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Aromatherapy

Aromatherapy is a form of herbal medicine. Instead of using the entire herb, it employs the fragrant "essential" oil that is released when a fresh herb is compressed or subjected to chemical extraction. Essential oils are also often used as fragrances in cosmetics and bath products.

When employed medicinally, essential oils are often evaporated into the air through the use of a humidifier. The famous Vicks VapoRub® is a gel form of the essential oils of peppermint, eucalyptus, and camphor. Essential oils may also be applied directly to the skin or clothes so they will release their odor near the patient.

Essential oils may be inhaled, taken by mouth, or applied to the skin.

Inhaled aromatherapy has become a popular, gentle treatment to reduce mild anxiety. It has also been tried for a variety of other conditions, including respiratory problems, post-surgical nausea, menstrual pain and tension headaches.

Topical treatment with essential oils has shown possible value for fungal infections and hair loss. Oral use of essential oils has shown promise for various digestive and respiratory problems.

There is a major difficulty in studying aromatherapy by inhalation: how to conduct a double-blind, placebo-controlled trial. For the results of a study to be truly reliable, both participants and researchers must be kept in the dark regarding participants who received real treatment and who received placebo. (For more information on why this is so crucial, see Why Does This Database Depend on Double-blind Studies?) Although it may be possible to keep researchers in the dark regarding which group is which, participants will certainly be aware of whether they smell something or not! Researchers have used various clever compromises in an effort to partially solve this problem. For example, some studies used a control group that received an aromatic substance believed to be ineffective. Unfortunately, it’s just as hard to prove that an aromatic substance is ineffective as it is to prove that it’s effective! If the placebo in a study is just as effective as the tested treatment, the study will falsely indicate that the tested treatment is ineffective.

In other studies, researchers tricked participants in the control group and told them that they might be receiving an active but odorless treatment, when in fact they were simply given an inactive treatment without much in it. Compromises such as these are necessary. Unfortunately, most published studies on aromatherapy were also poorly designed in various unnecessary ways, making their results unreliable.

These problems do not arise to the same extent in studies of essential oils taken by mouth or applied directly to the skin.

Inhalation of Essential Oils

Calming Effects

Preliminary controlled trials suggest that aromatherapy might be helpful for calming people with Alzheimer's disease and other forms of dementia. 2,3 For example, in one interestingly designed, but very small, study, a hospital ward was suffused with either lavender oil or water for two hours. An investigator who was unaware of the study’s design and who wore a device to block inhalation of odors entered the ward and evaluated the behavior of the 15 residents, all of whom had dementia. The results indicated that use of lavender oil aromatherapy modestly decreased agitated behavior. Furthermore, in a double-blind study of 71 people with severe dementia, use of a lotion containing essential oil of lemon balm reduced agitation compared to placebo lotion. Another set of researchers, however, point out that the ability to detect odors greatly decreases in Alzheimer's disease, and suggest that the benefits seen in the second study involved absorption of the herb through the skin rather than a true influence via aroma. This does not explain the results seen in the first study, however, and somewhat casts doubt on the results.

Several relatively poorly designed studies hint that aromatherapy combined with massage may help to relieve anxiety in people without Alzheimer's disease. Another study suggests that aromatherapy with geranium oil might modestly reduce anxiety levels (again in people without Alzheimer's). However, in a trial of 66 women waiting to undergo abortions, minutes of inhaling the essential oils of vetivert, bergamot, and geranium failed to reduce anxiety significantly more than placebo treatment. In another study, rosemary oil failed to reduce tension during an anxiety provoking task, and might have actually increased anxiety.

Cigarette Addiction

A controlled study suggests that inhalation of black pepper vapor may reduce the craving for cigarettes. In this trial, a total of 48 smokers used cigarette substitute devices that delivered black pepper vapor, menthol, or no fragrance. The results showed that use of the black pepper-based dummy cigarette reduced symptoms of craving for the first morning cigarette.

Tension Headaches

Weak evidence hints that peppermint oil applied to the forehead might relieve tension headaches.

A topical ointment known as Tiger Balm has also shown promise for headaches. Tiger Balm contains camphor, menthol, cajaput, and clove oil. A double-blind study enrolling 57 people with acute tension headache compared the application of Tiger Balm to the forehead against placebo ointment as well as the drug acetaminophen (Tylenol). 40 The placebo ointment contained mint essence to make it smell similar to Tiger Balm. Real Tiger Balm proved more effective than placebo and just as effective and more rapid-acting than acetaminophen.



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