The purpose of this editorial is to share a brief overview about essential oil aromatherapy and how it may be used for enhancing well-being. No doubt, whether it has been in a work, home, business, or social environment, and whether you were aware of it or not, you have been exposed to essential oil aromatherapy. What is essential oil aromatherapy all about? What are the basics about essential oil aromatherapy that you should know? Is aromatherapy with essential oils safe? Should you be using essential oil aromatherapy for yourself and your family in your own home? Let’s explore the “smelly” subject of essential oil aromatherapy.

Within the past decade, the popularity of essential oil aromatherapy as a self-care modality has dramatically increased in the United States (Manion & Widder, 2017; Price & Price, 2012). However, essential oils have been used for centuries, and essential oil practices, including aromatherapy, have been passed down through generations (Boire et al., 2013). Essential oils are highly concentrated, chemically complex substances derived from plants. Within native plants, essential oils attract pollinators, repel insects and microorganisms, heal injuries, and protect the plant during temperature fluctuations (Price & Price, 2012). Contemporary essential oils used in aromatherapy are vaporizable liquids that are most commonly derived from plants through a steam distillation process or less commonly may be obtained through an expression process with mechanical pressurizing (AromaTools, 2017).

Aromatherapy is the most customary therapeutic use of essential oils, and indirect inhalation (often called diffusion) and topical application of essential oils are the most common ways essential oils are used for aromatherapy. The therapeutic massage industry frequently uses essential oil aromatherapy as an adjunct therapy combined with therapeutic massage. However, the influence of aromatherapy from essential oil is far reaching; for example, the bouquets chosen for the Olympic medalists of the 2012 London Olympic games were required to have a “British smell”; thus, the bouquets contained rosemary, mint, and lavender to create this aroma (Crawley, 2012). Although essential oil aromatherapy has been embraced by much of the general public, it is less commonly accepted or discussed by U.S. health care professionals (Boesl & Saarinen, 2016). Increasing research evidence suggests that the use of essential oil aromatherapy can promote physical and mental well-being (Ali et al., 2015).

Essential oils are colorless, usually pleasant-smelling liquids that can produce positive aromatherapy effects that begin in the nose and mouth (Ali et al., 2015). Inhaled essential oils almost immediately interact with olfactory receptors and then affect the olfactory bulb within the brain. The olfactory bulb connects to limbic system structures of the amygdala, hippocampus, hypothalamus, and cingulate gyrus; these play an important role in emotional and physical responses in the human brain (AromaTools, 2017; Buckle, 2015). The amygdala is involved with emotions; the hippocampus plays a large role in memory (AromaTools, 2017; Buckle, 2015); the hypothalamus is responsible for hormone regulation and autonomic nervous system response; and the cingulate gyrus regulates blood pressure, pulse, focus, and attention (Price & Price, 2012). Scents also affect the brain by influencing the production of endorphins and noradrenaline, thus inhibiting pain signals, promoting relaxation and happiness, and increasing alertness and attention (Buckle, 2015). In addition to the described olfactory pathways affected by essential oils, inhaled essential oils also travel to the lungs where they are absorbed via the alveoli into the circulation and then subsequently affect the brain (Buckle, 2015).

Indirect inhalation for aromatherapy is a popular way essential oils are now used, and this is usually accomplished through use of a diffuser device (Allard & Katseres, 2016; Buckle, 2015). The essential oil is placed in a diffuser bowl and diluted with water (Allard & Katseres, 2016), allowing the essential oil to penetrate the air in its gaseous state; thus, the essential oil is delivered through indirect inhalation of micron-sized essential oil droplets (Buckle, 2015). Commonly accomplished with aroma sticks, cotton balls, aroma patches, or directly from the bottle is known as direct inhalation, the fastest method of essential oil delivery (Buckle, 2015). Topical applications have also become a popular way to use essential oils. This route of administration provides aromatherapy as well as potentially providing positive skin effects. Topical application of essential oils is usually administered with a carrier oil giving the essential oil a vehicle in which to be carried through the skin into the bloodstream (Buckle, 2015).

Some of the more commonly known and used essential oils for aromatherapy include lavender, eucalyptus, tea tree, and peppermint. Lavender aromatherapy is frequently used for insomnia and anxiety (Allard & Katseres, 2016), and research evidence supports effectiveness in improving these symptoms (Asazawa et al., 2018; McCaffrey et al., 2009; Muz & Tasci, 2017). Eucalyptus is commonly found in cough drops and frequently diffused or applied directly to the chest for cold symptoms (Allard & Katseres, 2016; Ferrara et al., 2012; Sadlon & Lamson, 2010). Tea tree oil is known to have antibacterial, antiviral, and anti-fungal properties and when diffused it is a good germ fighter and air purifier (Allard & Katseres, 2018; Pazyar et al., 2013; Rodriguez, 2015). Peppermint aroma is thought to help alleviate headaches, nausea, and vomiting either in conjunction with medication or alone (Chumpitazi et al., 2018; Hodge et al., 2014).

At this time, essential oils are not subject to regulation by the U.S. Food and Drug Administration; therefore, essential oil distributors cannot claim that an essential oil can treat, cure, mitigate, or prevent disease (Manion & Widder, 2017). However, numerous studies support the safety of essential oil aromatherapy when it is indirectly inhaled or applied topically for aromatherapy (Allard & Katseres, 2016; AromaTools, 2017). As with any complementary therapy, there are some general safety principles to be aware of when considering essential oils for aromatherapy or when discussing with patients. Consumers should purchase essential oils from reputable suppliers. Quality manufacturers will be knowledgeable about their products and should be willing to share information with the customer about the process used to produce the essential oils and the purity of the essential oils (Allard & Katseres, 2016). A specific essential oil should be researched prior to its use, and any potential interactions or adverse effects that could occur from the aromatherapy should be known (Allard & Katseres, 2018).

Essential oil aromatherapy is continuing to gain momentum in the United States as a self-care measure, so patients, and perhaps you, will want to explore its properties and consider a trial of this complementary therapy option. When there is the opportunity, enhance your knowledge about essential oils’ potential drug interactions, possible adverse effects, routes of administration, and clinical implications. Consider using essential oil aromatherapy to promote your own mental and physical health. Diffuse some essential oils and smell your way to well-being.

Patricia M. Childers, DNP, MSN, AGNP-BC
Caswell Developmental Center, Medical
Kinston, North Carolina

Mollie E. Aleshire, DNP, MSN, FNP-BC,
School of Nursing, University of North
Carolina at Greensboro
Greensboro, North Carolina


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