With more popularity, essential oils are showing up in an unexpected place

"Essential oils have been around for thousands of years, and it's kind of the wild, wild west out there right now."

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If you have a pulse and are living on planet Earth, especially in the United States, you’ve probably heard about essential oils. You may have inhaled them, rubbed them into your skin, or even ingested them. Over the past decade, they have come into the mainstream with the rise of companies like doTERRA, Saje, Plant Therapy, and Young Living. But essential oils — the scented liquid extracted from certain plants using steam or pressure — aren’t new. They’ve been used therapeutically for centuries.

“Essential oils have been around for thousands of years, and it’s kind of the wild, wild west out there right now,” Susanne Cutshall, a nurse practitioner at the Mayo Clinic, tells Inverse. “What’s happening is they are becoming more and more widely used and more companies are jumping on the bandwagon, saying, ‘OK, we’re going to have essential oils in our company,’ and the research is still catching up.”

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Essential oils may have benefits around mental health and relaxation, but medical benefits and risks need much more rigorous research.

Essential oils are natural, concentrated oils extracted from plants, and they pack a punch.

Often, they’re touted as cure-alls. Sales pitches can be found on Instagram, book covers, and on YouTube. There are countless testimonials about their stellar effects in treating a myriad of medical conditions. Essential oils are credited in treating autism, psoriasis, acne, cancer, and ADHD, among others. But these medical claims are anecdotal and unsupported by evidence-based research. Using essential oils for purported medical benefit can be expensive — and even dangerous.

Essential oils are not regulated as drugs by the Food and Drug Administration, so it is unlawful for companies to make medical claims about their use. And the adverse effects — skin and allergic reactions, endocrine disruption, and increased sun sensitivity — have been reported by various users, as well as scientific journals.

But the scarce scientific research supporting medical use doesn’t mean you should toss your oils out just yet — they may have therapeutic uses. For many, essential oils may make you feel good, and there’s value in reduced stress and anxiety, as well as better sleep. These effects are supported by scientific literature.

Some hospitals, like the Mayo Clinic, are even offering aromatherapy using high-quality essential oils to improve patient experience.

Ultimately, essential oils are useful for symptom management, not treatment, say Cutshall and her colleague, Nancy Rodgers, a massage therapist and integrative health specialist at the Mayo Clinic.

But choosing what kind of essential oil to use, or how much of it, can be difficult.

Essential oils everywhere

“The one thing I always tell people to remember is that it is the chemical of the plant and to not take it lightly,” Cutshall says. “It is very strong and can be very potent.”

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People don't just use essentials for physical or mental health health purposes; some use essential oils to clean their homes.

People have countless uses for essential oils, from household cleaning, skin treatment, and fighting off infection to even cooking. And they aren’t cheap: An oil collection from Young Living costs $138, while doTERRA’s “Beginner’s Trio Kit” costs $66.

Spearmint, citrus, lavender, tea tree oil, peppermint, chamomile, lemon, and frankincense are popular ones among the hundreds of commercially available oils.

For personal use, people often use them in one of three ways: They inhale them through aromatherapy, often using a diffuser; use them topically by rubbing them on skin through lotions or skin products; or they ingest them in baked goods, drinks, or directly into the mouth.

But eating them is riskier than inhalation or topical use. “We’re never recommending patients ingest oils because we do not have the evidence of how safe that is,” Rodgers says.

Sticking to the recommended dose or even diluting the oil can help prevent deleterious effects.

Oily benefits and risks

Though they won’t likely treat medical issues, essential oils may improve the quality of life and mental health of users.

Lavender oil is one of the most commonly used essential oils, and some therapeutic benefits such as reduced anxiety and better sleep have been seen.

Lavender oil has been shown in human studies to help reduce anxiety, improve sleep quality and insomnia, and temporarily relieve pain. But some of this research suffers from classic scientific problems: small sample sizes, a lack of placebo control, and limited long-term study. A few young boys, between the ages of 7 and 10, have also reported prepubertal gynecomastia, or the growth of breast tissue, after chronic lavender and tea tree oil use.

Some research has shown tea tree oil to have anti-microbial, anti-fungal, and anti-inflammatory effects, and is commonly used for acne, lice, dandruff, athlete’s foot, and nail fungus. It can be dangerous when swallowed.

One literature review, published in Frontiers in Aging Neuroscience in 2017, did find some evidence that certain essential oils are effective in treating symptoms of Alzheimer’s disease, dementia, epilepsy, anxiety, and other neurological disorders. The review also reported that essential oils could possess neuroprotective and anti-aging benefits but concluded that more research is needed.

Other studies report peppermint oil aiding headache pain; rosemary oil stimulating brain waves, autonomic nervous system activity, and mood; and citrus oil potentially aiding skin repair. But these studies have relatively small sample sizes.

Long-term human clinical trials and observational studies are needed to confirm any benefits and risks, as well as effects over time.

If you’re under 12, pregnant or breastfeeding, or have certain pre-existing medical conditions, you should use essential oils with caution and check with a health professional before trying them. Just because essential oils are labeled as “natural” does not necessarily mean they are safe or risk-free.

Essential oils are showing up in an unexpected place

Essential oils are common in health food stores, yoga studios, and spas, but they’re showing up in an unexpected place: hospitals. Aromatherapy using essential oils may be helpful in clinical settings, Cutshall and Rodgers say. The health professionals have helped incorporate aromatherapy into the Mayo Clinic hospital system. In hospital rooms, nurses offer aromatherapy using six high-quality oils —lavender, ginger, spearmint, mandarin, lemon, and frankincense — for different purposes.

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The Mayo Clinic has begun offering aromatherapy using essential oils to its patients.

Researchers have been collecting data on how this practice improves patient experience. Patients report feeling more relaxed, having better sleep, and improving nausea. After seeing the positive outcomes, Cutshall and Rodgers predict aromatherapy could be useful beyond acute medical centers, in nursing homes, and in other settings.

“We tell our patients it’s really more geared toward things that might be useful for you for comfort and managing your symptoms. But if they’re marketing to you, that this is going to be something that’s going to take your condition away, then you should beware of that,” Cutshall says. “We don’t have the research to support that, and many of the companies don’t have the information to give consumers about that and have actually gotten in trouble for marketing in that way.”

In the past few decades, the essential oils industry has rapidly expanded as the public grows wary of toxic chemical exposure in skin and food products. Some of the most successful essential oil companies, like Young Living and doTERRA, thrive off word of mouth testimonials through multilevel marketing schemes (MLM).

This strategy has been financially successful. Globally, the essential oils market is predicted to reach 27 billion dollars by 2022, according to Transparency Market Research. But MLM also makes it easier for misinformation to spread. Claims about effectiveness are impossible to regulate when they’re being made by independent sales reps in an industry historically known for high turnover.

In 2014, the FDA issued a warning letter to doTERRA to stop their representatives from claiming essential oils as effective treatment for “viral infections (including ebola), bacterial infections, cancer, brain injury, autism, endometriosis, Graves’ Disease, Alzheimer’s disease, tumor reduction, ADD/ADHD, and others.” On the same day, the FDA issued a similar warning letter to Young Living.

In response, doTERRA created a team to take down false claims across the internet and warn representatives to stick with company policy. Young Living also claimed to contact all their members and provide instructions to comply with the FDA’s letter.

A company spokesperson for doTERRA declined to comment on this story.

How to be a smart consumer

Most people can enjoy essential oils for therapeutic use. You just have to be smart to avoid the dangers and reap the rewards. Cutshall and Rodgers encourage rigorously researching the quality and safety of the oils, as well as how and where they are sourced and manufactured.

“They should really look at a hundred percent pure essential oil; so there should not be any other ingredients that are listed,” Cutshall says.

They caution against blending oils, which may result in unforeseen interactions. Users are also encouraged to select oils labeled organic, and choose their dose and application carefully.

“People have to be good consumers, but that doesn’t mean that particular company can’t misrepresent themselves on a label,” Cutshall says.

If people really want to stay or get healthy, Cutshall and Rodgers encourage focusing on changing their lifestyle, exercising more, and eating a healthy diet before looking for a magic cure.

“It’s working with your lifestyle to put you in the best position possible, Rodgers says. “When you do get your procedures and the medications you’re taking, it’s all working together.”