Indian-American physician, others talk of the promise, and risk, of essential oils

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Essential oils are seemingly everywhere – fitness studios, nail salons, juice bars, home stores, big-box pharmacies and even recipe blogs – promising benefits such as sounder sleep, deeper focus and improved well-being. Is any of it legit?

Even though aromatherapy is an ancient practice, the current craze arrived in a cloud of confusion and controversy. There are the multilevel marketing giants that hire untrained “wellness advocates” to pitch you products. There are megabrands that use synthetic imitations of oils without disclosing the difference. There’s the Food and Drug Administration, which has been slow to regulate the products (except for its crackdowns on a few MLMs that were making unsubstantiated claims about using oils to combat diseases). And there are well-meaning aromatherapists who perhaps rely too heavily on small-batch clinical studies and evolving research.

It all adds up to one big head scratch for consumers, who seem to cast essential oils into two categories: At best, they’re a harmless hippie indulgence along the lines of crystals and candles. At worst, they’re a dangerous marketing scam. Experts say neither is quite right. Essential oils – concentrated, aromatic, volatile liquids distilled from plants – are highly potent, often risky and full of possibilities.

“The research is quite promising,” said Harpreet Gujral, director of integrative medicine at Sibley Memorial Hospital in Washington, D.C. She cited ongoing clinical studies that strive to measure the degree to which oils can alleviate symptoms of anxiety and nausea, as well as how they affect mood. “The results are mixed, but the research is there,” she said. “We just need more.”

Of the 100 most common essential oils, about 10 have been researched “in great depth” over the past three decades, said Robert Tisserand, who wrote the widely cited 1995 textbook “Essential Oil Safety,” which received a substantial update in 2013. Those efforts have yielded some concrete evidence (the cooling sensation of peppermint oil, the bacteria-killing power of tea tree oil or the calming effect of lavender, for example) but the results aren’t guaranteed for everyone.

Some researchers believe essential oils could also be key in solving the looming antibiotic-drug-resistance crisis. “Research strongly suggests that bacteria don’t develop resistance to essential oils the way they do to antibiotics,” Tisserand said.

For now, most people encounter essential oils in cosmetic environments such as spas or salons or in health food stores. They make up what has become a multibillion-dollar industry. Revenue in the United States spiked 40 percent from 2014 to 2018 and, according to Grand View Research, is expected to reach more than $5 billion in the next four years. Although some of that growth is from the food industry, which uses the extracts’ antimicrobial properties to improve shelf life, the rise of plant-based chemicals in personal care is significant. As consumers search for greener alternatives to synthetic cosmetics and prescription drugs, aromatherapy has crossed over from New Age hobby to mainstream phenomenon and revived the conversation around the natural healing properties of plants.

Skeptics tend to wrestle with the ambiguity of essential oils, which occupy a gray area between perfume and medicine. Plant elixirs are often promoted with lofty promises and fuzzy science and, like supplements, aren’t regulated by the FDA. That means companies don’t have to prove their products are safe or effective and largely aren’t held accountable for what they put on the label. As a result, shopping for essential oils can be a nightmare. Consumers face a marketplace that’s littered with deceptive marketing, unsubstantiated claims and conflicting advice.

“There is, unfortunately, a lot of bad information out there,” Tisserand said. “And the way it spreads now, it’s very difficult to navigate.”

Don’t be discouraged. Just because there’s a glut of misinformation doesn’t mean essential oils aren’t worth exploring or can’t help you. Many researchers think we’ve only scratched the surface when it comes to unearthing their healing properties. “Essential oils have become mainstream because people are seeing them as an aesthetic; they smell good, they look good.” Gujral said. “They are so much more than that.”

Before you fill your medicine cabinet with these potent potions, arm yourself with as much information as possible. Here are some tips for navigating the marketplace.

– Watch for fakes

Although there are exceptions, products sold at big-box retailers or chain drugstores that boast essential oils are probably not the real deal. “Many mass-market ‘aromatherapy’ products that list oils on their cosmetic labels actually contain either synthetic fragrances or isolated fragrance chemicals such as linalool and geraniol limonene rather than natural essential oils,” said Annette Davis, a seasoned aromatherapist and the president of the National Association for Holistic Aromatherapy. Tisserand sympathizes with confused consumers. “Sometimes, it’s even difficult for a specialist lab technician to tell whether or not an essential oil has been adulterated,” he said. Synthetic chemicals may not sound like the worst thing, especially if the real oil hasn’t yet proved to be effective, but Davis says the issue is transparency. Consumers of essential oils are typically looking for a natural alternative to commercial products, as well as a specific effect (calming, anti-inflammatory, etc.). Knowing the source, authenticity and exact concentration is preferable to buying a mysterious blend.

One way to separate real oils from synthetics is price. Essential oils are difficult and expensive to produce and often require large amounts of plants. “It takes almost 2,000 lavender blossoms to give us just a few drops of essential oil,” Gujral said. “So when I see it being sold for $5 on Amazon, I know something isn’t right.”

– Understand the terms

All the earthy nomenclature around essential oils – even the term itself – can be confusing. Essential oils aren’t called that because they’re vital for a healthy life but because they contain a plant’s fragrance, or “essence.” Similarly, don’t take much stock in terms such as “therapeutic grade,” “pharmaceutical grade” and “medical grade” when it comes to oils. Like the term “natural,” these labels aren’t regulated by the FDA and are relatively meaningless, Davis said.

What you want to see, Gujral said, are botanical names. “If a company does not list the plant’s scientific or botanical name as well as where they sourced it from, it’s likely not a good product,” she said. “Take lavender, for example. It should say lavender lavandula [under ingredients], as well as the state or country of origin. Did it come from Arizona? Puerto Rico? That information should be included.” The National Association for Holistic Aromatherapy also recommends looking for labels that include required warnings against toxic oils (such as wintergreen), any specific growing methods (such as “organic” or “wild”) and special extraction methods. Most essential oils are distilled, Davis said. If the extraction method is anything other than distilled (cold-pressed or via CO2, for example), it should be listed. Some include a chemical process that could be toxic.

– Be safe

When Gujral was a doctoral student at the University of Minnesota, she took a class in aromatherapy that she hoped would deliver “the magic recipes,” or special blends for curing ailments and alleviating pain. Instead, she said, “the lesson was, these are volatile, potent chemicals,” she said. “They should only been used when necessary, as indicated. We have to be reasonable. Of course they aren’t a magic fix. Of course you don’t use them every day.”

There’s a reason aromatherapists are so quick to talk about safety. Essential oils are often highly potent and, as a result, risky. Bottled oils are 50 to 100 times more concentrated than the oils in the plant itself. Although many sites will encourage you to absorb and even ingest essential oils, experts strongly advise against it. Generally, it’s best to avoid applying pure essential oils directly onto the skin, because their high concentration can cause chemical burns or irritation. Instead, they should be diluted into a blending oil or lotion. “Don’t ingest oils unless you absolutely know what you’re doing,” Tisserand cautions, “and definitely don’t put essential oils in water and drink them. That is terrible advice.”

One popular way to use the oils is with a diffuser – but not all are created equal. Beginners should look for ultrasonic diffusers, which mist a mixture of water and oils into the air. Those with more experience may want to consider nebulizing diffusers, which distribute pure, undiluted oil via pumps of air. Because the oil is undiluted, you’ll want to have a solid understanding of what oils you’re using. A tip: Don’t leave it on all day. A quality diffuser should be able to fill the room in about 30 minutes, and overexposure to certain oils, particularly from inhalation, can cause side effects such as headaches and spikes in heart rate.

Oils should be kept away from children and babies, who are more susceptible to potential toxicity, and pregnant women should take caution with certain compounds. Peppermint oil is so powerful that it can prematurely induce labor, Gujral said.

– Be informed

If you’re interested in experimenting with essential oils, consider consulting a certified aromatherapist. Most have had to complete about 200 hours of coursework and will be able to offer more informed guidance based on your medical history and the nuances of the plant. Tisserand, who runs an online education portal called the Tisserand Institute that prioritizes clinical research over folklore and word of mouth, says he marvels at how many people still turn to Facebook for answers. “I’ve been saying this for 40 years: You need to read a book, follow the guidelines, talk to an expert.” Otherwise, the risk is not dissimilar to blindly experimenting with prescription drugs, he said. “Sometimes you’re playing with fire, and sometimes you’re buying things that are not going to work.”

If you’re keen to do your own research, there are several reputable organizations with materials that might help serve as a guide. The National Association for Holistic Aromatherapy has safety guidelines, approved schools and reputable brands on its website, and the American Botanical Council has a newsletter called HerbalEGram that Gujral recommends. The National Cancer Institute also has information about current clinical trials.