Shirley Price - step by step to safe essential oil use

Essential Oil safety notes Safety notes General Safety Information: Do not take any oils internally without consultation from a qualified aromatherapy practitioner. Do not apply undiluted essential oils onto the skin. If you are pregnant, epileptic, have liver damage, have cancer, or have any other medical problem, use oils only under the proper guidance of a qualified aromatherapy practitioner. Use extreme caution when using oils with children and give children only the gentlest oils at extremely low doses. It is safest to consult a qualified aromatherapy practitioner before using oils with children. A skin patch test should be conducted prior to using an oil that you've never used before. It is prudent to use organic oils where as in citrus they are obtained by expression (crushing) of the epicarps. For example there is therefore no great merit in buying organically grown chamomile but we would recommend organic lemon, manadarin, orange or grapefruit oil. Allergens are listed in accordance with EU Directive 2003-15. Aromatherapists have been using pure essential oils without synthetics added professionally (diluted with carrier oil) without contact dermatitis for several decades without ill effect. Step by step to safe practice Essential oils are highly concentrated, complex chemical compounds and should always be treated with respect. Just because they are ‘natural’ does not mean that they cannot do any harm. The definition of Aromatherapy includes the phrase “the controlled use of essential oils”. The word ‘controlled’ should never be forgotten. An important safety issue, highlighting the importance of the controlled use of essential oils, is that of quantity. Paracelsus is famous for coining the phrase 'all things are poisenous it depends on the dose". Excessive consumption of water has killed. As essential oils are so concentrated they are rarely used neat. Under normal circumstances they are always diluted to 1-3% using a carrier. A total of 6 drops of oil per day, preferably of different types, is considered safe. For children and pregnant women (who should be treated only by a qualified Aromatherapist) essential oils must be diluted even further to 1-2%. A Golden Rule to remember is that ‘Less Is Best’. Another Golden Rule that helps to maintain the safety of Aromatherapy is ‘Use Quality Oils’. It is of great importance that the content of the oil is known. Oils are sometimes adulterated (or stretched) in some way by adding alcohol, another cheaper oil, or a synthetic product. These oils are obviously more likely to produce skin irritations and are less likely to successfully perform their expected action. The first step to ensuring the quality of the oils is to purchase them from a reputable supplier. Oils purchased from a reputable supplier should be correctly bottled in coloured glass with a dropper insert. The label should be indelible and should give information such as the botanical name, country of origin, supplier’s name and address and a batch number. If the essential oil is diluted in a carrier the percentage of the mix should be quoted, along with details of the carrier. Another important safety benefit gained from buying oils from a reputable supplier is that they will not supply hazardous oils, so you gain even more peace of mind. Once you have purchased the essential oils look after them! Due to the chemistry of the oils, they should be stored in their coloured glass bottles in a cool, dark place. This will help their shelf life. On average a bottle of essential oil should be used within one year of opening, or two years if stored in a refridgerator. Essential oils must be treated with care. They are volatile and flammable, so keep them away from naked flames and strong sources of heat. They should also be kept away from homeopathic remedies as some strong oils may negate them. Essential oils will ‘rot’ plastics. For this reason care should be taken when using them in the jacuzzi or in plastic baths. They should not be allowed to come into contact with varnished wood, plastic surfaces or any equipment with plastic workings such as dishwashers and washing machines. Needless to say, contact with any plastic-based contraceptive aids such as condoms and diaphragms must be avoided. Within the field of Aromatherapy essential oils should NOT be used internally. Tragically, children (typically between the ages of 1-3 years old) have been killed as a result of drinking a whole bottle of essential oil. As well as storing oils out of the reach of children, it is also obviously preferable to use child resistant tops as a further safety measure. Should a child or an adult take more than 5ml of essential oil internally, give them milk to drink (the fat dissolves the essential oil) and seek medical assistance immediately. Take the appropriate bottle to the medical practitioner, as the information on the label may be useful in establishing a treatment. Due to the potency of neat essential oils, harm can also be caused if they are accidentally splashed into the eyes or onto the skin. If essential oils make contact with the eyes wash the eyes out with milk or with a vegetable oil. Do not attempt to use water as the essential oil will not dissolve in it. Seek medical advice, taking the appropriate labelled bottle with you. It is also dangerous for undiluted essential oils to come into contact with other mucous membranes such as the mouth, vagina or rectum. In all cases seek medical advice immediately. Should a severe dermal irritation occur as the result of neat essential oil making contact with the skin, dilute it with vegetable oil. Wash the skin with unperfumed soap and water and then dry it. Seek medical advice, taking along the appropriate bottle. Some essential oils are so hazardous they should NEVER be used in Aromatherapy massage. Here is a list of them: Almond (Bitter) Prunus amygdalis, var. amara Aniseed Pimpinella anisum Arnica Arnica montana Camphor Cinnamomum camphorus Cassia Cinnamomum cassia Cinnamon (Bark) Cinnamomum zeylanicum Costus Saussurea lappa Elecampane Inula helenium Fennel (Bitter) Foeniculum vulgare Origanum Origanum vulgare Origanum (Spanish) Thymus capitatus Pine (Dwarf) Pinus pumilio Sage Salvia officinalis Savory (Summer) Satureia hortensis Savory (Winter) Satureia montana Thuja (Cedarleaf) Thuja occidentalis Wintergreen Gaultheria procumbens Wormwood Artemisia absinthium Essential oils that don’t feature on the list of hazardous oils can be used in Aromatherapy but this does not mean that they are completely safe. Skin irritations and allergic reactions may occur, but the risk can be minimised by never exceeding the 1-3% dilution guideline and patch testing to identify if there is going to be a problem before using the oil on a wider scale. You must be aware, however, that some so called ‘safe’ oils are more likely to irritate the skin than others, and so it is sometimes necessary to be even more cautious. For example peppermint oil can cause chemical burns, particularly on skin that has already been traumatised. Skin irritations are largely determined by the chemistry of the oil, and so a knowledge of Chemistry has important safety benefits Oils high in aldehydes, oxides, ketones and phenols are more likely to cause a reaction. These oils should therefore be diluted to as little as 0.1% (1 drop of oil in 50ml of carrier). The method of extraction used may introduce other chemicals into the oil and these may cause skin irritations. Some oils may cause sensitisation. This is when oils can be used infrequently without signs of intolerance but, with continued use, reactions occur such as skin inflammation or rashes. It is therefore important to regularly change the oils used or alternate them to avoid the effects of extended exposure. Here’s a list of oils that commonly irritate the skin or cause sensitisation. They should all be diluted to 0.1% before use. Please note that this is by no means a definitive list. Each person is an individual who will react as such to any treatment. Angelica Angelica archangelica Black Pepper Piper nigrum Cinnamon (Leaf) Cinnamomum zeylanicum Citronella Cymbopogon nardus Clove (all parts) Eugenia caryophyllata Ginger Zingiber officinalis Lemon Citrus limon Lemongrass Cymbopogon citratus/flexuosus Lemon Verbena Lippia citriodora Nutmeg Myristica fragrans Orange (Sweet) Citrus sinensis Peppermint Mentha piperita There’s something else to worry about! Some essential oils can increase the skin’s sensitivity to ultraviolet light. These oils are called photosensitisers. Photosensitisation occurs when skin, treated with a photosensitising oil, is exposed to ultraviolet light (e.g. sunlight, rays from a sunbed or radiation). The effects range from pigmentation of the skin to severe burns. It is the chemistry of the oil that produces this effect. Furocoumarins (a type of lactone) are responsible for increasing the skin’s sensitivity to sunlight. For example, oxypeucedanin and bergapten are found in lemon oil. Bergapten is also found in bergamot and was used in fake sun-tan preparations until cases of skin reactions were reported. This table lists some of the most common photosensitising oils which should not be used before exposure to the sun or other forms of ultraviolet light. Angelica Angelica archangelica Bergamot Citrus bergamia Lemon Citrus limon Lime Citrus medica var. amara Orange (Sweet) Citrus sinensis Another group of oils that you should be familiar with are those that can cause toxicity or chronic toxicity if used, even in low amounts, over a period of time. These oils can cause tissue damage to the liver and kidneys, as these organs are responsible for filtering out dangerous substances. Continued use of these oils causes toxins to build up in these organs and this can, in extreme cases, result in death. This chart shows some oils with a risk of toxicity or chronic toxicity. These oils should therefore be used with caution and certainly not used for more than a few days at any one time. Basil Occimum basilicum Cedarwood Cedrus atlantica Cinnamon (Leaf) Cinnamomum zeylanicum Eucalyptus (Blue Gum) Eucalyptus globulus Fennel (Sweet) Foeniculum vulgare Hyssop Hyssopus officinalis Lemon Citrus limon Orange (Sweet) Citrus sinensis Nutmeg Myristica fragrans Thyme Thymus vulgaris So far we have just considered the safety of the various oils. Knowing which oils are: hazardous (never used) irritants (used in weaker dilutions) sensitisers (used in weaker dilutions and not used over extended periods)photosensitisers (not used if exposure to ultraviolet light is imminent) toxic (used with care only over short periods) - is vital, but let’s not forget that the client comes into the equation too! Before a client is treated a full case history must be taken (see the ‘Professionalism’ section for details). Taking a case history has enormous safety benefits as it highlights aspects of the client’s condition that may impact on many of your decisions, such as Should I treat this client? If so, how? What oils are appropriate? The ‘aspects’ of the client’s condition that negatively affect your decision (in other words prevent the treatment of a client, restrict the appropriate methods of use or reduce the range of suitable oils) are called contra-indications. Let’s look at contra-indications that prevent the Aromatherapy treatments first. Contra-indications that PREVENT Aromatherapy Treatments 1. Currently Treated by Doctor A client with any condition that is being treated by a doctor should not receive an Aromatherapy treatment without first getting a letter of consent from the doctor concerned. This obviously includes cancer patients, sufferers of angina or other heart problems and blood disorders. 2. Taking Medication Clients taking medication, whether prescribed or not, should not be treated without the doctor’s permission. The reactions of essential oils with conventional medicines are not yet fully understood. Theoretically, essential oils could compete with the drug, inhibit its effect or produce a different effect. 3. Severe, Untreated Medical Problem A client with any severe condition, who is not being treated by a doctor, should be referred to their doctor for a letter of consent before any treatment is started. 4. Unexplained Seats of Pain Should a client have any unexplained pain, lumps or bumps, they should be referred to their doctor before commencing any treatment. It is not the function of an Aromatherapist to diagnose, so before a diagnosis has been made there is nothing that can safely be done. Contra-indications that RESTRICT the Methods of Use 1. Hypersensitive Skin It may be inappropriate to choose a method of use that involves the essential oil coming into contact with the skin in cases of acute skin disorders such as dermatitis, psoriasis, eczema and severe allergies. This isn’t to say that no form of treatment can be given. For example it may be appropriate to give the client some oil to use in a burner or inhaler. These would not necessarily treat the skin disorder, but may be of other benefit to the client. 2. Contagious Diseases For obvious personal safety reasons, it is not advisable to use massage (a contact treatment) on clients with contagious diseases, e.g. mumps, herpes, measles, chicken pox and ringworm. Contagious diseases therefore limit the treatment to the non-contact methods of use such as burners, bath oils etc.. 3. Steroid Users Long term users of steroids tend to have very thin skin. If, with the consent of their doctor, treatment is considered appropriate the non-contact methods of use would be favourable. The last group of contra-indications are those that reduce the range of suitable oils. There are 3 main contra-indications in this category: abnormal blood pressure, pregnancy and epilepsy. Abnormal Blood Pressure This is a difficult contra-indication to assess. Unless the client has been tested by their doctor and advised of a blood pressure problem it may go undetected. If the client is receiving treatment for abnormal blood pressure then the doctor’s consent must be obtained before any treatment commences. High or low blood pressure reduces the range of suitable oils as some act to further increase the blood pressure and some act to further decrease it. Essential oils that raise blood pressure are termed hypertensive. Clearly these shouldn’t be used if the client is already suffering from high blood pressure (hypertension). Hypertensive oils include rosemary, clary-sage, black pepper, juniperberry, thyme and clove (bud). The essential oils that lower blood pressure are called hypotensive and obviously shouldn’t be used in cases where the blood pressure is known to be low (hypotension). Hypotensive oils include lavender, marjoram, melissa, ylang ylang and lemon. Blood pressure can also be affected by hyssop. Hyssop is an adaptogen (natural balancer) and is able to react in opposite ways depending on the need of the body. So, when the blood pressure is high, hyssop will act to reduce it. On the other hand, when the blood pressure is low, hyssop will act to increase it. WARNING! Hyssop is contra-indicated to epilepsy and pregnancy and is also toxic. Pregnancy Many Aromatherapists will not treat pregnant women. Others argue that, as long as the oils contra-indicated to pregnancy are avoided, Aromatherapy can be of great benefit to the expectant mother as it can help to minimise the various discomforts of pregnancy. Whenever essential oils are used on a pregnant woman, the dilution must be reduced from the usual 1-3% to 1-2%, except for the irritating/sensitising oils which must be diluted to 0.1%. Remember that essential oils are absorbed into the blood and transported around the body. In pregnant women, although the maternal and foetal blood are never in direct contact, it is believed that the essential oils can cross the placenta. There are two groups of oils to be aware of, those contraindicated to the first three months of pregnancy and those contra-indicated to the whole of the pregnancy and any breast feeding period that follows. The oils to be avoided in the first three months are those with an abortifacient tendency (induce abortion) and those which have an emmenagogic action (induce menstrual flow). Theoretically these oils could induce a miscarriage. Here is a list of oils to be avoided during the first three months of pregnancy. They can be used carefully in the remaining months unless there is any history of miscarriage. Chamomile (German) Matricaria chamomilla Chamomile (Roman) Anthemis nobilis Lavender Lavandula angustifolia Rose Rosa centifolia/damascena These oils must be avoided for the entire pregnancy and for any breast feeding period that may follow: Basil Ocimum basilicum Black Pepper Piper nigrum Cedarwood Cedrus atlantica Clary-Sage Salvia sclarea Cypress Cupressus sempervirens Fennel (Sweet) Foeniculum vulgare Geranium Pelargonium graveoleus Hyssop Hyssopus officinalis Jasmine Jasminium officinalis Juniperberry Juniperis communis Marjoram Origanum majorana Myrrh Commiphora myrrha Nutmeg Myristica fragrans Peppermint Mentha piperita Rosemary Rosmarinus officinalis Tarragon Artemisia dranunculus Thyme Thymus vulgaris Epilepsy Some essential oils can instigate an epileptic type fit in those that are susceptible. It is therefore important that a full case history is taken to establish if the client suffers from epilepsy before starting any treatment. (Note: although some oils are anticonvulsive, it is not common for Aromatherapy to be used to actually treat the epilepsy.) Oils to be avoided in cases of epilepsy: Fennel (Sweet) Foeniculum vulgare Hyssop Hyssopus officinalis Peppermint Mentha piperita Rosemary Rosmarinus officinalis Thyme Thymus vulgaris We’ve now covered all the contra-indications. As a summary, they are all listed together here. Contra-indications that Prevent Aromatherapy Treatments: Currently treated by doctor (including cancer, angina, heart problems, blood disorders) Taking medication Severe, untreated medical problemUnexplained seats of pain Contra-indications that Restrict the Methods of Use Hypersensitive skin, Contagious diseases Steroid use (if consent from doctor obtained) Contra-indications to Reduce the Range of Suitable Oils: Abnormal blood pressure (if consent from doctor obtained) Pregnancy Epilepsy We began this section by looking at the essential oils themselves, listing those that were hazardous, irritants, sensitising, photosensitising and toxic. We then looked at how certain conditions of the client will affect (and sometimes prevent) the treatment. When deciding on the best treatment, look at the picture as a whole. Consider both the properties of the oils and the condition of the client. Once the inappropriate oils and methods of use have been eliminated, select the oils and methods of use based on all the information you have. Remember that it is not the role of an Aromatherapist to diagnose so, if in doubt, refer the client to a doctor. Lastly, the importance of safety cannot be overstated.