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Aromatherapy, or essential oil therapy, is a form of alternative medicine that uses essential oils and other naturally derived aroma compounds for a holistic therapeutic approach to psychological and overall physical well-being. While the potency and efficacy of aromatherapy has been contested, research has found it to have beneficial effects for many problems and ailments. Aromatherapy relies on the principle of absorption of essential oils, and other aromatic compounds, into the body, either through smell or skin application, which is then thought to bring about a systemic therapeutic effect. Essential oils for aromatherapy can be dispensed by various methods including the following:

  • Diffusers
  • Aromatic spritzers
  • Inhalers
  • Bathing salts
  • Body oils for massage or topical application
  • Creams for massage or topical application
  • Lotions for massage or topical application
  • Facial steamers
  • Hot compresses
  • Cold compresses
  • Clay masks
  • Aromatherapy massages
  1. Aromatherapy oils
  2. Types of aromatherapy treatments
  3. Indications for aromatherapy
  4. Preparation for aromatherapy
  5. Complications if aromatherapy
  6. Precautions and contraindications of aromatherapy

Essential oils are hydrophobic (do not mix with water) oily liquids that contain volatile (evaporate easily at room temperatures) substances in them and are generally derived from plants and other natural sources. Essential oils are named after the plant they are derived from (for example, clove oil is extracted from the clove plant) and contain the ‘essence' of the plant – that is its fragrance. However, it is important to note that the term ‘essential’ refers only to the essence of the fragrance being derived and not to an indispensable property of the oil which would make it irreplaceable to the human body (as in the case of essential amino acids or essential fatty acids, which are important nutritional requirements). Essential oils are extracted, distilled, processed and packaged for use by various industrial techniques. They are then used in the manufacturing of various perfumes, soaps, body lotions, creams, cosmetics, food flavouring, cleaning household products, incense sticks and many other lifestyle products. Essential oils are also used therapeutically in aromatherapy, also called essential oil therapy, at times. Unlike other medicinal drugs and substances, aromatherapy essential oils are not regulated by the FDA (Food and Drug Administration, USA) as they are categorised as cosmetic products. Therefore, although easily available, these products should only be purchased from reliable retailers and licensed practitioners.

Hundreds of essential oils and other aromatic compounds are available commercially for use. However, aromatherapy oils are not regulated very stringently by drug regulating authorities on account of them being categorised as cosmetic products. It is also important to note that while essential oils are purely constituted of distilled plant products, adulterated versions with additional perfumes and chemicals are also available in the market. These oils of inferior quality pose the risk of not only having subpar therapeutic effects but also of causing harmful side effects. Some popular and useful aromatherapy essential oils used include:

  • Clary sage oil (Salvia sclarea Linn.)
  • Eucalyptus oil (Eucalyptus globulus Labill)
  • Geranium oil (Pelargonium graveolens L' Herit)
  • Lavender oil (Lavandula officinalis Chaix.)
  • Lemon oil (Citrus limon Linn.)
  • Peppermint oil (Mentha piperita Linn.)
  • Roman chamomile oil (Anthemis nobilis Linn.)
  • Rosemary oil (Rosmarinus officinalis Linn.)
  • Tea tree oil (Melaleuca alternifolia Cheel)
  • Ylang ylang oil (Cananga odorata Hook. F. & Thoms)

Following are the different types of aromatherapy treatments: 

  • Aromatherapy massage: The use of essential oils and aromatic compounds with massage therapy is a popular mode of aromatherapy opted for by many individuals seeking overall physical body pain relief, alleviation of anxiety and relaxation. Many different types of massages are available to address the different needs and wants of an individual’s body. These include, but are not limited to deep tissue, swedish, prenatal and hot stone massage. Aromatherapy essential oils can be added to any type of massage therapy for an enhanced experience and outcome. While the relaxing properties of these therapies have been noted, it has also become evident that there are other benefits to be gained from aromatherapy massage like:
  • Cosmetic aromatherapy: The aim of cosmetic aromatherapy is to attain revitalised, rejuvenated and healthy skin, nails and hair. Essential oils, and their products, are applied on the skin, body, face and hair in order to cleanse, tone, moisturise and dry, as required by the individual, to achieve glowing radiant skin and hair. While creams, lotions, body washes, shampoos and other products with added essential oils are available for easy use, a few drops of pure essential oil can also be applied directly. Full body baths or foot baths are also a treatment option individuals can try.
  • Medical aromatherapy: Modern-day aromatherapy has been extended for use as complementary treatments to many ailments where their properties have been extremely useful. Notable conditions that have shown benefit with the use of adjunct aromatherapy (topical, inhalation or massage based) include, but are not limited to:
  • Olfactory aromatherapy: Inhalation of aromatherapy essential oils with diffusers, perfumes and spritzers have shown enhanced emotional wellness, calmness, relaxation or rejuvenation of the human body. The release of stress is found to be connected to pleasant essential oil scents that unlock odour memories. Although essential oils can improve and aid psychological well-being, they are not a substitute for allopathic medicine or psychiatric help. 
  • Psycho aromatherapy: Similar to olfactory, or smell-based, aromatherapy, psycho aromatherapy involves the dissension of certain essential oil scents in the individual’s habitat to bring about certain desirable moods. Emotions become associated with specific essential oil scents and upon their inhalation can return the individual to that specific state of mind.

The benefits of aromatherapy (inhalational, topical and massage based therapies) have been observed and utilised for a long time. These include, but are not limited to:

  • Improving sleep quality
  • Reducing stress
  • Addressing agitation
  • Alleviating anxiety
  • Managing pain
  • Soothing headaches and migraines
  • Antimicrobial action (antibacterial, antiviral, antifungal and insecticidal properties)

Recently, more research has been carried out to test the efficacy and potential use of aromatherapy clinically, as an adjunct complementary regimen along with allopathic medicine for enhanced outcomes. Newer applications of inhalation and massage aromatherapy include:

  • Improved physical and psychological well-being of cancer patients
  • Nausea and vomiting associated with cancer chemotherapy
  • Dysmenorrhea
  • Neuropathic pain associated with diabetes
  • Pain and functional ability in osteoarthritis (especially of the knee joints)
  • Labour pains in both passive and active phases of labour

When choosing to opt for aromatherapy treatments, it is important to find a suitable licensed aromatherapy practitioner or masseuse. As aromatherapy treatments are complementary to medical care, you must consult with your primary physician or doctor before beginning any such treatment. Before booking a session, meet with the aromatherapy practitioner who will be carrying these treatments out to discuss medical, health and other lifestyle issues the individual may experience, to create a personalised plan of treatment. Issues to discuss with the aromatherapist include the type of products and techniques to be used, as well as the number of sessions and the treatment targets. After booking an aromatherapy session, there are some steps that can be taken by individuals to have the most fulfilling and rewarding experience. In order to reap the most benefits, the following measures can be taken by aromatherapy massage seekers:

  • Addressing any cancers or issues with the aromatherapist before the session. Any preexisting allergies, a history of asthma, or known sensitivity to certain essential oils must be disclosed to the practitioner. Some essential oils can bring on an asthma attack or exacerbation of a preexisting breathing condition. In such cases, the practitioner will advise avoiding certain essential oils in susceptible people.
  • Discuss which essential oils and techniques would be used and their benefits for you with the aromatherapist. The aromatherapy practitioner usually makes recommendations based on an individual’s needs before the session. For example, citrus-based oils, like lemon oil can boost energy, lavender oil promotes relaxation and eucalyptus oil has known pain-relieving properties.
  • A skin patch test should ideally be done before the use of essential oils in aromatherapy as some essential oils can cause skin sensitivity in susceptible people.
  • Maintain adequate hydration before and after the session.
  • Have a light snack about an hour before the aromatherapy massage session to avoid dizziness or syncope.
  • Do not have a big heavy meal right before the aromatherapy massage session as it can lead to nausea and an upset stomach.
  • Avoid sun exposure after aromatherapy treatment with citrus-based oils (like lemon oil, grapefruit oil, etc) as they make the skin more sensitive to sun damage.
  • Have a hot shower after the session to wash off the extra essential oil that may still be adherent to the skin.
  • Aromatherapy sessions are designed to be a quiet relaxing experience for the individual. Therefore, the aromatherapist does not speak unless prompted by the client.
  • Individuals should feel free to ask for alterations in the application of essential oils, reduction or increase in pressure applied, change in pressure points or in the ambience of the aromatherapy room as per their preference during the session. Aromatherapy practitioners are more than happy to ensure the most fruitful experience possible for the individual.

Although most essential oils are safe for use and have minimal side effects, some of the following complications can arise.

  • Rashes
  • Asthma attacks
  • Headaches
  • Allergic reactions
  • Skin irritation
  • Nausea

Following are some things you should keep in mind about aromatherapy:

  • Never orally consume or drink essential oils.
  • Avoid certain essential oils if an individual has asthma or other preexisting breathing conditions as they may become exacerbated. Aromatherapists have a responsibility to make the patient aware of which oils may be dangerous for them. Steam inhalations can trigger attacks of asthma.
  • Essential oils should be avoided in the presence of an active skin condition like psoriasis, atopic dermatitis or eczema. If essential oils are to be used, an opinion must be taken from the individual’s dermatologist before proceeding.
  • Caution should be exercised while using aromatherapy in hypertensive patients (raised blood pressure). Red thyme, hyssop, pine, rosemary and sage oil should ideally be avoided.
  • Caution should be exercised while using essential oil therapy in patients known to suffer from epilepsy. Basil, eucalyptus, fennel, hyssop, sage and rosemary oil should be given a miss.
  • Avoid use while pregnant or breastfeeding. Essential oils may be used for labour pains under the supervision of a trained medical professional. Basil, birch, camphor, cassia, cedarwood, clary sage, clove bud, coriander fennel, sweet hyssop, jasmine, juniper, lemon, marjoram, myrrh, peppermint, rose, rosemary, sage and thyme oil should not be used in pregnancy.
  • Avoid the use of essential oils in children.
  • Never apply an essential oil to the skin directly without the use of a carrier oil. 
  • Avoid sun exposure after the use of citrus-based essential oils as it can lead to increased sun sensitivity, damage and rashes.
  • Take a hot shower after therapy to wash off excess oils on the body.

References

  1. Aziz ZAA, Ahmad A, Setapar SHM, Karakucuk A, Azim MM, Lokhat D, et al. Essential Oils: Extraction Techniques, Pharmaceutical And Therapeutic Potential - A Review. Curr Drug Metab. 2018;19(13):1100-1110. PMID: 30039757.
  2. Reis D, Jones T. Aromatherapy: Using Essential Oils as a Supportive Therapy. Clin J Oncol Nurs. 2017 Feb 1;21(1):16-19. PMID: 28107335.
  3. Boehm K, Büssing A, Ostermann T. Aromatherapy as an adjuvant treatment in cancer care--a descriptive systematic review. Afr J Tradit Complement Altern Med. 2012 Jul 1;9(4):503-18. PMID: 23983386.
  4. Zorba P, Ozdemir L. The Preliminary Effects of Massage and Inhalation Aromatherapy on Chemotherapy-Induced Acute Nausea and Vomiting: A Quasi-Randomized Controlled Pilot Trial. Cancer Nurs. 2018 Sep/Oct; 41(5):359-366. PMID: 28426542.
  5. Sut N, Kahyaoglu-Sut H. Effect of aromatherapy massage on pain in primary dysmenorrhea: A meta-analysis. Ther Clin Pract. 2017 May;27:5-10. PMID: 28438280.
  6. Gok Metin Z, Arikan Donmez A, Izgu N, Ozdemir L, Arslan IE. Aromatherapy Massage for Neuropathic Pain and Quality of Life in Diabetic Patients. J Nurs Scholarsh. 2017 Jul;49(4):379-388. PMID: 28605119.
  7. Nasiri A, Mahmodi MA. Aromatherapy massage with lavender essential oil and the prevention of disability in ADL in patients with osteoarthritis of the knee: A randomized controlled clinical trial. Complement Ther Clin Pract. 2018 Feb;30:116-121. PMID: 29389470.
  8. Tanvisut R, Traisrisilp K, Tongsong T. Efficacy of aromatherapy for reducing pain during labor: a randomized controlled trial. Arch Gynecol Obstet. 2018 May;297(5):1145-1150. PMID: 29397442.
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