National Association for Holistic Aromatherapy

15 Pages·2017·1.41 MB·English

National Association for Holistic Aromatherapy
naha.org/explore-aromatherapy/safety/naha-safety-statements
NAHA Safety Statements
For Safety Information regarding Dermal concerns, Pregnancy, Eye safety and General Safety, please click
here.
For NAHA's safety page, please visit: http://www.naha.org/explore-aromatherapy/safety/
NAHA is frequently asked about techniques such as "drop therapies" which commonly use undiluted, dermal
sensitizing essential oils, internal use, undiluted application as well as questions about companies who recommend
the indiscriminate use of essential oils. Here are our safety statements regarding each of these modalities.
1. Certain essential oils are unsuitable for internal use and application on the skin, or contain constituents which
may irritate or sensitize the skin if applied without first being properly diluted in a carrier. NAHA does not condone
the indiscriminate use of such essential oils.
2. Internal Use
Do not take essential oils internally without appropriate advanced aromatherapy education and
understanding of the safety issues involved in doing so. Essential oils are commonly used internally throughout
the world. Some individuals are doing so without the appropriate knowledge or understanding of safety concerns.
NAHA does not support the indiscriminate or uneducated internal use of essential oils. If essential oils are used
internally, we recommend doing so under the guidance of a knowledgeable health professional. To learn more, we
recommend you receive education from a NAHA approved school. NAHA is dedicated to promoting education in
this area so that internal use is better understood, and if done, is performed safely and effectively.
3. Undiluted Application
Certain essential oils are unsuitable for undiluted application on the skin, or contain constituents which may irritate
or sensitize the skin if applied without first being properly diluted in a carrier. NAHA does not support the use or
application of undiluted dermal sensitizing essential oils. NAHA recommends diluting essential oils down in a
suitable carrier (e.g. vegetable oils, unscented natural lotions, etc.). To learn more, we recommend you receive
education from a NAHA approved school.
Click here to learn more about aromatherapy!
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National Association for Holistic Aromatherapy
naha.org/explore-aromatherapy/safety
Safety Information
In this section:
Dermal Safety
Pregnancy Safety
Eye Safety
General Safety
Safety involves a state of being free from risk or occurrence of injury, harm, or danger. Individuals who practice
aromatherapy need to be aware of the safety issues involved with using essential oils in order to avoid potential
adverse effects. According to Burfield, “Although many essential oils are potentially hazardous materials, if handled
in the appropriate manner, the risks involved in their use can be very small. So therefore, most commercially offered
essential oils are safe to use for the purpose intended in a domestic/ professional or clinical environment.”1 The
informed use of essential oils may create occasional irritation or minor discomfort, but it is extremely unlikely to
create serious injury or lasting physical problems,2 particularly when basic guidelines are followed.
Factors that influence the safety of essential oils include
1. Quality of essential oil being utilized: Adulterated essential oils increase the likelihood of an adverse response
and hence the need for pure, authentic, and genuine essential oils is of the utmost importance.
2. Chemical composition of the oil: Essential oils rich in aldehydes (e.g., citronellal, citral) and phenols (e.g.,
cinnamic aldehyde, eugenol) may cause skin reactions. Essential oils rich in these constituents should always be
diluted prior to application to the skin. According to Schnaubelt, “diluting such oils so that the resulting solution
becomes non-irritant, may require diluting them to concentrations much lower than in normal circumstances.
Another option is to blend such irritant oils asymmetrically with other essential oils, which mitigate their irritant
effects.”3
3. Method of application: Essential oils may be applied on the skin (dermal application), inhaled, diffused or taken
internally. Each of these methods have safety issues which need to be considered. The potential safety concerns
with dermal application will be discussed below. With regard to inhalation, from a safety standpoint, inhalation
presents a very low level of risk to most people. Even in a relatively small closed room, and assuming 100%
evaporation, the concentration of any essential oil (or component thereof) is unlikely to reach a dangerous level,
either from aromatherapy massage, or from essential oil vaporization.4
Tisserand and Balacs further point out that “the only likely risk would be from prolonged exposure (perhaps 1 hour or
more) to relatively high levels of essential oil vapor which could lead to headaches, vertigo, nausea and lethargy”.
With regard to internal use, NAHA does not support the indiscriminate internal use of essential oils. Click here for
more information.
4. Dosage/dilution to be applied: Most aromatherapy oil based blends will be between 1 and 5 percent dilutions,
which typically does not represent a safety concern. As one increases dilution, potential dermal (skin) reactions may
take place depending on the individual essential oil, the area in which the oil is applied, and other factors related to
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the client’s own sensitivity levels. Any excessive usage of essential oils may cause irritation or other undesired
effects due to their lipophilic nature.5
5. Integrity of skin: Damaged, diseased, or inflamed skin is often more permeable to essential oils and may be
more sensitive to dermal reactions. It is potentially dangerous to put undiluted essential oils on to damaged,
diseased or inflamed skin. Under these circumstances the skin condition may be worsened, and larger amounts of
oil than normal will be absorbed. Sensitization reactions are also more likely to occur.6
6. Age of client: Infants, toddlers, and young children are more sensitive to the potency of essential oils and safe
dilutions include .5 - 2.5% depending on condition. Also, some essential oils should simply be avoided for this
population, e.g. Birch or Wintergreen, which are both rich in methyl salicylate and Peppermint. Elderly clients may
have more skin sensitivities so a reduced concentration/dilution may be indicated.
Possible Dermal Reactions
Of primary importance to the aromatherapists is the safety of essential oil application to the skin. Dermal or skin
reactions that may occur with essential oils include: irritation, sensitization and phototoxicity/photosensitization.
Dermal irritant
A dermal irritant will produce an immediate effect of irritation on the skin. The reaction will be represented on the skin
as blotchy or redness, which may be painful to some individuals. The severity of the reaction will depend on the
concentration (dilution) applied.
General safety guidelines include: avoid application of known dermal irritant essential oils on any inflammatory or
allergic skin condition; avoid undiluted application; avoid application on open or damaged skin; and dilute known
dermal irritants with appropriate vegetable oil or other carrier. If you suspect a client has sensitive skin, perform a
skin patch test. Table 1 lists some common essential oils considered to be dermal irritants.
Dermal Irritants (Table 1)
Essential Oil Latin Name
Bay Pimento racemosa
Cinnamon bark or leaf Cinnamomum zeylanicum*
Clove bud Syzygium aromaticum
Citronella Cymbopogon nardus
Cumin Cuminum cyminum
Lemongrass Cymbopogon citratus
Lemon verbena Lippia citriodora
Oregano Origanum vulgare
Tagetes Tagetes minuta
Thyme ct. thymol Thymus vulgaris
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*bark is more irritating than leaf
Dermal sensitization
Dermal sensitization is a type of allergic reaction. It occurs on first exposure to a substance, but on this occasion, the
noticeable effect on the skin will be slight or absent. However, subsequent exposure to the same material, or to a
similar one with which there is cross-sensitization, produces a severe inflammatory reaction brought about by cells
of the immune system (T-lymphocytes).7 The reaction will be represented on the skin as blotchy or redness, which
may be painful to some individuals.
The problem with dermal sensitization is that once it occurs with a specific essential oil the individual is most likely
going to be sensitive to it for many years and perhaps for the remainder of his/her life. The best way to prevent
sensitization is to avoid known dermal sensitizers and avoid applying the same essential oils every day for lengthy
periods of time. Sensitization is, to an extent, unpredictable, as some individuals will be sensitive to a potential
allergen and some will not.8
According to Burfield (2004), the following oils listed in Table 2 are considered to be dermal sensitizers and are not
recommended for use in aromatherapy massage.
Dermal Sensitizers (Table 2)
Essential Oil Latin Name
Cassia Cinnamomum cassia
Cinnamon bark Cinnamomum zeylanicum
Peru balsam Myroxylon pereirae
Verbena absolute Lippia citriodora
Tea absolute Camellia sinensis
Turpentine oil Pinus spp.
Backhousia Backhousia citriodora
Inula Inula graveolens
Oxidized oils from Pinaceae family (e.g., Pinus and Cupressus species) and Rutaceae family (e.g., citrus oils)
Photosensitization
An essential oil that exhibits this quality will cause burning or skin pigmentation changes, such as tanning, on
exposure to sun or similar light (ultraviolet rays). Reactions can range from a mild color change through to deep
weeping burns. Do not use or recommend the use of photosensitizing essential oils prior to going into a sun tanning
booth or the sun. Recommend that the client stay out of the sun or sun tanning booth for at least twenty-four hours
after treatment if photosensitizing essential oils were applied to the skin. Certain drugs, such as tetracycline,
increase the photosensitivity of the skin, thus increasing the harmful effects of photosensitizing essential oils under
the necessary conditions. Table 3 lists some common essential oils considered to be photosensitizers.
Photosensitizers (Table 3)
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Essential Oil Latin Name
Angelica root Angelica archangelica
Bergamot Citrus bergamia
Cumin Cuminum cyminum
Distilled or expressed grapefruit (low risk) Citrus paradisi
Expressed lemon Citrus limon
Expressed lime Citrus medica
Orange, bitter (expressed) Citrus aurantium
Rue Ruta graveolens
Non-phototoxic citrus oils (Table 4)
Essential Oil Latin Name
Bergamot: Bergapteneless Citrus bergamia
(FCF: Furanocoumarin Free)
Distilled lemon Citrus limon
Distilled lime Citrus medica
Mandarin - Tangerine Citrus reticulata
Sweet orange Citrus sinensis
Expressed tangerine Citrus reticulata
Yuzu oil (expressed or distilled) Citrus juno
Idiosyncratic irritation or sensitization
Idiosyncratic irritation or sensitization is an uncharacteristic or unusual reaction to a commonly used essential oil.
This type of reaction is difficult to predict and rarely occurs but is a possibility.
Mucous membrane irritant
A mucous membrane irritant will produce a heating or drying effect on the mucous membranes of the mouth, eyes,
nose, and reproductive organs. It is recommended that mucus membrane irritating essential oils not be used in a full
body bath unless placed in a dispersant first (e.g., milk, vegetable oil). It would also be wise to put the dispersed
essential oils into the water after you have gotten into the bath. Bay, clove, cinnamon bark, lemongrass, and thyme
ct. thymol essential oils should be avoided in baths completely. Table 5 lists some common essential oils considered
to be mucous membrane irritants.
Mucous membrane irritants (Table 5)
Essential Oil Latin Name
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Bay Pimento racemosa
Caraway Carum carvi
Cinnamon bark or leaf Cinnamomum zeylanicum
Clove bud or leaf Syzygium aromaticum
Lemongrass Cymbopogon citratus
Peppermint Mentha x piperita
Thyme ct. thymol Thymus vulgaris
Other Safety Considerations
Pregnancy
NAHA will be adopting similar guidelines as the International Federation of Professional Aromatherapists.
Here are their guidelines. Please visit ifparoma.org for more information about IFPA.
The use of essential oils during pregnancy is a controversial topic and one that is yet to be fully understood. The
main concern during pregnancy appears to be the risk of
essential oil constituents crossing over into the placenta. According to Tisserand and Balacs, crossing the placenta
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does not necessarily mean that there is a risk of toxicity to the fetus; this will depend on the toxicity and the plasma
concentration of the compound.9 It is probable that essential oil metabolites cross the placenta due to the intimate
(but not direct) contact between maternal and embryonic or fetal blood. Tony Burfield goes on to say, “to my thinking
the responsible attitude is to discourage the use of essential oils completely during the first few months of
pregnancy”.10
Jane Buckle comments “the use of essential oils in pregnancy is a contentious subject, especially during the vital
first 3-month period. It is extremely unlikely that a nightly bath containing a few drops of essential oils will cause any
problems for the unborn child” and later states “there are no records of abnormal fetuses or aborted fetuses due to
the ‘normal’ use of essential oils, either by inhalation or topical application.”11
According to Wildwood, “A common myth in aromatherapy is that massage oils containing essential oils such as
Clary sage, rose or even rosemary can cause a miscarriage and hence should be avoided throughout pregnancy.
Authors such as Ron Guba, Kurt Schnaubelt, and Chrissie Wildwood have all pointed out that there have been ‘no
recorded cases of miscarriage or birth defect resulting from aromatherapy massage using therapeutic applications
of any essential oil.”12
Ron Guba points out that toxicity during pregnancy is almost exclusively due to pregnant women taking large, toxic
doses of essential oils, notably pennyroyal (rich in the ketone, pulegone, which is metabolized to the highly toxic
furan epoxide, menthofuron) and parsley seed (rich in the dimethyl ether, apiol) in an attempt to abort the fetus.13
And Battaglia shares this insight: “the judicious use of essential oils together with appropriate forms of massage by
a skilled therapist can help ease the discomforts of pregnancy and provide a sense of nurturing that will comfort the
mother at times she is likely to be feeling rather fragile.”14
Due to the lack of clear information regarding the toxicity of essential oils during pregnancy, it would be best to
adhere to general safety guidelines. According to Tisserand and Balacs, the following essential oils should not be
used during pregnancy: wormwood, rue, oak moss, Lavandula stoechas, camphor, parsley seed, sage, and
hyssop.15
The following properly diluted essential oils appear to be safe for use during pregnancy: benzoin, bergamot, black
pepper, chamomile (German & Roman), clary sage, cypress, eucalyptus, frankincense, geranium, ginger, grapefruit,
juniper, lavender, lemon, mandarin, majoram (sweet), neroli, petitgrain, rose, sandalwood, orange (sweet), tea tree,
ylang ylang.
Essential oils to Avoid throughout Pregnancy, Labor, and while Breastfeeding (Table 6)
Essential Oil Latin Name
Aniseed Pimpinella anisum
Basil ct. estragole Ocimum basilicum
Birch Betula lenta
Camphor Cinnamomum camphora
Hyssop Hyssopus officinalis
Mugwort Artemisia vulgaris
Parsley seed or leaf Petroselinum sativum
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Pennyroyal Mentha pulegium
Sage Salvia officinalis
Tansy Tanacetum vulgare
Tarragon Artemisia dracunculus
Thuja Thuja occidentalis
Wintergreen Gaultheria procumbens
Wormwood Artemisia absinthium
Essential Oils and Eye Safety
by Robert Tisserand
(used with permission: www.roberttisserand.com)
There has been much social media discussion recently (February 2012) about the wisdom or otherwise of putting
essential oils into your eyes to treat eye problems. This arose from two webpages, here and (2nd page no longer
available). One of these, on the Livestrong website, states: “More and more people are choosing to use alternative
medicines to treat minor illnesses rather than taking a prescription. Putting essential oils in or near the eyes isn’t
something that is widely known about, but there are several that can aid in the treatment of eye problems. Before
using essential oils for your eyes, always contact your doctor.
Clary sage is the essential oil that is most widely used to treat vision problems. It is placed in the eye, so advice
from an optometrist is important before use. Clary sage is used as a cleanser for the eyes. It can also be used to
clear eye sight due to foggy vision or an injury to the eyes. Clary sage can also be used to brighten the eyes and
improve vision. Finally, it can have beneficial results for people with eye issues related to aging.” -Eliza Martinez
EYE IMAGE: Damage to the cornea after inadvertent
adminstration of Olbas Oil. Courtesy of Nature Publishing
Group
This actually dates from May 2010, but judging from the
related comments, has only recently been noticed. The
statement that “Clary sage is the essential oil that is most
widely used to treat vision problems” is not true, since there
are no essential oils commonly used to treat vision problems.
The only evidence for any essential oil treating any eye
problem relates to tea tree oil and eyelash mites (see below).
The reference to clary sage probably derives from 17th
century European herbalists, but this refers to using clary sage seeds, or mucilage made from them, and not to clary
sage essential oil: “The seed put into the eyes clears them from motes and such like things gotten within the lids to
offend them, and it also clears them from any white and red spots which may be on them” (Culpeper 1652). Another
common name for clary sage (Salvia sclarea) was “clear eye” because of this common use of the seeds, which
probably pre-dated Culpeper by many years. “Clary” may derive from “clear-eye.”
Not only is there no evidence that any essential oil can help with vision problems, age-related or otherwise, but
placing any essential oil “in the eye” is extremely dangerous advice. Almost any undiluted essential oil coming into
contact with the ocular membranes will be corrosive, possibly causing scarring of the cornea, and certainly causing
significant pain.
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Eye damage I could find no reports in the literature of ocular accidents involving single essential oils, but there are
several for Olbas oil. This is a mixture of essential oils and menthol:
35.45% Eucalyptus oil
35.45% Dementholized mint oil
18.5% Cajuput oil
4.1% Menthol
3.7% Wintergreen oil
2.7% Juniper berry oil
0.1% Clove oil
A 2009 report from an ophthalmologist in Bristol UK, describes partial loss of corneal tissue (ie erosion) when a 73-
year-old man dripped Olbas Oil into his left eye (he had no right eye) because he thought he was using eye drops
(see picture above). He was “considerably incapacitated”, but recovered after a week of treatment with “topical
antibiotics and lubricants”. On checking, the author found that just his hospital, in the previous 18 months, had seen
12 patients who had mistakenly dripped Olbas Oil into one eye. He describes the result as a chemical burn, though
he found that Olbas Oil in tears was pH neutral (most chemical burns are caused by substances that are strongly
acid or alkaline). All “Olbas Oil patients” recovered fully within one week following intensive treatment (Adams et al
2009).
Olbas Oil may cause problems even when not applied directly to the eyes. The mother of a 4-month-old boy placed
several drops of Olbas Oil in his right nostril in an attempt to help his respiratory infection, not realizing that the
product warns against use in infants. The child immediately showed signs of respiratory distress, and was taken to
the emergency room. Two hours after admission his eyes became inflamed, and examination revealed bilateral
superficial corneal scarring. He also had conjunctivitis, and could not open his eyes. They were flushed with saline
over four days, and he recovered with no residual scarring (Wyllie and Alexander 1994).
Emergency treatment
More than 65,000 work-related eye injuries and illnesses are reported annually in the USA, a “significant
percentage” of these being ocular chemical burns. They require rapid treatment, and severe burns have a poor
prognosis. The standard treatment is copious irrigation with saline solution for 1-2 hours. Contact lenses should not
be removed initially (Peate 2007). With essential oils, fatty oil has been suggested as an appropriate first aid
treatment though the advantage of saline is that the eyes can be continually flushed, and this is less easy with fatty
oil.
What about diluted essential oils?
The second article describes using essential oils diluted to (by my estimation) about 3%. It includes the following
advice:
“Here is a truly natural solution, which has been shown to benefit your eye health and the only one I will use. Gary
Young has used this recipe for his patients at the Ecuador Clinic for macular degeneration, health issues, cataracts,
and improving sight. I’ve been using it for a couple of years and love it! I started using this recipe before I had to
have a vision exam in order to purchase new contacts. And I knew my vision had deteriorated from my last exam.
So I put the drops in my eyes every night for about 6 months prior to the exam and my prescription had not changed
according to their records, but I know what I was not seeing and I know what I was seeing as a result of using these
drops – clearly my vision had improved! The recipe is as follows:
7-10 drops of Frankincense
7-10 drops of Rosemary
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7-10 drops of Cypress
2 Tbsp of V-6
Put oils in a glass dropper bottle with a lid on it. My experience has been that I can see much more clearly just after
putting the drops in my eye so I am also going to experiment with putting a drop in my eyes in the morning” (Diana
Ewald).
“V-6” is a proprietary blend of vegetable oils. The above implies that using these oils on a daily basis is likely to have
a healing effect in cases of cataract, macular degeneration or failing eyesight. Although the article continues to
describe various effects of the essential oils, none of them have any relationship with any of these conditions. So the
question arises – how to weigh potential benefits against potential risks?
The word “experiment” in the above seems appropriate. Eyesight problems are difficult to treat, and once damage
has occurred, recovery is not always simple. A 3% dilution may not be sufficient to cause corneal erosion, but on the
other hand there is no evidence of any benefit. One concern is that the wrong dilution may be used, and the risk of
this is substantial. For example, it would be easy to confuse “tbsp” with tsp”, resulting in a dilution of about 10%
instead of 3%.
In a Chinese study, an ointment containing 5% tea tree oil was used by patients whose eyelash follicles were
infested with “eyelash mites” (Demodex folliculorum). The ointment was applied to the lid margins with eyes closed,
daily for 4 weeks after washing the face, and resulted in considerably less itching and fewer mites. Two of the 24
patients experienced slight irritation from the ointment. The 5% concentration was arrived at after preliminary testing
using various dilutions on rabbit eyes (Gao et al 2012).
Conclusions
* Undiluted essential oils should not be applied to the eyes.
* It is rash to suggest that essential oils are commonly used to treat eye problems
* Eye injuries and diseases are medical conditions, and any product claiming to treat them is a medicine, subject to
drug legislation.
* There is currently no evidence that applying dilutions of essential oil to the eyes will be beneficial in any condition.
* Diluted (5%) tea tree oil may help eradicate eyelash mites, but it should not be placed into the eyes.
References
(for "The Eyes" only)
Adams MK, Sparrow JM, Jim S et al 2009 Inadvertent administration of Olbas oil into the eye: a surprisingly frequent
presentation. Eye (London) 23:244
Culpeper N 1652 The English Physitian, or an Astro-physical discourse of the vulgar herbs of this nation. Being a
compleat method of physick, whereby a man may preserve his body in health; or cure himself, being sick. Thomas
Kelly, London
Gao YY, Xu DL, Huang IJ et al 2012 Treatment of ocular itching associated with ocular demodicosis by 5% tea tree
oil ointment. Cornea 31:14-17
Peate WF 2007 Work-related eye injuries and illnesses. American Family Physician 75:1017-1022
Wyllie JP, Alexander FW 1994 Nasal instillation of ‘Olbas Oil’ in an infant. Archives of Disease in Childhood 70:357-
358
This article also appears in the International Journal of Professional Holistic Aromatherapy, Vol. 1 Issue 4
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