Essential Oil Safety for Health Care Professionals

Essential Oil Safety for Health Care Professionals: Clinical Applications and Risk Management

This advanced 4-hour program equips clinicians with the knowledge and skills to use essential oils safely and effectively in therapeutic practice. Drawing from Essential Oil Safety (Tisserand & Young, 2014) and current evidence, the lecture explores toxicology, pharmacokinetics, dermal and respiratory risks, drug interactions, and population-specific precautions. Participants will learn to distinguish hazard from risk, identify high-risk constituents, and manage adverse reactions.

Through practical demonstrations, attendees will calculate precise dilutions and prepare essential oil formulations for nasal inhalers, topical creams, and carrier oil blends. The course also addresses quality control, oxidation prevention, and medico-legal considerations, including FDA regulations and scope-of-practice boundaries. By the end, clinicians will be able to integrate essential oils into patient care with confidence, safety, and professional accountability.

Transcript

1. Essential Oil Safety Essential Oil Safety Guidance for Health Care Professionals Guidance for Health Care Professionals Skin and Inhaler Applications Skin and Inhaler Applications Andrew S. Bonci Andrew S. Bonci Chiropractor Chiropractor Private Practice Private Practice
2. Thank You MCPA District 2 Dr. Russ Matthias (Chiropractic Bard) Dr. Ragan Fairchild-Bonci (Retired) Photo Credit: ID 98790252 | Aromatherapy © George Tsartsianidis | Dreamstime.com 2 www.drbonci.com
3. Disclosures I have no special interest in selling you anything. Relax and enjoy yourself as I know that there are other places that you’d rather be. 3 www.drbonci.com
4. www.drbonci.com 4 Disclaimer Information provided here is for educational use only and is not a substitute for professional medical advice or treatment. Essential oil knowledge evolves; always confirm details against current research and safety standards. Follow the maxim: “When in doubt, leave it out.” Be mindful of FDA distinctions between drugs and cosmetics, and comply with all laws regulating pharmacy, compounding, and the practice of medicine. Safe use is ultimately the responsibility of the practitioner.
5. www.drbonci.com 5 ACKNOWLEDGMENT: Antoinette
6. Primary Source Alan Sorkin said, “Good writers borrow from other writers. Great writers steal from them outright.” – Andrew Bonci. Essential Oil Safety Guidance for Aromatherapy: Dermal and Respiratory Applications. Inflorescence Publishing. 2025. 6 www.drbonci.com
7. www.drbonci.com 7 Drawing on gold-standard research, this work expands into practical applications. This book transforms complex safety data into accessible guidelines for daily and professional use. Whether you are a healthcare provider, aromatherapist, or an informed home user, this manual is designed to help you practice with both effectiveness and caution.
8. www.drbonci.com 8 DEDICATION: Dr. Sam Ashkar
9. www.drbonci.com 9 tisserandinstitute.org
10. www.drbonci.com 10
11. www.drbonci.com 11 INTRODUCTION
12. Lecture Framework This lecture provides a framework of reference for those interested in the safe and effective use of essential oils in a cosmetic or therapeutic context (p. 27) . Proving safety is always a challenge, but especially when almost all the funding for research goes to single chemicals, and not to plant-derived products (p. 29) . 12 www.drbonci.com
13. www.drbonci.com 13 Lavender (Lavandula angustifolia)
14. www.drbonci.com 14 Aromatherapy The world of aromatherapy is rich with potential, offering a holistic path to well-being that engages the senses, supports the body, and calms the mind. (p. 1) Yet, amidst the well-intentioned zeal that surrounds this field, a critical element is often overlooked: the imperative of safety. Essential oils are potent, concentrated plant compounds that command respect and knowledge.
15. www.drbonci.com 15 Risk Management The practice of clinical aromatherapy, when approached with seriousness, shares a fundamental ethos with pharmacology and pharmacy: to maximize potential benefit while minimizing potential harm. (p. 1) – This requires a systematic approach to risk management, moving beyond generic guidelines to a nuanced understanding of the individual sitting before the practitioner.
16. www.drbonci.com 16 Core Principles Risk management in aromatherapy is a proactive process. (p. 1) – It involves identifying potential hazards, assessing the likelihood and severity of harm, and implementing strategies to mitigate that risk. – Never Neat!
17. www.drbonci.com 17 Patchouli (Pogostemon cablin)
18. www.drbonci.com 18 Hazard vs. Harm A hazard is the innate potential of a substance to cause adverse effects. It is an intrinsic property of the chemical constituents within the essential oil. (p. 8) – Harm (or Risk) is the likelihood that a hazard will actually cause an adverse effect under specific conditions of use. – Harm is not guaranteed; it is a function of exposure.
19. www.drbonci.com 19 Risk Management Example For instance, dermal damage from phenols, such as those found in Oregano oil, increases to a high risk if the oil is applied undiluted. (p. 8-9) Conversely, this risk becomes low when the oil is properly diluted to a safe level, such as 0.5% in a carrier oil, for a short-term, targeted purpose.
20. www.drbonci.com 20 Factor to Control Risk
21. www.drbonci.com 21 Practical Wisdom All essential oils are hazardous on some level due to their high concentration of bioactive compounds. (p. 10) Not all essential oils are harmful when used with knowledge and respect. Labeling an oil as “dangerous” focuses only on its hazard, which leads to fear and avoidance.
22. www.drbonci.com 22 What are Essential Oils? Essential oils are highly concentrated, complex mixtures of volatile aromatic compounds produced by aromatic plants as secondary metabolites. (p. 11) Steam Extraction Cooling and Separation [Hydrolat]
23. www.drbonci.com 23 Roman Chamomile (Chamaemelum nobile)
24. www.drbonci.com 24 What are Absolutes? An absolute is a highly concentrated, aromatic material extracted from delicate plant matter or resins that cannot withstand the heat of steam distillation. (p. 11) Solvent Extraction resulting in a waxy concentrate. Alcohol Washing which is then chilled, filtered, and evaporated, leaving behind the pure absolute.
25. www.drbonci.com 25 What are Tinctures? A tincture is an alcoholic extract, not a concentrated oil. (p. 10) The process of making a tincture is simple: Maceration: Plant material is covered with a solvent (e.g., alcohol, vinegar, or glycerin). Steeping for weeks, with periodic shaking. Straining: The liquid is strained from the plant matter.
26. www.drbonci.com 26 Vanilla (Vanilla planifolia) – CO2 Extract
27. www.drbonci.com 27 Comparative Overview
28. www.drbonci.com 28 Chemotypes These are plants of the same genus that are virtually identical in appearance, but which produce essential oils with different major constituents (p. 47) . – Chemotypes (CTs) are named after the main constituent(s). – e.g., Basil (CT Linalool)
29. www.drbonci.com 29 Volatiles in Essential Oils
30. www.drbonci.com 30 Phenylpropanoids
31. www.drbonci.com 31 Clove (Syzygium aromaticum)
32. www.drbonci.com 32 Contamination vs Adulteration
33. www.drbonci.com 33 Is it an Authentic Essential Oil?
34. www.drbonci.com 34 EO vs Fragrance Oil
35. www.drbonci.com 35 Paper Test: EO vs FO
36. www.drbonci.com 36 Gya Labs Rainbow Abby Aura Cacia
37. www.drbonci.com 37 Additivity vs Synergy What is frequently and casually described as synergy in popular aromatherapy is most often additivity. (p. 27) Blending two oils that contain high levels of linalool (e.g., Lavender and Ylang-ylang) does not create a new, magical compound. It makes a blend with a much higher total concentration of linalool.
38. www.drbonci.com 38 The Additivity Caution This distinction is not merely academic. (p. 27) Increased Therapeutic Load: Blending two oils with similar actions can effectively increase the dose of a desired constituent. Increased Toxicological Load: More dangerously, blending oils that share potentially irritating or toxic constituents additively increases the risk of adverse effects.
39. www.drbonci.com 39 Narrow Therapeutic Index In pharmacology, a Narrow Therapeutic Index (NTI) drug is defined as one where the difference between the dose required for efficacy and the dose that causes toxicity is very small or has a narrow margin. (p. 28) “Hot” essential oils are, in effect, the botanical world’s equivalent of NTI compounds ( phenols, aldehydes, and phenolic ethers).
40. www.drbonci.com 40 NTI Essential Oils:
41. www.drbonci.com 41 NTI Essential Oils
42. www.drbonci.com 42 General Safety Guidelines “Less is More” Prioritizing Safety and Tolerance “When in Doubt Leave it Out”
43. www.drbonci.com 43 RESPIRATORY REACTIONS
44. www.drbonci.com 44 Bronchial Hyper-Reactivity Respiratory irritation from essential oils occurs when volatile molecules stimulate nerve endings in the mucosa of the respiratory tract, primarily the trigeminal and vagus nerves. (p. 36) This stimulation can trigger reflex reactions such as coughing, laryngospasm (a sudden spasm of the vocal cords), or bronchoconstriction.
45. www.drbonci.com 45 Peppermint (Mentha × piperita)
46. www.drbonci.com 46 Sensory Irritation When an odorous substance is sufficiently pungent, trigeminal or vagal afferent C fibers in the nose, mouth and eyes are activated (Tisserand, 2014, p. 449) . – It evokes sensations such as irritation, tickling, burning, warming, cooling, and stinging in the nasal and oral cavities and in the cornea, via pain receptors and the trigeminal nerve. – Effects may be exacerbated by low humidity.
47. www.drbonci.com 47 Eucalyptus (Eucalyptus globulus)
48. www.drbonci.com 48 Risky Oils for BHR and SI
49. www.drbonci.com 49 Respiratory Allergy This reaction is distinct from the nerve- mediated irritation that causes bronchospasm, though the two conditions can sometimes occur together. (p. 36) The mechanism involves the immune system of a sensitized individual identifying airborne essential oil molecules as allergens. Sensitization / Haptenation Look for atopic shiners & intertrigo & coryza
50. www.drbonci.com 50 Spearmint (Mentha spicata)
51. www.drbonci.com 51 Anaphylaxis Anaphylaxis represents a rare but severe, life- threatening systemic allergic reaction. (p. 37) This event is the culmination of the sensitization process; upon re-exposure to the allergen, the immune system triggers a massive, body-wide release of inflammatory chemicals. This leads to a rapid and dramatic drop in blood pressure and severe airway constriction.
52. www.drbonci.com 52 Anaphylaxis is an Emergency ANAPHYLAXIS IS A MEDICAL EMERGENCY REQUIRING IMMEDIATE ADMINISTRATION OF EPINEPHRINE (EpiPen) AND A CALL TO EMERGENCY SERVICES. (p. 37) – The risk, although minute, underscores the importance of proper dilution in diffusion and respecting individual sensitivities.
53. www.drbonci.com 53 Vulnerable Populations
54. www.drbonci.com 54 Standard Adult Guideline (Neat)
55. www.drbonci.com 55 Warnings for Pediatric Use
56. www.drbonci.com 56 Never Use with Children
57. www.drbonci.com 57 Children & Elderly
58. www.drbonci.com 58 EOs to Avoid in Polypharmacy
59. www.drbonci.com 59 Oils to Avoid in Nasal Inhalers • Cinnamon (any type: leaf, bark, cassia) • Oregano • Clove (bud, leaf, stem) • Thyme (especially thymol CT) • Lemongrass • Citronella • Wintergreen • Mountain Savory • Bay Leaf (West Indian) • Pennyroyal
60. www.drbonci.com 60 Use Extreme Caution Peppermint: Highly potent. A single drop is often sufficient in a blend. Can cause respiratory reflex arrest in infants and young children. Eucalyptus: Very high in 1,8-cineole.Not recommended for asthmatics or children. Rosemary: Potent and stimulating. Can be irritating to sensitive individuals.
61. www.drbonci.com 61 Special Populations (Neat) Pregnancy, Asthma, Seizure Disorders, or Serious Health Conditions: – Consult a Healthcare Professional First. – Do not assume an oil is safe. – Avoid potent stimulants or sedatives (e.g., Peppermint, Eucalyptus Rosemary on asthmatics; Sage, Fennel during pregnancy).
62. www.drbonci.com 62 Nasal Inhaler Calculator
63. www.drbonci.com 63 NASAL INHALER LAB Neti Stik Amazon Bulk Apothecary
64. www.drbonci.com 64 SYSTEMIC OVERLOAD
65. www.drbonci.com 65 Constituent Overload A fundamental principle of toxicology, attributed to Paracelsus, is that “the dose makes the poison.” (p. 39) “Overload” refers to the cumulative strain placed on the body’s systems—primarily the liver, skin, and nervous system—from the prolonged or excessive use of oils rich in specific constituents.
66. www.drbonci.com 66 Phenolic Overload
67. www.drbonci.com 67 Aldehyde Overload
68. www.drbonci.com 68 Ketone Overload
69. www.drbonci.com 69 Furocoumarin Overload
70. www.drbonci.com 70 Sweet Orange (Citrus sinensis)
71. www.drbonci.com 71 Dermal Safety Guidelines
72. www.drbonci.com 72 Leave-On / Rinse-Off The safety profile of a topical essential oil product is fundamentally determined by whether it is designed to be left on the skin or rinsed off. (p. 43) Key factors such as exposure time, dilution percentage, and the risk of sensitization must be carefully evaluated for each application type.
73. www.drbonci.com 73 Leave-On / Rinse-Off Safety
74. www.drbonci.com 74 Neroli (Citrus aurantium)
75. www.drbonci.com 75 DERMAL REACTIONS
76. www.drbonci.com 76 Dermal Irritation Irritation is a non-immune response. It occurs when the chemical constituents of an essential oil directly damage the skin’s surface cells upon contact with the skin. (p. 32) Think of it as a localized chemical burn or abrasion.
77. www.drbonci.com 77 Allergic Contact Dermatitis This is a two-stage process involving the immune system, often misunderstood as a single event. (p. 32) Sensitization/haptenation and immune mediated dermatitis is often overlooked by the lay practitioner. It is imperative that this phenomenon is recognized and considered when working with essential oils.
78. www.drbonci.com 78 Phototoxicity Phototoxicity is a non-allergic, chemically driven reaction that occurs when certain essential oil constituents (furocoumarins) are activated by ultraviolet A (UVA) radiation from the sun or tanning beds. (p. 32) This creates a severe, localized toxic reaction that damages skin cells.
79. www.drbonci.com 79 Bergamot (Citrus bergamia)
80. www.drbonci.com 80 Minimizing Dermal Risk
81. www.drbonci.com 81 DILUTION
82. www.drbonci.com 82 The Drop Size Dilemma
83. www.drbonci.com 83 The Adhesion Problem Even when you move from drops to the more accurate method of weighing, a significant error is introduced when you transfer oils between containers. A substantial amount of precious oil can be lost as it adheres to the walls of the weighing vessel.
84. www.drbonci.com 84 Measurement Practicalities The best method depends on the context. Weighing is for precision and professionalism; dropper counts are for practicality and small-scale personal use. Understanding the limitations of each allows for informed decision-making. Measure in micrometers, mark with chalk, and cut with an axe. Err on the side of less.
85. www.drbonci.com 85 Droper per Volume
86. www.drbonci.com 86 Dilution Chart
87. www.drbonci.com 87 Dilution Guide by Application
88. www.drbonci.com 88 Leave-On Dilution Calculator
89. www.drbonci.com 89 DILUTION LAB Amazon
90. www.drbonci.com 90 CARRIER OILS
91. www.drbonci.com 91 Occlusivity Occlusivity is the property of a substance to form a physical barrier on the surface of the skin that impedes this water loss.(p. 293) The mechanism of action is purely physical: the occlusive agent creates an inert, hydrophobic layer that water molecules cannot easily penetrate, thus trapping hydration beneath it.
92. www.drbonci.com 92 Enhanced Penetration By hydrating the stratum corneum, this film can temporarily increase its permeability. (p. 293) This “plasticizing” effect can improve the absorption and efficacy of other beneficial ingredients, including essential oils, allowing them to work on more hydrated, receptive tissue. Descreased transepidermal water loss (TEWL)
93. www.drbonci.com 93 Carrier Oil Occlusivity
94. www.drbonci.com 94 EO Absorption A non-occlusive base may allow for faster absorption and a quicker perceived effect of the essential oil. (p. 295) An occlusive base may slow the absorption of essential oils help “fix” the aroma to the skin for a longer duration by reducing the evaporation of volatile compounds.
95. www.drbonci.com 95 Comedogenicity/EO Absorption A carrier oil with a higher comedogenic rating is more likely to mix with and potentially clog the sebum and keratin within pores. (p. 298) This congestion can create a reservoir effect, trapping essential oils and leading to prolonged, concentrated exposure within the follicle, thereby elevating the risk of localized irritation or sensitivity.
96. www.drbonci.com 96 General Rule of Thumb “When in doubt, leave it out.” – The risk of irritation or adverse effect is not worth the potential benefit. – There are many other gentle and effective oils (like Lavender, Frankincense, or Sandalwood) that can be used safely.
97. www.drbonci.com 97 GOOD MANUFACTURING PRACTICES
98. www.drbonci.com 98 Good Manufacturing Practices Good Manufacturing Practice (GMP) is a system of processes, procedures, and documentation that ensures products are consistently produced and controlled according to quality standards. – Ultimately, Good Manufacturing Practice is less a complex regulatory hurdle and more a formalization of common- sense principles. – It is a quality mindset, largely determined by the practitioner's commitment to diligence, cleanliness, and meticulous record-keeping.
99. www.drbonci.com 99 PRESERVING POTENCY AND SAFETY
100. www.drbonci.com 100 Enemies of Oil Integrity
101. www.drbonci.com 101 Essential Oils That Improve With Age
102. www.drbonci.com 102 EMERGENCY METHODS
103. www.drbonci.com 103 Dermal First-Aid
104. www.drbonci.com 104 What to Avoid
105. www.drbonci.com 105 Immediate Medical Attention
106. www.drbonci.com 106 MEDICO-LEGAL CONCERNS
107. www.drbonci.com 107 Practicing Medicine? Possibly, if the lotion/inhaler: – Treats a disease (e.g., “This lotion will cure your eczema”). – Claims the lotion treats a specific medical condition (beyond general wellness).
108. www.drbonci.com 108 Practicing Pharmacy (Compounding a Drug) ? Possibly, if the lotion/inhaler is: – Customized for therapeutic intent (e.g., “This will reduce your inflammation”). – Contains drug-like claims (e.g., “anti- inflammatory,” “analgesic”).
109. www.drbonci.com 109 Violating FDA Regulations? Cosmetic vs. Drug Status: – If marketed as a moisturizer (“softens skin”), it’s a cosmetic (FDA-regulated but less strict). – If marketed to treat a condition (“relieves arthritis”), it’s a drug (requires FDA approval or compounding license). OTC Monograph Violations: Some EOs (e.g., tea tree, peppermint) are listed in FDA monographs as drugs in specific contexts.
110. www.drbonci.com 110 Is It a Cosmetic, a Drug, or Both? (Or Is It Soap?) https://www.fda.gov/cosmetics/cosmetics-laws- regulations/it-cosmetic-drug-or-both-or-it-soap
111. www.drbonci.com 111 5 Key Risk-Reduction Strategies 1. Avoid Drug Claims: Use general wellness language. No therapeutic claims. List ingredients. Safe dilution. 2. Disclaimers & Documentation 3. Follow State Scope of Practice 4. Use GRAS/Generally Safe Ingredients 5. Avoid EOs with FDA drug monographs (e.g., tea tree for antifungal claims).
112. www.drbonci.com 112 My Compliance Solution www.ApothecaMythica.com
113. www.drbonci.com 113
114. www.drbonci.com 114
115. Thank You! Thank You! Andrew S. Bonci Andrew S. Bonci Chiropractor Chiropractor Private Practice Private Practice