Complementary therapies: Essential oils and eczema

What are essential oils?

Essential oils are a mix of compounds taken from fragrant flowers, bark, leaves, or fruit of different plants. They are often marketed as a natural alternative to conventional remedies for a number of eczema symptoms, from skin infections to helping with sleep. However, there is very little robust scientific evidence that they can improve eczema symptoms. While this does not mean that there isn’t supporting evidence that has yet to be discovered, essential oils should be treated with a great deal of caution. 

 

Essential oils are known to irritate skin and trigger allergic reactions when used directly onto the skin, diluted in bath water or diffused into the air¹. These reactions can happen to anyone who uses them, but people with eczema are particularly prone to reactions. This is because the skin barrier of eczema sufferers is damaged making it easier for their skin to absorb any irritants and allergens in essential oils.

 

The best illustration that I have of the widespread nature of these reactions is that the first thing I’m asked when I talk to dermatologists about this blog is: ‘You don’t recommend essential oils do you?’.

 

The problems with using essential oils for childhood eczema

Ingredients may vary

Essential oils are extracted through a steam distillation process that uses heat and solvent chemicals. The result is a highly concentrated liquid mix of chemicals including both the active ‘essential’ compounds and other compounds that have made it through the extraction process. As they are derived from a natural product, essential oils will also vary from batch to batch.

 

Unregulated sale and production

Anyone can set up a business extracting and selling essential oils to the public so long as they don’t make any medical claims on the advertising or packaging. There is no way of knowing how pure an essential oil is.

 

Risk of skin irritation

Eczema sufferers are particularly prone to skin irritation from essential oils in all their forms. This includes undiluted, diluted in a carrier oil, diluted in water or airborne. While they may help with some people’s eczema, there is a high chance that any one oil or batch of oil could cause irritation.

 

Toxicity

Essential oils can be toxic if ingested, tea oil alone was responsible for 1387 poisoning incidents in Australia between 2014 and 2018². Personally, I’d rather play it safe and not keep unnecessary toxins in the house.

 

Essential oils commonly associated with eczema treatment

These should not be taken as recommendations for usage, but as a list of ingredients commonly found in children’s skin care products to treat with caution. Some essential oils are found so ubiquitously that it is easy to miss them as potential eczema triggers. For example, lavender oil diffusers are commonly suggested as a sleep aid but may actually be contributing to the problem. 

 

Borage

Borage oil is derived from the seeds of the Borago officinalis plant and is rich in Omega 6 fatty acids. These fatty acids are important in maintaining a healthy skin barrier but are typically lacking in eczema skin. It has been shown to reduce the symptoms of eczema when applied directly to the skin in two studies^{3, 4}. While encouraging, both studies were small (looking at just 69 children in total) and more research is needed to establish long term benefit and safety.

 

Tea tree

Tea tree oil is produced by distilling oil from the Melaleuca alternifolia (Myrtaceae), a tree that is native to Australia. It is thought to possess anti-inflammatory, antimicrobial, and antifungal properties that are likely to be beneficial for eczema sufferers. However, tea tree oil needs to be diluted in a carrier oil to reduce the risk of irritation. Again, while the results of scientific studies are encouraging⁵, more work needs to be done to establish benefits, safety and dosages. 

 

Lavender

Lavender oil is commonly used to promote relaxation and sleep and has been used for centuries to promote wound healing. Early research indicates that it also has anti-inflammatory⁶ and anti-microbial properties. It has been shown to be effective against the bacteria Staphylococcus aureus, which commonly infects eczema skin⁷. However, it is also known to cause contact dermatitis in some people⁸. Lavender oil should always be diluted in a carrier oil and patch tested before use.

 

Chamomile

Chamomile has been used medicinally since ancient times as an anti-inflammatory, antioxidant, mild astringent and wound healing medicine. Initial research suggests that chamomile can be helpful in reducing the symptoms of eczema⁹ and the likely mechanism for this is the dampening down of inflammation pathways¹⁰. 

 

Clove oil

The painkilling properties of cloves have been used for centuries as the traditional cure for toothache. These same properties have now been shown to reduce itching resulting from a number of causes (although no eczema cases were included in the research)¹¹. It has also been shown to have antimicrobial¹² and anti-fungal properties¹³.

 

Carrier oils 

While some essential oils (including lavender and chamomile) can be used undiluted, the majority will require dilution with a carrier oil to minimise the risk of skin irritation. Dilution reduces the risk of irritation by spreading the active compounds more sparingly and can also improve their uptake into the skin. 

 

Common carrier oils include sunflower oil, coconut oil, jojoba oil and almond oil. Given the growing understanding of food allergies growing out of skin sensitisation, it is wise to avoid the use of food oils until your child has been eating those foods for a while. This is especially true for nut oils. For blended carrier oils, check that they do not include peanut oil (also known arachis oil). Olive oil should also be avoided as this can damage the skin barrier¹⁴.

 

Other risks associated with essential oils

In addition to the risk of skin irritation, there is also concern that essential oils may cause hormonal changes. Over 65 essential oils contain compounds that are hormone disruptors which mimic or oppose hormones made in the body. Repeated use of essential oils containing these chemicals may lead to unwanted hormonal changes.

 

For example, clinical research found that repeated use of topical lavender oil and tea tree oil likely caused three adolescent boys to develop breast tissue¹⁵.

 

In summary

While essential oils can help alleviate eczema symptoms in some cases, the current lack of research into their effectiveness and possible side-effects, coupled with the lack of regulation over their production, makes them a risky choice for treating a child’s eczema. They are the ‘pet hate’ of every dermatologist I have spoken to.

If you do decide to try them, wait until your child is over 3 months old, choose a good quality supplier for your oils, dilute with a carrier oil for topical applications. As with all new topical products, patch test each oil (in the carrier oil) before using.