Essential oils

09 sept

Essential oils. What a topic. Essential oils have become an enemy of most dermatologists throughout the past several years. The reason for this is because board certified dermatologists usually follow evidence based medicine and most research has highlighted their risks rather than their benefits. This doesn’t mean potential benefits don’t exist, they just haven’t been proven in literature. There has been more and more recent evidence showing potential benefits of various essential oils. That being said, I do believe it is important to understand the risks of using such compounds and warning signs to look for prior to using them regularly.

Essential oils are compounds that are extracted from flowers, leaves, barks, roots, fruits, or other plant materials. These are usually extracted by distillation or cold-pressing. In order for essential oils to maintain such strong fragrances, high amounts of the plants must be processed and therefore these compounds contain very high concentrations of the active ingredients. This raises a potential concern for the skin as small concentrations of an active ingredient may not cause skin issues, but a concentrated amount can reach the threshold of causing an irritant reaction on the skin. As a general rule, the stronger the smell, the more concentrated the oil.

Now let’s talk about some positive things. Newer research is pointing towards benefits of essential oils. I will talk about essential oils as a broad term, but there numerous different types of essential oils and benefits and risks are not equal across the board. Studies have shown positive effects on mood with essential oil use topically or through a diffuser. The exact mechanisms of this phenomena have not been teased out. As we have discussed prior, enhancing the mood is always good for the skin. Other studies have demonstrated some antimicrobial and antioxidant properties, but these come at a risk and I will discuss that later. Essential oils have been studied more and more as a delivery agent of other medications as they may create increased permeability of the skin. This is something that can be interesting for the future of medicine but isn’t much to incorporate into our day to day lives as of yet. Finally, there is some evidence supporting certain essential oils for insect repellants, which could potentially not be a bad alternative to medication repellants.

Now I will discuss why us dermatologists are so hesitant to recommend essential oil use. The main issue is that many of these compounds are known contact allergens, which are culprits for contact dermatitis. Contact dermatitis is an itchy rash that develops when our skin comes into contact with a certain compound. Not everyone is allergic to the same compound. There may be certain individuals who have contact allergies to several compounds and there may be others who don’t have allergy to any of the common compounds. There are also threshold amounts that must be met to induce a contact dermatitis and essential oils, as we have mentioned, often contain high concentrations of active ingredients and as a result reach this threshold sooner. Contact dermatitis may also occur even if the essential oils are not directly applied to the skin but rather dispersed via a diffuser. Just because these compounds are “natural” doesn’t make them harmless. Poison ivy is also a natural plant, but we don’t want to be rubbing its extract on our skin.

From a practical approach we don’t need to altogether avoid all essential oils. There are many other potential contact allergens that we expose ourselves to on a daily basis such as leather, nail polish, shampoos, etc. But I do think we need to be aware and cautious of possible reactions that can occur when using essential oils. I recommend avoiding essential oils if you have sensitive skin in general. People with sensitive skin or eczema are more prone to having contact dermatitis in general. I also strongly recommend avoiding use of essential oils on an active rash. I am aware that it is common to hear various recommendations for home/herbal remedies to treat rashes but most of these do not work. These may not only worsen your rash but will also make it more difficult to treat the rash properly. In the same token, avoid using essential oils on open wounds. Open wounds are more prone to developing contact dermatitis as the barrier of the skin is compromised already. If you would like to incorporate essential oils into your life I recommend doing a ‘repeat open application test’ prior to incorporating the essential oil into your routine. You can google ‘repeat open application test’ for instructions. You can always try an essential oil, but if you develop a rash, itchiness, or any irritation it’s time to stop the oil immediately.


Essential Oils. Good or bad?

It’s not that simple. 

Essential oils have been shown to have benefits such as enhancing mood, having antioxidant properties, and good alternatives to chemical bug repellants.

They do come at a risk though.

The main reason dermatologists don’t like essential oils is because of the risk for contact dermatitis.

Safe tips: avoid essential oils if you have sensitive skin, an active rash or open wounds. If you begin to develop a rash after essential oil, stop using it. Otherwise, enjoy your life.