Essential Oil Safety for Healthcare Providers

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. Acknowledgments 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. Primary Source Alan Sorkin said, “Good writers borrow from other writers. Great writers steal from them outright.” – Robert Tisserand and Rodney Young. Essential Oil Safety: A Guide for Health Care Professionals. Elsevier Health Sciences. 2nd Edition, 2014. – Page numbers in this presentation are from Tisserand and Young (2014). 4 www.drbonci.com
5. www.drbonci.com 5 Want the Slides? www.drbonci.com
6. www.drbonci.com 6 INTRODUCTION
7. 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) . 7 www.drbonci.com
8. www.drbonci.com 8 Lavender (Lavandula angustifolia) Top Terpenes: Linalool (~30–50%), Linalyl acetate (~25–45%). Top 3 Uses: Stress relief, wound healing, sleep aid. Irritation: Low (safe at 2–5% dilution). Haptenation: Low (oxidized linalool may sensitize). Phototoxicity: None. Bronchial Hyper-Reactivity: Low (may relax airways).
9. www.drbonci.com 9 Aromatherapy Aromatherapy is not a single discipline, but can include almost any application of essential oils to the human body (p. 29) . This would include natural perfumes (mixtures of essential oils, absolutes, etc.) and personal care products that contain them. 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.
10. www.drbonci.com 10 Potential for Toxicity Toxicity in essential oils is an attribute we welcome when we want them to kill viruses, bacteria, fungi or lice, and human cells share some characteristics with these very small organisms (p. 31) . – So it should not be totally surprising that some of the most useful antimicrobial essential oils, such as eucalyptus, garlic and savory, possess a degree of human toxicity.
11. www.drbonci.com 11 Adverse Reactions Adverse reactions include abortion or abnormalities in pregnancy, neurotoxicity manifesting as seizures or retardation of infant development, a variety of skin reactions, bronchial hyperreactivity, hepatotoxicity and more. Interactions with chemotherapeutic or other prescribed drugs are a particular concern (p. 32) .
12. www.drbonci.com 12 Accidents Most accidents with essential oils involve young children, and are preventable (p. 32) . – In the quantities in which they are most commonly sold (5–15 mL), essential oils can be highly toxic or lethal if drunk by a young child, and there have been a number of recorded fatal cases over the past 70 years.
13. www.drbonci.com 13 Hazard v. Risk We live in a world replete with toxic substances, yet ‘hazard’ should not be confused with ‘risk’ (p. 34) . – The presence of a toxic substance (hazard) is only problematic if exposure is sufficiently great (risk). – Context is often important too. – Leave-On versus Rinse-Off products
14. www.drbonci.com 14 Patchouli (Pogostemon cablin) Top Terpenes: Patchoulol (~30%), α-Bulnesene (~15%). Top 3 Uses: Grounding, antifungal, skin regeneration. Irritation: Low (safe at 1–2%). Haptenation: Very low. Phototoxicity: None. Bronchial Hyper-Reactivity: None.
15. www.drbonci.com 15 ESSENTIAL OIL COMPOSITION
16. www.drbonci.com 16 Plant Oils Plants are capable of synthesizing two kinds of oils: fixed oils and essential oils (p. 40) . – Fixed oils consist of esters of glycerol and fatty acids (triglycerides or triacylglycerols). – Essential oils are mixtures of volatile, organic compounds originating from a single botanical source, and contribute to the flavor and fragrance of a plant.
17. www.drbonci.com 17 Eucalyptus (Eucalyptus globulus) Top Terpenes: 1,8-Cineole (~70%), α-Pinene (~10%). Top 3 Uses: Decongestant, antimicrobial, pain relief. Irritation: Moderate (dilute to 1–2%). Haptenation: Low (unless oxidized). Phototoxicity: None. Bronchial Hyper-Reactivity: High (avoid in asthma/COPD).
18. www.drbonci.com 18 Essential Oils The word ‘essential’ is used to reflect the intrinsic nature or essence of the plant, and ‘oil’ is used to indicate a liquid that is insoluble in, and immiscible with, water (p. 41) .
19. www.drbonci.com 19 Environmental & Agricultural Factors Terroir (Growing Conditions) – Temperature, humidity, and sunlight exposure alter terpene synthesis. Altitude: Higher elevations often increase terpene concentration Soil Composition: Mineral Conten pH Levels: Slightly acidic soils favor certain terpenes (e.g., myrcene in hops). Water Availability: Drought stress can increase monoterpenes
20. www.drbonci.com 20 Hydro/Steam Distilled The principal historical method for isolating essential oils was hydrodistillation, in which the plant material is boiled in water (p. 42) . During steam distillation, volatile plant constituents are vaporized and then condensed on cooling to produce an immiscible mixture of an oil phase and an aqueous phase.
21. www.drbonci.com 21 Peppermint (Mentha × piperita) Top Terpenes: Menthol (~40%), Menthone (~20%). Top 3 Uses: Headache relief, digestive aid, cooling muscle rub. Irritation: Moderate (dilute to 1–2%). Haptenation: Low. Phototoxicity: None. Bronchial Hyper-Reactivity: High (menthol triggers cough reflex, laryngiospasm in children).
22. www.drbonci.com 22 Cold Pressing Citrus oils may be extracted by cold pressing (expression) (p. 44) . – “FCF” (Furanocoumarin-Free) Oils: Bergamot FCF and steam-distilled citrus oils (e.g., distilled lime) are non-phototoxic. – Dilution Limits: For phototoxic citrus oils, keep ≤0.4% in leave-on products (e.g., 2 drops per 30ml lotion). – Sun Avoidance: Wait 12–24 hours after application before UV exposure.
23. www.drbonci.com 23 Sweet Orange (Citrus sinensis) Top Terpenes: Limonene (~90%), Myrcene (~2%). Top 3 Uses: Mood booster, digestive aid, cleaning. Irritation: Moderate (safe at 2–4%). Haptenation: Moderate (oxidized limonene). Phototoxicity: Moderate (only cold-pressed; distilled is safe). Bronchial Hyper-Reactivity: None.
24. www.drbonci.com 24 Essential Oil Yield Fresh aromatic plant material typically yields 1– 2% by weight of essential oil on distillation, although a typical yield from roses is 0.015%, and rose otto is consequently highly priced (p. 45) .
25. www.drbonci.com 25 Solvent Isolation Fresh aromatic plant material typically yields 1– 2% by weight of essential oil on distillation, although a typical yield from roses is 0.015%, and rose otto is consequently highly priced (p. 45) . Fragrant oils can also be extracted with organic solvents, producing concretes, absolutes or resinoids, or with liquid carbon dioxide, producing CO2 extracts .
26. www.drbonci.com 26 Essential Oil Composition Essential oils typically contain dozens of constituents with related, but distinct, chemical structures (p. 45) . – Each constituent has its characteristic odor and pattern of effects on the body. – Monoterpenes (C10) – Sesquiterpnes (C15) – Diterpenes (C20)? – Terpene-adjacent compounds
27. www.drbonci.com 27 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)
28. www.drbonci.com 28 Roman Chamomile (Chamaemelum nobile) Top Terpenes: Isobutyl angelate (~37%), Butyl angelte (~35%). Top 3 Uses: Calming, anti-inflammatory, skin soothing. Irritation: Very low (safe for babies at 0.5–1%). Haptenation: Low. Phototoxicity: None. Bronchial Hyper-Reactivity: None.
29. www.drbonci.com 29 Contaminants Contaminants are substances that are not natural constituents, artifacts of distillation, or adulterants (adulteration being intentional dilution or fabrication) (p. 48) . – They can include plasticizers and pesticides, or traces of solvent in solvent-extracted products.
30. www.drbonci.com 30 Biocides There are over 400 chemical biocides (pesticides or herbicides) that might be used on aromatic plants, and many of these do carry over during steam distillation (p. 49) . – The products of solvent extraction (absolutes, resinoids and CO2 extracts) are even more likely to retain any biocides, as are cold-pressed citrus oils.
31. www.drbonci.com 31 Biocide Absorption It is feasible that an essential oil might enhance the dermal absorption of a biocide, and exposure through inhalation is also possible (51) . – The potential toxicity from biocides in essential oils is minimal, but still contributes to the total xenobiotic load, especially if biocides are also being ingested in foods, and zero exposure is surely preferable.
32. www.drbonci.com 32 Adulteration The purpose of adulteration is to increase profits by adding either odorous or non-odorous substances in order to dilute an essential oil or absolute (p. 55) . – Odorous adulterants include essential oil fractions or residues and synthetic aromachemicals. – Non-odorous adulterants, or ‘extenders’, include ethanol, mineral oil, isopropyl myristate, glycols, phthalates, and fixed oils such as rapeseed and cottonseed.
33. www.drbonci.com 33 Oil Purity? There are no tests that guarantee purity per se, but analysis by gas chromatography (GC) can be extremely useful (p. 58) . Olfactory evaluation by a trained nose may be a useful adjunct to laboratory analysis, but it will not detect non-odorous adulterants (59) .
34. www.drbonci.com 34 Degradation The three principal factors responsible for essential oil degradation are (p. 59) : 1. oxygen 2. heat 3. uv-light.
35. www.drbonci.com 35 EO Chemistry in Brief The types of compound found in essential oils include hydrocarbons, alcohols, phenols, aldehydes, ketones, esters, ethers, peroxides, lactones, carboxylic acids, furans, furanocoumarins and sulfur compounds (p. 104) .
36. www.drbonci.com 36 TOXICITY
37. www.drbonci.com 37 Adverse Effects Toxicity can manifest locally or systemically in a number of ways (p. 118) . – It may involve the reversible or irreversible disruption of normal biochemical processes, which may result in impairment or loss of cell viability and regenerative capacity. – In extreme cases, whole organs may fail and the organism may die.
38. www.drbonci.com 38 Susceptibility Toxicity also depends on the frequency and duration of use and on the susceptibility of the individual (p. 118) . Individual sensitivity to potentially toxic substances can vary considerably, depending on such factors as age, gender, genetic profile, nutritional status and health status.
39. www.drbonci.com 39 Therapeutic Window The therapeutic window (or pharmaceutical window) of a drug is the range of drug dosages which can treat disease effectively without having toxic effects (https://en.wikipedia.org/wiki/Therapeutic_index) . – Medication with a small therapeutic window must be administered with care and control, frequently measuring blood concentration of the drug, to avoid harm.
40. www.drbonci.com 40 Interactions Between Compounds When two or more substances are co- administered, three outcomes are possible (p. 122) . – Additivity – Synergy – Antagonism Although the toxicity of an essential oil cannot always be predicted from its chemical composition, the actions of major constituents tend to dominate (p. 124).
41. www.drbonci.com 41 Poisoning Virtually all cases of serious poisoning from essential oils are a consequence of oral ingestion of the undiluted oil, in amounts much higher than therapeutic doses (p. 126) . – Judging from the large quantities ingested, a few were probably suicides. (Death from essential oil overdose is slow, and can take from 15 minutes to 3 days.)
42. www.drbonci.com 42 Remember These Camphor and methyl salicylate, and the oils of clove, cinnamon and eucalyptus, are most frequently and consistently reported to cause toxicity (p. 126) . – In recent years, cases of tea tree oil ingestion have escalated in the USA. – With less frequency, ingestion of citronella, hyssop, pennyroyal, sage, sassafras, thuja or wormseed oil has all caused toxicity in humans.
43. www.drbonci.com 43 KINETICS AND DOSING
44. www.drbonci.com 44 Therapeutic Goal The aim of the therapist in administering a physiologically active substance is to elicit the maximum therapeutic benefit while keeping any accompanying toxic or otherwise undesirable effects to a minimum (p. 186-187) . For many essential oil constituents, reliable quantitative information about the latter two points is not currently available.
45. www.drbonci.com 45 Spearmint (Mentha spicata) Top Terpenes: Carvone (~50%), Limonene (~15%). Top 3 Uses: Digestive support, focus, mild pain relief. Irritation: Low (safer than peppermint). Haptenation: Low. Phototoxicity: None. Bronchial Hyper-Reactivity: Moderate (less than peppermint).
46. www.drbonci.com 46 Absorption It depends on the following factors (p. 188) : – the substance administered – the mode and route of administration – the recipient Bioavailability is subject to biological variation (p. 190). No two individuals will handle the same substance in the same way because of factors such as health status, nutritional status, age, integrity of skin, and metabolism.
47. www.drbonci.com 47 Distribution The distribution of substances within the body is largely determined by their solubility in the various aqueous and fatty body compartments (p. 226) . – Once absorbed into the bloodstream, the extent to which a substance is taken up by different body tissues depends partly on the amount of blood they receive (p. 227).
48. www.drbonci.com 48 Metabolism Firstly, a metabolite is usually more hydrophilic than its parent compound, and it will therefore be eliminated more rapidly via the kidneys (p. 232) . Secondly, a metabolite usually has different pharmacological and/or toxicological properties compared to its parent compound.
49. www.drbonci.com 49 Phase I & II Reactions Phase I reactions are hydrolysis, oxidation and reduction, and they occur primarily in the liver (p. 234) . Phase II reactions are also known as conjugation reactions. (p.236) They are those in which substances are combined with polar endogenous molecules in order to substantially reduce their lipid solubility and prepare them for excretion.
50. www.drbonci.com 50 Excretion The main organs of excretion are the kidneys, liver, lungs and skin (p. 245). – For many substances, the most important of these is the kidney, which functions as a filter for the blood. – Very small amounts of essential oil constituents may be released into various body secretions, including sweat, saliva and milk.
51. www.drbonci.com 51 Neroli (Citrus aurantium) Top Terpenes: Linalool (~54%), Limonene (~15%). Top 3 Uses: Anxiety relief, skin rejuvenation, hormonal balance. Irritation: Low. Haptenation: Low. Phototoxicity: None (bergapten-free). Bronchial Hyper-Reactivity: None.
52. www.drbonci.com 52 Drug Interactions When the pharmacological or toxicological consequences of administering two or more drugs concurrently cannot be directly attributed to their individual actions, a drug interaction is said to occur (p. 247) . – This can be especially problematic for drugs with narrow therapeutic indexes or when blood plasma levels must be maintained within a specified range.
53. www.drbonci.com 53 Cytochrome P450 Family Enzyme Inductors increase the production of metabolic enzymes causing a decrease in the blood levels of a drug.(p. 250). Enzyme Inhibitors decrease the production of metabolic enzymes causing an increase in the blood level of a drug.
54. www.drbonci.com 54 Monoamine Oxidase Monoamine oxidase (MAO) is an enzyme that breaks down certain neurotransmitters, including serotonin, dopamine, epinephrine and norepinephrine (p. 258) . – Myristicin, a constituent of nutmeg oil, appears to inhibit rodent brain MAO, as does nutmeg oil, albeit in higher doses than myristicin
55. www.drbonci.com 55 Champaca (Michelia champaca) Top Terpenes: 2-Phenylethanol (~34%), Indole (~12%). Top 3 Uses: Perfumery, meditation, aphrodisiac. Irritation: Low. Haptenation: Low. Phototoxicity: None. Bronchial Hyper-Reactivity: None.
56. www.drbonci.com 56 Blood Clotting Several clinical cases raise the question of a possible potentiating effect of topically applied salicylates on the action of the anticoagulant, warfarin, and the kind of symptoms this can cause (p. 260).
57. www.drbonci.com 57 THE SKIN
58. www.drbonci.com 58 Adverse Skin Reactions Fragrance is the second most common cause of skin allergy (Type IV Delayed Hypersensitivity) , after nickel (p. 306-307) . – However ‘fragrance’ is not a single substance; it is a term that encompasses thousands of chemicals and hundreds of essential oils. – Risk needs to be balanced with benefit. – If every essential oil was used at a level that presented zero risk, there would be no benefits at all.
59. www.drbonci.com 59 Types of Skin Reactions The three principal categories of adverse skin reaction relevant to essential oils are (p. 397) – Irritation (ICD), – Sensitization (ACD) and – Photosensitization.
60. www.drbonci.com 60 Vanilla (Vanilla planifolia) – CO2 Extract Top Terpenes: Vanillin (~85%), 4-Hydroxybenzaldehyde (8.5%). Top 3 Uses: Relaxation, aphrodisiac, flavoring. Irritation: Very low. Haptenation: None. Phototoxicity: None. Bronchial Hyper-Reactivity: None.
61. www.drbonci.com 61 Irritation Irritation causes reversible skin damage, and is less severe than corrosion (p. 330) . – Corrosive chemicals, which include acids and alkalis, usually act on the surface of the skin, disrupting its function as a barrier. – These chemicals may dissolve the stratum corneum, allowing water to be lost from the tissues and harmful substances to penetrate into deeper layers of the skin.
62. www.drbonci.com 62 5 Irritating Essential Oils Cinnamon Bark (Cinnamomum zeylanicum) Oregano (Origanum vulgare) Clove Bud (Syzygium aromaticum) Lemongrass (Cymbopogon citratus) Thyme CT Thymol (Thymus vulgaris)
63. www.drbonci.com 63 Sensitization/Haptenation The mechanisms involved in sensitization are quite well understood, and generally involve the binding of haptens to dermal proteins (p. 398) . – The allergen is then large enough to be recognized by antigens on Langerhans cells, which interact with T-helper cells, leading to the release of histamine from mast cells.
64. www.drbonci.com 64 Clove (Syzygium aromaticum) Top Terpenes: Eugenol (~80%), β-Caryophyllene (~10%). Top 3 Uses: Dental pain relief, antifungal, immune support. Irritation: High (max 0.5% dilution). Haptenation: High (eugenol is sensitizing). Phototoxicity: None. Bronchial Hyper-Reactivity: Moderate (avoid inhalation in asthma).
65. www.drbonci.com 65 Type IV: Delayed Hypersensitivity The most common skin reaction to fragrance materials is sensitization, which causes ACD (p. 398) . – It is generally a delayed hypersensitivity reaction that manifests as a rash.
66. www.drbonci.com 66 5 Hapenizing Essential Oils • Tea Tree (Melaleuca alternifolia) • Lemon (Cold-Pressed) (Citrus limon) • Lavender (Lavandula angustifolia) • Ylang-Ylang (Cananga odorata) • Peru Balsam (Myroxylon balsamum)
67. www.drbonci.com 67 Risk Factors The factors that affect adverse skin reactions all involve one or more of the following (p. 397) : – dose metrics (duration of exposure, quantity and concentration of substance) – degree of percutaneous absorption of substance – degree of reactivity between substance and immune system.
68. www.drbonci.com 68 Oxidized Oils Oxidized essential oils are more likely to cause adverse skin reactions (p. 399) . – It is recommended that effective antioxidants be used in preparations containing oxidation-prone essential oils.
69. www.drbonci.com 69 Phototoxicity Phototoxicity is a skin reaction that occurs in the presence of a phototoxic chemical and ultraviolet light in the UVA range, leading to the formation of ROS, and sun damage on the skin (p. 399-400) . – The most common phototoxic agents found in essential oils are the furanocoumarins, such as bergapten, which can be phototoxic even at very low concentrations.
70. www.drbonci.com 70 Bergamot (Citrus bergamia) Top Terpenes: Limonene (~35%), Linalyl acetate (~25%). Top 3 Uses: Mood uplift, antiseptic, digestive aid. Irritation: Low (unless oxidized). Haptenation: Moderate (oxidized limonene). Phototoxicity: High (bergapten; use FCF for safety). Bronchial Hyper-Reactivity: Low (avoid in asthma if oxidized).
71. www.drbonci.com 71 Photoallergy This is an uncommon type of skin reaction to UV light; an allergic reaction without pigmentation (p. 361) . – Photoallergens have been shown to bind to proteins in the skin under the influence of UV light. – The most common photoallergens are chemicals used as sunscreens. – Phototoxicity can increase photoallergy risk.
72. www.drbonci.com 72 Managing Adverse Skin Reactions Once an allergic reaction begins it cannot be halted, but any essential oil remaining on the surface of the skin should be removed by washing the skin with soap, preferably unperfumed (p. 381-382) . – A long-term approach to dealing with intolerance to cosmetics and perfumes in general is complete avoidance of all cosmetic and cleaning products for a period of time
73. www.drbonci.com 73 Occlusive Carriers Carriers that form a physical barrier on the skin, reducing transepidermal water loss (TEWL) by sealing in moisture. – Texture: Thicker, greasier, slower to absorb. – Prolonged Absorption: Forms a barrier that slows evaporation of Eos – Increasing skin contact time with EOs enhances potential for adverse reations. – Can lead to systemic buildup of EOs – Increases risk of sensitization
74. www.drbonci.com 74 Occlusive Carriers Examples Mineral oil (highly occlusive, not natural). Jojoba oil (technically a wax ester, semi- occlusive). Shea butter (solid at room temp, highly occlusive). Coconut oil (solid below 76°F, moderately occlusive). Avocado oil (heavy, rich in oleic acid)
75. www.drbonci.com 75 Non-Occlusive Carriers Oils that absorb quickly without forming a barrier, allowing skin to “breathe.” – Texture: Lightweight, fast-absorbing, non-greasy. – Reduced Absorption: EOs absorb or evaporate quickly minimizing systemic exposure. – Less risk of EO adverse reactions.
76. www.drbonci.com 76 Non-Occlusive Carriers Examples Grapeseed oil (high linoleic acid, astringent). Sunflower oil (light, non-comedogenic). Hemp seed oil (fast-absorbing, anti- inflammatory). Fractionated coconut oil (liquid, non-greasy).
77. www.drbonci.com 77 Dilution Guidelines Facial Lotion: 0.5% - 1% Body Lotion: 1% - 2% Targeted Treatment (e.g., muscle relief): 2% - 3% (avoid face). Children (2+ yrs) / Elderly: 0.25% - 0.5%
78. www.drbonci.com 78 Dilution Math Carrier How may carrier drops are in: 1 mL = 20 drops 5 mL = 100 drops 10 mL = 200 drops 15 mL = 300 drops 30 mL = 600 drops
79. www.drbonci.com 79 Semi-Occlusive Carriers Hand creams or lotions with water and glycerin as primary ingredients are typically non- occlusive or very lightly semi-occlusive, depending on their full formulation. – Water (Aqua): Hydrates but evaporates quickly without occlusives to seal it in. – Glycerin: A humectant (draws moisture into skin) but not occlusive. It doesn’t block transepidermal water loss (TEWL).
80. www.drbonci.com 80 Dilution Math 10 mL Blend % Dilution = 100*(EO drops/200 drops) EO drops = (% Dilution * 200 drops)/100 0.25% = 0.5 drops 0.5% = 1 drop 1% = 2 drops
81. www.drbonci.com 81 Dilution Math 30 mL Blend % Dilution = 100*(EO drops/600 drops) EO drops = (% Dilution * 600 drops)/100 0.25% = 1.5 drops 0.5% = 3 drops 1% = 6 drops
82. www.drbonci.com 82 THE RESPIRATORY SYSTEM
83. www.drbonci.com 83 Gas Exchange Due to their large surface area, rich blood supply, and the thin membrane separating air and blood, the lungs are very efficient organs for the absorption of gases and volatile substances from the air (p. 445) . – The mucous membranes of the nasal cavity and pharynx make a contribution to gas exchange, but much less so.
84. www.drbonci.com 84 Volatile Organic Compounds Common sources of VOCs in the home include hair sprays and air fresheners, which may contain volatile propellants in addition to a high proportion of low molecular weight fragrance chemicals (pp. 447-448) . – The regular use of air fresheners and aerosols in the home has been strongly correlated with an increased incidence of diarrhea in infants and headache in new mothers.
85. www.drbonci.com 85 Adverse Effects of Ambient EOs The two principal adverse effects of ambient essential oils and other inhaled substances are (p. 448) – bronchial hyper-reactivity (BHR), and – sensory irritation (SI), which includes both eye and airway irritation.
86. www.drbonci.com 86 Bronchial Hyper-Reactivity Bronchial hyper-reactivity (BHR) is an exaggerated narrowing of the airways in response to irritants, common in asthma, COPD, and allergies. Essential oils (EOs) can trigger or soothe BHR, depending on the oil and individual sensitivity.
87. www.drbonci.com 87 Risky Oils for BHR and SI High 1,8-Cineole: Eucalyptus & Rosemary – can be stimulating at low doses but irritating at high doses. High Menthol: Peppermint, Cornmint – reflexive airway tightening. Phenols & Strong Oxides: Oregano & Thyme – mucous membrane irritants. Aldehydes (Citral, Citronellal): Lemongrass & Lemon Balm – coughing or laryngospasm in sensitive individuals.
88. www.drbonci.com 88 Sensory Irritation When an odorous substance is sufficiently pungent, trigeminal or vagal afferent C fibers in the nose, mouth and eyes are activated (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.
89. www.drbonci.com 89 Risky Oils for SI Peppermint Oil (Mentha piperita) Eucalyptus Oil (Eucalyptus globulus) Clove Oil (Syzygium aromaticum) Cinnamon Oil (Cinnamomum zeylanicum) Thyme Oil (CT Thymol) (Thymus vulgaris)
90. www.drbonci.com 90 Respiratory Disease In light of all of the above, an important question is whether any essential oils are safe to use by inhalation for respiratory disease, especially since BHR is an issue in many such diseases (p. 463) . Acute Respiratory Infections COPDs Allergic Rhinitis
91. www.drbonci.com 91 Bronchospasm Bronchospasm is a problem in many respiratory conditions, and there is ex vivo evidence of bronchodilatory effects for essential oils of ajowan, anise, angelica root, basil, clove, sweet fennel and rose; similarly, for the constituents carvacrol and 1,8-cineole (p. 471) .
92. www.drbonci.com 92 Sensory Hyper-Reactivity SHR is characterized by upper and lower airway symptoms induced by inhaled substances such as those listed above (p. 475) . – Common symptoms include rhinitis, hoarseness, coughing, phlegm, dyspnea and eye irritation, with some individuals also experiencing fatigue and headache.
93. www.drbonci.com 93 Olfactory Hypersensitivity Migraine is the only disease associated with a pronounced increase in olfactory sensitivity. Even between episodes, migraine sufferers show greater olfactory hypersensitivity to vanillin than controls (p. 476) . – They also display abnormal cerebral activation patterns in response to olfactory stimulation.
94. www.drbonci.com 94 Warnings for Pediatric Use • Avoid for infants and toddlers (<2 years): Their airways are narrow, and strong scents can trigger laryngospasm (airway tightening) or breathing difficulties. • Ages 2–6: Use only under professional guidance (e.g., aromatherapist or pediatrician). • Ages 6+: Mild oils may be used with strict dilution limits (see below).
95. www.drbonci.com 95 Never Use with Children Menthol-rich oils: Peppermint, Cornmint (risk of apnea or bronchospasm). High 1,8-cineole oils: Eucalyptus globulus, Rosemary (camphor type) – linked to neurological issues in seizures). Phenols/aldehydes: Oregano, Cinnamon, Thyme (thymol) – mucous membrane irritants.
96. www.drbonci.com 96 EOs to Avoid in Polypharmacy Eucalyptus & Rosemary Peppermint Wintergreen Clove & Oregano Grapefruit Lavender & Tea Tree Sage
97. www.drbonci.com 97 MEDICO-LEGAL CONCERNS
98. www.drbonci.com 98 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).
99. www.drbonci.com 99 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”).
100. www.drbonci.com 100 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.
101. www.drbonci.com 101 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
102. www.drbonci.com 102 5 Key Risk-Reduction Strategies Avoid Drug Claims: Use general wellness language. No therapeutic claims. List ingredients. Safe dilution. Disclaimers & Documentation Follow State Scope of Practice Use GRAS/Generally Safe Ingredients Avoid EOs with FDA drug monographs (e.g., tea tree for antifungal claims).