What is aromatherapy?

Aromatherapy is the use of essential oils from plants for healing. Although the word "aroma" makes it sound as if the oils are inhaled, they can also be massaged into the skin, or rarely, taken by mouth. You should never take essential oils by mouth without specific instruction from a trained and qualified specialist. Whether inhaled or applied on the skin, essential oils are gaining new attention as an alternative treatment for infections, stress, and other health problems. However, in most cases, scientific evidence is still lacking.

Essential oils are concentrated extracts taken from the roots, leaves, seeds, or blossoms of plants. Each contains its own mix of active ingredients, which determines the use of the oil. Some oils are used to promote physical healing. For example, to treat swelling or fungal infections. Others are used for their emotional value, they may enhance relaxation or make a room smell pleasant. Orange blossom oil, for example, contains a large amount of an active ingredient that is thought to be calming.

Essential oils have been used for therapeutic purposes for nearly 6,000 years. The ancient Chinese, Indians, Egyptians, Greeks, and Romans used them in cosmetics, perfumes, and drugs. Essential oils were also commonly used for spiritual, therapeutic, hygienic, and ritualistic purposes.

More recently, René-Maurice Gattefossé, a French chemist, discovered the healing properties of lavender oil when he applied it to a burn on his hand caused by an explosion in his laboratory. He then started to analyze the chemical properties of essential oils and how they were used to treat burns, skin infections, gangrene, and wounds in soldiers during World War I. In 1928, Gattefossé founded the science of aromatherapy. By the 1950s, massage therapists, beauticians, nurses, physiotherapists, doctors, and other health care providers began using aromatherapy.

Aromatherapy did not become popular in the U.S. until the 1980s. Today, many lotions, candles, and beauty products are sold as "aromatherapy" products. However, many of these products contain synthetic fragrances that do not have the same properties as essential oils.

Researchers are not entirely clear how aromatherapy works. Some experts believe our sense of smell may play a role. The "smell" receptors in your nose communicate with parts of your brain (the amygdala and hippocampus) that serve as storehouses for emotions and memories. When you breathe in essential oil molecules, some researchers believe they stimulate these parts of your brain and influence physical, emotional, and mental health. For example, scientists believe lavender stimulates the activity of brain cells in the amygdala similar to the way some sedative medications work. Other researchers think that molecules from essential oils may interact in the blood with hormones or enzymes.

Aromatherapy massage is a popular way of using essential oils because it works in several ways at the same time. Your skin absorbs essential oils and you also breathe them in. Plus, you experience the physical therapy of the massage itself.

Professional aromatherapists, nurses, physical therapists, pharmacists, and massage therapists can provide topical or inhaled aromatherapy treatment. Only specially trained professionals can provide treatment that involves taking essential oils by mouth.

At an aromatherapy session, the practitioner will ask about your medical history and symptoms, as well any scents you may like. You may be directed to breathe in essential oils directly from a piece of cloth or indirectly through steam inhalations, vaporizers, or sprays. The practitioner may also apply diluted essential oils to your skin during a massage. In most cases, the practitioner will tell you how to use aromatherapy at home, by mixing essential oils into your bath, for example.

Aromatherapy is used in a wide range of settings, from health spas to hospitals, to treat a variety of conditions. In general, it seems to relieve pain, improve mood, and promote a sense of relaxation. In fact, several essential oils, including lavender, rose, orange, bergamot, lemon, sandalwood, and others, have been shown to relieve anxiety, stress, and depression.

Several clinical studies suggest that when essential oils (particularly rose, lavender, and frankincense) were used by qualified midwives, pregnant women felt less anxiety and fear, had a stronger sense of wellbeing, and had less need for pain medications during delivery. Many women also report that peppermint oil relieves nausea and vomiting during labor. Similarly, preliminary studies suggest aromatherapy may be an effective approach for post-operative nausea. Other studies suggest aromatherapy in conjunction with massage can help reduce symptoms of colic in infants.

Massage therapy with essential oils (combined with medications or therapy) may benefit people with depression. The scents are thought by some to stimulate positive emotions in the area of the brain responsible for memories and emotions. But the benefits seem to be related to relaxation caused by the scents and the massage. A person's belief that the treatment will help also influences whether it works.

In one study, Neroli oil helped reduce blood pressure and preprocedural anxiety among people undergoing a colonoscopy.

In test tubes, chemical compounds from some essential oils have shown antibacterial and antifungal properties. Some evidence also suggests that citrus oils may strengthen the immune system and that peppermint oil may help with digestion. Fennel, aniseed, sage, and clary sage have estrogen-like compounds, which may help relieve symptoms of premenstrual syndrome (PMS) and menopause. However, human studies are lacking.

Other conditions for which aromatherapy may be helpful include:

• Alopecia areata (hair loss)
• Agitation, possibly including agitation related to dementia
• Anxiety
• Constipation (with abdominal massage using aromatherapy)
• Dementia
• Insomnia
• Pain. Studies have found that people with rheumatoid arthritis (RA), cancer (using topical chamomile), and headaches (using topical peppermint) require fewer pain medications when they use aromatherapy.
• Itching, a common side effect for those receiving dialysis
• Wound healing
• Herpes infections
• Menopausal symptoms
• Psoriasis

Pregnant women, people with severe asthma, and people with a history of allergies should only use essential oils under the guidance of a trained professional and with the full knowledge of their doctors.

Pregnant women and people with a history of seizures should avoid hyssop oil.

People with high blood pressure should avoid stimulating essential oils, such as rosemary and spike lavender.

People with estrogen-dependent tumors (such as breast or ovarian cancer) should not use oils with estrogen-like compounds such as fennel, aniseed, sage, and clary sage.

People receiving chemotherapy should talk to their doctors before trying aromatherapy.

As with any new therapy, people receiving medical care for any illness should talk to their doctors about any aromatherapy they are planning on using.

Most topical and inhaled essential oils are generally considered safe. You should never take essential oils by mouth unless you are under the supervision of a trained professional. Some oils are toxic, and taking them by mouth could be fatal.

Rarely, aromatherapy can induce side effects, such as rash, asthma, headache, liver and nerve damage, as well as harm to a fetus.

Oils that are high in phenols, such as cinnamon, can irritate your skin. Add water or a base massage oil (such as almond, coconut, or sesame oil) to the essential oil before applying to your skin. Avoid using oils near your eyes.

Essential oils are highly volatile and flammable. So they should never be used near an open flame.

Animal studies suggest that active ingredients in certain essential oils may interact with some medications. Researchers do not know if they have the same effect in humans. Eucalyptus, for example, may cause certain medications to be less effective, including pentobarbital (used for seizures) and amphetamine (used for narcolepsy and attention deficit hyperactivity disorder).

While there are currently no boards that certify or license aromatherapists in the U.S., many professionals are members of professional organizations. To locate a qualified aromatherapist in your area, contact the National Association of Holistic Therapy at www.naha.org. Many aromatherapists are trained in some other form of therapy or healing system, such as massage or chiropractic, and include aromatherapy in their practice.

Although essential oils have been used for centuries, few studies have looked the safety and effectiveness of aromatherapy in people. Scientific evidence is lacking and there are some concerns about the safety and quality of certain essential oils. More research is needed before aromatherapy becomes a widely accepted alternative remedy.