Aromatherapy

The words ‘aroma’ and ‘therapy’ come from Latin and Greek and mean sweet odor or spice, and curing or healing. Aromatherapy is also referred to as essential or volatile oil therapy, and more rarely aromatic medicine. Aromatherapy encompasses the use of essential oils derived from different types of plant sources (more often the uncrushed whole plant), claimed to possess therapeutic properties, for a variety of application methods. Approximately 40 different essential oils derived from plants are used in aromatherapy, extracted either by distillation or by cold pressing (expression).1 Lavender, rosemary, eucalyptus, chamomile, marjoram, jasmine, peppermint, lemon, ylang ylang, and geranium are some of the most popular.

Aromatherapy is offered within the public healthcare system in countries such as Australia, Canada, Germany, Switzerland, the United Kingdom and the United States.

This summary includes studies which assess the effect of aromatherapy on its own or in conjunction with massage therapy.

Application, dosage and storage

Aromatherapy/essential oils can either be self-administered or administered by a practitioner. Many aromatherapists are primarily trained as massage therapists and use essential oils as part of their practices. Most commonly, oils are applied topically in diluted forms, often together with a carrier oil as part of massage therapy to manipulate the soft tissue of the body, or by using an incense burner for inhalation of the aroma. Some essential oils are also inhaled, ingested through teas, added to bathwater or pillows, or added to ointments, creams and compresses. Some aromatherapists argue that the use of certain herbs in food can be considered a part of aromatherapy. It has been suggested that a safe and effective dilution for most aromatherapy/essential oils in massage therapy is a maximum of 2.5 % for adults (2 drops of essential oil per 100 drops of carrier oil). For full-body baths the dosage of essential oil is usually 5–10 drops per bath. Essential oils are normally kept in a cool dark place, in the fridge, and out of reach of small children.

History/provider(s)

Aromatic, perfumed oils were used in ancient Egypt to embalm mummies, as well as in ancient China and India. Avicenna (c. 980 - 1037) from Persia was the first to distil oil of the rose plant.2 The burning of aromatic plants in various religious rites has also been documented. The term ‘aromatherapy’ was coined by French chemist and perfumiér René Maurice Gattefossé in the 1920s and is a subcategory of ‘herbal medicine’.3 Gattefossé suggested aromatherapy could be used to treat diseases in virtually every organ system, citing mostly anecdotal and case-based evidence.3 In the 1960s aromatherapy was revived by French homeopath Dr. Maury, and in the 1980s it increased in popularity in the United States. It is fairly well-established in countries such as Australia, Canada, France, Germany, New Zealand, Switzerland and the UK.4 Providers of essential oils are numerous and widespread in countries where aromatherapy is practiced. Training of aromatherapists and courses are offered by some schools.

Claims of efficacy

Essential oils are used to improve physical, spiritual and emotional wellbeing. A wide range of claims for the effect of certain oils have been put forward, ranging from: to affect a patient’s "subtle body;" bring balance to the chakra; restore harmony to the energy flow; become centered; contribute to spiritual growth; alter mood and improve overall health; to more specific claims such as having anticonvulsive and spasmolytic properties. It has been suggested that the topical application of aromatic oils may exert antibacterial, anti-inflammatory, and analgesic effects. For cancer patients, claims of benefits include reduced anxiety levels and relief of emotional stress, pain, muscular tension and fatigue. Some of these alleged outcomes are vaguely defined.

Mechanism(s) of action

The chemical properties and composition of a specific type of oil gives it whatever therapeutic qualities the essential oil might have. A number of theories, which can be categorized into psychological aspects and neuro-chemical effects, try to explain the mechanism of action. Effects on the limbic and olfactory system are suggested to have an effect on mood,4 but only very limited research confirms such mechanisms. Proponents of essential oils / aromatherapy also believe that the effects these oils have on the body are greater than the sum of the individual components of the scents.5

Alleged indication(s)

It has been claimed that the application of aromatherapy can help patients cope with stress, chronic pain, nausea and depression; contribute to relieving bacterial infections, stimulating the immune system, help to fight colds, flues and sore throats, increase urine production and circulation, and relieve cystitis, herpes simplex, acne, headaches, indigestion, premenstrual syndrome, muscle tension, and even cancer. Specific indications vary according to the used oil(s).6

Prevalence of use

A yet unpublished systematic review on prevalence data of cancer patients’ use of complementary and alternative medicine suggests a global use between <1 and 11% by cancer patients.7 Figures for cancer patients’ use of aromatherapy vary from country to country, including 1% in Australia (three surveys); between <1 and 4% in Canada (two surveys), <1 to 2% in Italy, Span and Turkey, 40.6% In the UK (six surveys), 11% in the US, and 6% in New Zealand.

Legal issues

Since aromatherapy can also be applied orally or rectally, the administration of such oils may not be legally permitted in several countries, unless it is applied by a medically qualified person. There may be legal issues resulting from the fact that diluted essential oils can “penetrate the skin”, which could be considered as administering a drug. National medicinal authorities in some countries have approved some products.8-9

Cost(s) and expenditures

Some cancer clinics or other voluntary organizations now offer aromatherapy or aromatherapy massage free of charge or at a lower cost. The cost of essential oils varies depending on the quality. Treatments of aromatherapy usually are priced from €40 to €75 for a 90 minute session.