, chamomile, geranium, juniper, orange, oregano, patchouli, rose, clary sage and sandalwood. These are oils that also work on stress and fatigue (Ryman 1991). Chamomile (both types), eases the inflammation that accompanies eczema while lavender can be used to help in healing and regeneration (Buckle 2003). A clinical trial of childhood atopic eczema used random trial with eight children and their working mothers. The treatment included counseling and a massage with essential oils in addition to normal medical treatment. The children were massaged by a therapist weekly and by their mother every day. Oils were chosen by the mothers and included sweet marjoram, frankincense, German chamomile, myrrh, thyme, benzoin, spike lavender and Litsea cubeba. The oils were chosen simply because they are often used in aromatherapy and the mother's chose an essential oil based on personal preference. The control group received counseling and massage without essential oils. The evaluation of progress in treatment of the eczema used day-time irritation scores and night-time disturbance scores plus evaluation by the therapist, a practitioner and the mother. There was no significant difference with essential oils vs. regular massage. In fact, there may have been a deterioration after the second eight weeks, perhaps due to adverse reaction. (Anderson et al. 2000). Some of the oils contain skin irritants and may have contributed to the lack of improvement. This study is an illustration of the importance of evidence-based aromatherapy over anecdotal which allows us to understand the efficacy of particular constituent properties and gives us unbiased clinical trials (Pearlstine 2006).
When skin is damaged or broken there are several considerations. One must control bacterial infections, control pain, promote blood flow and healing and prevent scarring. The best oils for these purposed are ones that are able to be used directly on the skin or within the wound itself. For sores and bruises most of the essential oils are ones that possess an alcohol/ester synergy or contain alcohol components. The alcohols make them gentler for the skin and they are mostly soothing, analgesic and antibiotic. Schnaubelt recommends Helichrysum italicum immediately after an accident as well as later to speed healing. For burns, lavender is the most famous and perhaps the most effective; German chamomile is also recommended frequently and is an anti-inflammatory. The other recommended essential oils reduce the risk of infection but also stimulate new growth and healing (see Table 1).
Wounds, whether small or large, can also be treated with seemingly effective essential oils. Most of the recommendations are intended to reduce infection and help with healing and scarring. Many are also calming and probably help with large wounds. A specific recommendation from Schnaubelt includes using Helichrysum directly in a wound to calm inflamed tissue and stimulate healing. For scarring, rose essential oil is recommended (Ryman 1991). A hospital trial (Warnke et al. 2005) used a mix of oils based on Eucalyptus to assist in healing 'malodorous necrotic ulcers' in cancer patients. The oils were chosen to provide potent antibacterial effects but a pleasant aroma and anti-inflammatory effects were also highly desirable to mask the scent of the ulcers and aid in healing (see Table 2). The patients received the standard treatment of antibiotics upon admittance to the hospital but also received a rinse of antibacterial essential oils twice a day. In all patients the bad smell accompanying the ulcer was completely resolved by the third or fourth day and inflammation was also reduced. Some of the ulcers healed completely. The doctors highly recommend this approach in palliative and cancer treatments. In addition to improved healing of ulcers, the patients were much relieved and family members were once again able to visit. The authors also suggest that antibiotic use might be reduced under this regimen.
Without question, one of the most well-known properties of essential oils is in their action on infectious agents. I found an essential oil treatment for shingles that includes geranium, lavender, myrtle and rosemary. Geranium and lavender both contain alcohols and esters which are antiviral as well as calming to the nervous system. General recommendations for viruses include phenols and terpene alcohols which are able to counteract viruses (Schnaubelt 1999). Many of these are used externally for cold sores. Antibacterial essential oils are common as are those with generally antibiotic properties.
Traditional recommendations for fungus infections such as athlete's foot, candida and ringworm include lavender, tea tree, myrrh, patchouli and sweet marjoram. Most of these contain some type of terpene which is a good antibiotics. Tea tree is especially recognized as strongly antimicrobial. A study by Carson et al (2006) used in vitro data to support the antimicrobial and anti-inflammatory properties of tea tree oil and calls it an important component of the "post-antibiotic era." In a clinical trial against herpes simplex virus type 1 and type 2, investigators used peppermint oil against the viruses (Schuhmacher et al 2003). At a 1% solution it reduced plaque formation by 82% in type 1 and 92% in type 2. In a higher concentration it was more than 90% effective. The authors recommend it as a topical therapy for recurrent herpes infections.
Insect bites and repellents
For stings and bites monoterpenes and aldehydes are generally recommended. These are antseptic, slightly analgesic and may stimulate circulation. Cold compresses are also recommended. Citronella or Melissa may also relieve pain from such bites (Ryman 1991). Citronella and mints have long been used as insect repellents. These contain a variety of compounds that can be vaporized in a room for a pleasant smell as well as keeping away pests. Lemongrass oil was tested as a mosquito repellent by Oyedele et al in 2002. They studied bite deterrence using a variety of different bases and found a 50% repellency at a 15% concentration that lasted 2 to 3 hours. They consider the citral in lemongrass to be the active ingredient. They felt that this was comparable to commercial mosquito repellent and recommend using a hydrophilic base to provide the most effective repellent.
Lice, fleas, scabies, ticks, mosquitoes, ants and moths have all been repelled by a variety of compounds including those with alcohols, aldehydes, terpenes and eugenol. It is probable that plants, throughout their history, have uniquely evolved a variety of compounds to repel insects and thus we see a many different actions in pest repellents. A test of Lippia multiflora (African bush tea) essential oil against scabies proved to be more effective than a benzyl benzoate emulsion, caused less skin irritation, and was recommended by the authors (Oladimeji et al. 2005).
An analysis of ingredients of the essential oils prescribed for a variety of skin conditions (generally for healing) indicated that many have some of the same components. One of the important characteristics of essential oils is their complexity of ingredients. However, many have one or two predominant ingredient types such as alcohols or terpenes. Essential oils used to treat the variety of skin conditions in this paper tend to contain some ingredients more commonly than others. Alcohols, monoterpenes, sesquiterpenes and esters are found in relatively high concentration in all but eight of the 44 essential oils recommended by aromatherapists for skin treatment. Most of them are found in combination with each other such as the alcohol/ester synergy indicated for essential oils such as lavender, geranium and clary sage. Monoterpenes are found in most essential oils but not always a high concentration. They can be irritating to the skin. Sesquiterpenes are anti-inflammatory, calming, and bactericidal. Alcohol may be found as a principle ingredient but is very commonly found in combination with others and may tend to 'gentle' out other active ingredients. Alcohols are strongly bactericidal, antiviral, antifungal and antiseptic while also being non-irritating. Esters are calming, anti-inflammatory, anti-fungal and are a cell regenerator (Watson, Caddy 1997). The essential oils chosen for the clinical trials had the same general characteristics, 15 of the 18 essential oils used in clinical trials contained one or more of the four oils listed above.
For general skin health and healing there are a wide variety of choices for aromatherapy practitioners. Most of them have some common healing, antiseptic and anti-inflammatory ingredients. Clinical trials have generally proved the efficacy of these treatments and tend to use essential oils that have been used traditionally or have selected ones that have similar chemical constituents.
Anderson, C., M. Lis-Balcin and M. Kirk-Smith. 2000. Evaluation of Massage with Essential Oils on Childhood Atopic Eczema. Phytotherapy Research. 14: 452-456.
Buckle, Jane 2003. Clinical Aromatherapy: Essential Oils in Practice. Churchill Livingstone, London.
Caddy, Rosemary 1997. Aromatherapy: Essential Oils in Color. Ambassador Litho Ltd., Bristol, Great Britain.
Carson, C.F., K.A. Hammer, and T.V. Riley 2006. Melaleuca alternifolia (Tea Tree) Oil: a Review of Antimicrobial and Other Medicinal Properties. Clinical Microbiology Reviews June 2006: 50-62.
Hay, I.C., M.JJamieson and A.D. Ormerod. 1998. Randomized Trial of Aromatherapy: Successful Treatment for Alopecia Areata. Arch. Dermatol. 134: 1349-1352.
Lawless, Julia 1995. The Illustrated Encyclopedia of Essential Oils. Thorsons, London, England.
Long, L., A. Huntley, E. Ernst 2001. Which complementary and alternative therapies benefit which conditions? A survey of the opinions of 223 professional organizations. Complementary Therapies in Medicine 2001: 178-185.
Oladimeji, F.A., L.O. Orafidiya, T.A.B. Ogunniyi, T.A. Adewunmi, and O. Onayemi. 2005. A comparative study of the scabicidal activities of formulations of essential oil of Lippia multiflora Moldenke and Benzyl benzoate emulsion BP. The International Journal of Aromatherapy 2005: 15: 87-93.
Oyedele, A.O., A.A. Gbolade, M.B. Sosan, F.B. Adewoyin, O.L. Soyelu and O.O. Orafidiya. 2002. formulations of an effective mosquito-repellent topical product from Lemongrass Oil. Phytomedicine 9: 259-262.
Pearlstine, Leonard 2006. Araomatherapy Science. Aromascents 35: 17-24.
Ryman, Danielle 1991. Aromatherapy: The Complete Guide to Plant and Flower Essences for Health and Beauty. Bantam Books, New York, NY.
Schnaubelt, Kurt 1995. Advanced Aromatherapy: The Science of Essential Oil Therapy. Healing Arts Press, Rochester, VT.
Schnaubelt, Kurt 1999. Medical Aromatherapy: Healing with Essential Oils. Frog, Ltd. Berkeley, CA.
Schuhmacher, A., J. Reichling, and P. Schnizler 2004. Virucidal effect of peppermint oil on the enveloped viruses herpes simplex virus type 1 and type 2 in vitro. Phytomedicine 10: 504-510.
Tisserand, Robert B. 1977. The Art of Aromatherapy: The Healing and Beautifying Properties of the Essential Oils of Flowers and Herbs. Healing Arts Press, Rochester, Vermont.
Warnke, P.H., E. Sherry, P.A.J. Russo, Y. Acil, J. Wiltfang, S. Sivananthan, M. Sprengel, J. C. Roldan, S. Schubert, J.P. Bredee, and I.N.G. Springer. Phytomedicine -------
Worwood, Valerie Ann 1991. The Complete Book of Essential Oils and Aromatherapy New World Library, Novato, CA