Essential oils: How safe? How effective?
Given the ubiquity of these plant-based oils, your patients might ask about using them. Here’s the evidence on safety and efficacy to guide your response.
PRACTICE RECOMMENDATIONS
› Utilize lavender essential oil as an adjunctive treatment for fibromyalgia, dysmenorrhea, anxiety, and insomnia symptoms. B
› Recommend peppermint essential oil as an adjunctive treatment for irritable bowel syndrome, chemotherapy-induced nausea, and headache. B
Strength of recommendation (SOR)
A Good-quality patient-oriented evidence
B Inconsistent or limited-quality patient-oriented evidence
C Consensus, usual practice, opinion, disease-oriented evidence, case series
One RCT with 120 patients evaluated diluted intranasal peppermint oil and found that it reduced migraine intensity at similar rates to intranasal lidocaine.13 In this study, patients were randomized to receive one of the following: 4% lidocaine, 1.5% peppermint EO, or placebo. Two drops of the intranasal intervention were self-administered while the patient was in a supine position with their head suspended off the edge of the surface on which they were lying. They were instructed to stay in this position for at least 30 seconds after administration.
With regard to tension headache treatment, there is limited literature on the use of EOs. One study found that a preparation of peppermint oil applied topically to the temples and forehead of study participants resulted in significant analgesic effect.14
Fibromyalgia. Usual treatments for fibromyalgia include exercise, antidepressant and anticonvulsant medications, and stress management. Evidence also supports the use of inhaled and topically applied (with and without massage) lavender oil to improve symptoms.26 Positive effects may be related to the analgesic, anti-inflammatory, sleep-regulating, and anxiety-reducing effects of the major volatile compounds contained in lavender oil.
In one RCT with 42 patients with fibromyalgia, the use of inhaled lavender oil was shown to increase the perception of well-being (assessed on the validated SF-36 Health Survey Questionnaire) after 4 weeks.27 In this study, the patient applied 3 drops of an oil mixture, comprising 1 mL lavender EO and 10 mL of fixed neutral base oil, to the wrist and inhaled for 10 minutes before going to bed.
The use of a topical oil blend labeled “Oil 24” (containing camphor, rosemary, eucalyptus, peppermint, aloe vera, and lemon/orange) also has been shown to be more effective than placebo in managing fibromyalgia symptoms. A randomized controlled pilot study of 153 participants found that regular application of Oil 24 improved scores on pain scales and the Fibromyalgia Impact Questionnaire.28
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