Aromatherapy: An Overview

Massage aromatherapy is the essence of Ayurvedic therapy. It dates back to about 3500-5000 years and is one of the oldest systems of medicine. Due to its holistic approach in treating the mind, body, and spirit, aromatherapy massage is popular among patients with chronic pain and is widely used in ayurvedic spa centers.

Aromatherapy is a branch of herbal science, which involves the skillful and controlled use of essential oils for better physical, emotional, and psychological health. The psychological and physical effects of aromatherapy can recur very rapidly.

How does aromatherapy help?

The pleasantness and inexpensiveness of essential oils makes aromatherapy a popular treatment option. It is often connected to other treatments, such as massage. Thus, it is not easy to isolate its effect when applied topically.

Here is a list of benefits of aromatherapy:

• It is commonly used to manage stress in healthy individuals.

• It has been used for therapeutic pain control.

• It has been used to alleviate psychological distress like anxiety and depression in cancer patients and palliative care.

• It is popularly used to treat joint and muscle pain.

• Lemon aromatherapy is effective in controlling nausea and vomiting due to pregnancy.

• Lavender, orange, and peppermint essential oils are used to treat anxiety and nausea.

• Neroli essential oil, derived from flowers of Citrus X aurantium, can reduce systolic pressure in patients undergoing colonoscopy.

• A blend of lavender, roman chamomile, and neroli in the ratio of 6:2:0.5 can reduce anxiety, stabilize blood pressure, and increase sleep in patients undergoing cardiac stent insertion.

• Tea  tree oil and Melaleuca alternifolia have antibacterial and antifungal properties.

• Black pepper can be topically applied to improve vein visibility and palpability before intravenous catheter insertion in patients who have limited vein accessibility.

• Helichrysum italicum can be used as an antispastic, rose geranium as anti-inflammatory agent, and Origanum majorana as antimutagenic agent. However, clinical validation does not currently exist for these.

Is aromatherapy effective?

The exact biological basis of aromatherapy massage is poorly understood. Very few papers have been published about the biological outcome measures after aromatherapy massage.

There is some clinical scientific evidence that the use of essential oils treatments before and after surgeries is beneficial. Aromatherapy treatments have the potential to reduce perioperative pain, but the evidence is poor.

Thus, so far, efficacy evidence is conflicting and some literature reviews give very negative opinions.

How does aromatherapy work?

In the lowest basic level, smells can be used to stimulate the body in a psychological and physical manner. Once aromatic substances such as herbal oil are inhaled, they emit odor molecules. Receptor cells in the nasal cavity transmit impulses directly to the olfactory region of the brain. This region is closely associated to other systems of the body that control the senses of emotions, memory, sex, hormones, and heart rate. These impulses act immediately and hormones are released. The hormones act to calm, ease, elate, appease, or stimulate the individual, thus leading to mental and physical changes.

Aromatherapy is an appealing method for coping with stress because it is effective and easily implementable. The inhalation method is the most commonly used technique of delivery.

Side effects of aromatherapy

Essential oils can be contact sensitizers. Due to their complicated composition that involves being composed of 2-3 major constituents at a very high concentration and other constituents present in trace amounts, their mode of action is not completely understood. It is possible that they may interact with certain drugs. Also, peculiar metabolic conditions of a surgical patient should be kept in mind before administering aromatherapy treatment.

The reported adverse effects of aromatherapy range from mild to severe and include one fatality. The most commonly reported adverse effect is dermatitis. The most common essential oils responsible for causing adverse effects are lavender, peppermint, tea tree oil, and ylang ylang. However, this is because they are most commonly used.

A case of seizure was reported which was associated with the use of rosemary essential oil. However, this was secondary to loss of tissue sodium or potassium gradient leading to raised cellular hyperexcitability. A case of coma was also reported which was induced by the long-term abuse and intoxication from menthol present in cough droplets.

There is a tendency now-a-days to use uncommon essential oils, which are often derived from wild plants that produce several cultivars with different chemical compositions. These different chemotypes have often not been tested toxicologically. Thus, in an uncontrolled market, this non-testing could lead to such adverse effects.

References:

Lakshmi C. Allergic Contact Dermatitis (Type IV Hypersensitivity) and Type I Hypersensitivity Following Aromatherapy with Ayurvedic Oils (Dhanwantharam Thailam, Eladi Coconut Oil) Presenting as Generalized Erythema and Pruritus with Flexural Eczema. Indian J Dermatol. 2014 May;59(3):283-6. doi: 10.4103/0019-5154.131402. PubMed PMID: 24891661; PubMed Central PMCID: PMC4037951.

Yavari Kia P, Safajou F, Shahnazi M, Nazemiyeh H. The effect of lemon inhalation aromatherapy on nausea and vomiting of pregnancy: a double-blinded, randomized, controlled clinical trial. Iran Red Crescent Med J. 2014 Mar;16(3):e14360. doi: 10.5812/ircmj.14360. Epub 2014 Mar 5. PubMed PMID: 24829772; PubMed Central PMCID: PMC4005434.

Stea S, Beraudi A, De Pasquale D. Essential oils for complementary treatment of surgical patients: state of the art. Evid Based Complement Alternat Med. 2014;2014:726341. doi: 10.1155/2014/726341. Epub 2014 Feb 24. Review. PubMed PMID: 24707312; PubMed Central PMCID: PMC3953654.

Wu JJ, Cui Y, Yang YS, Kang MS, Jung SC, Park HK, Yeun HY, Jang WJ, Lee S, Kwak YS, Eun SY. Modulatory effects of aromatherapy massage intervention on electroencephalogram, psychological assessments, salivary cortisol and plasma brain-derived neurotrophic factor. Complement Ther Med. 2014 Jun;22(3):456-62. doi: 10.1016/j.ctim.2014.04.001. Epub 2014 May 2. PubMed PMID: 24906585.

Liu SH, Lin TH, Chang KM. The physical effects of aromatherapy in alleviating work-related stress on elementary school teachers in taiwan. Evid Based Complement Alternat Med. 2013;2013:853809. doi: 10.1155/2013/853809. Epub 2013 Oct 21. PubMed PMID: 24228065; PubMed Central PMCID: PMC3818840.