The Importance of Safety When Using Aromatherapy

by Sylla Sheppard-Hanger, LMT & Nyssa Hanger, MA LMT  

The following is an excerpt from The Importance of Safety When Using Aromatherapy,
published in Volume 30, Number 1 of the International Journal of Childbirth Education. If
you would like a copy of the entire paper, kindly send us a request at
info@atlanticinstitute.com and we will be mail it to you.

Abstract: This paper focuses on the safety issues concerning the use of aromatherapy with
childbirth and child care, as practiced by various healthcare professionals. This paper covers
topical and environmental inhalation methods of application of essential oils in childbirth
and child care, the reasons certain oils are to be avoided, and an emphasis on the risks of
undiluted application on the skin. Through a synthesis of existing safety data, this paper
offers guidelines for safe practices to avoid harm to the practitioner, mothers, and their
children.

Essential oils are not universally safe and misuse can lead to injury.

Overuse can cause adverse effects (Injury Report, http://www.atlanticinstitute.com/injury-

reporting with updated 2015 due in Feb). This is especially true when using with special
populations like pregnant women and children.

The number one most recent safety concern with topical aromatherapy use besides toxicity,
photo toxicity and irritation is the risk of sensitization. Sensitization is an irreversible allergic
reaction that a person can acquire after repeated undiluted use of an essential oil. Certain oils
are known sensitizers (See Table 3) and topical use should be avoided. However it is well
known that repeated undiluted use of ANY essential oil, including the gentle oils, like lavender,
has been known to cause a sensitization response. Sensitization typically takes several
applications before adverse effects occur. Many people do not realize what is happening.
Special populations such as pregnant women or their infants are at particular risk for
sensitization. In addition, fetal toxicity is possible through the overuse of essential oils since
the fetus shares blood with the mother and is affected by what she is exposed to topically
and environmentally. Therefore we do not promote undiluted or oral use for pregnancy
because of risk of adverse effects and the fact that whatever is put on the mother will get to
the baby through the bloodstream. Risk of adverse reaction is entirely dose dependent.

Safety during pregnancy: During pregnancy, the use of essential oils should be treated
the same as medications, and essential oils can also interfere with medications being taken.
However, they are useful for minor ailments such as nausea and are often safer than
medications. There is no debate about which essential oils are appropriate and safe to use
on a pregnant woman. See Table 2 for a list of oils commonly considered safe for pregnancy
and Table 1 for the mental effects.

Safety during childbirth: In practice, the authors have encountered several mothers and
midwives who used aromatherapy in the birthing process, through methods such as a

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 The Importance of Safety When Using Aromatherapy
by Sylla Sheppard-Hanger, LMT & Nyssa Hanger, MA LMT  

massage blend to help the mother relax between contractions and a diffused scent. Several
issues arise:
• First, be aware of the laboring mother’s heightened smell sensitivity during her
pregnancy. Aromas that she likes at the beginning of labor may be repulsive
several hours later
• Second, all essential oils applied to the skin need to be non irritant or
sensitizing and diluted to a max of 2.5% (15 drops in one ounce of carrier oil);
but be mindful of over-use, which can cause preventable headaches and
nausea
• Finally, do not place essential oils in the birthing water. Essential oils do not mix
with water and can severely burn the eyes and mucous membranes of baby or
mother, or worse, they could be inhaled by the baby. This could lead to
dangerous situations.

Safety with children:

Essential oils should be kept away from children, risking overexposure or ingestion. Children
may confuse them with candy and ingest, which can cause serious injury. Be aware that
certain oils, like peppermint and eucalyptus, include components that, when used too much
or put too close to nostrils, can trigger a reflex in really young children that slows breathing
down significantly. For more information, see Essential Oil Safety: For Health Care
Professionals, 2nd Edition, by Robert Tisserand and Rodney Young.

Essential oils can be used on children over two years old the same way they are used with
adults, with the exception of using only a small fraction of the same amount of oil. A parent
may give a child a massage with a relaxing blend, for example, but the dilution would be 1%
or less. A drop in the bath of non-irritant oils is fine, and diffusion is often more appropriate. Be
aware that undiluted or overuse on their skin use may set children up for sensitization later in
life, or create aversions if the oil or oils irritate the skin.

In conclusion, aromatherapy provides health and body care on a completely natural basis.
With safe methods of use, essential oils can enhance the well-being of the whole family in a
truly cost effective and efficacious manner.

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 The Importance of Safety When Using Aromatherapy
by Sylla Sheppard-Hanger, LMT & Nyssa Hanger, MA LMT  

Table 1. General Categories of Mental Effects of Essential Oils

(The Aromatic Mind Book, Sheppard-Hanger 2008)
http://www.atlanticinstitute.com/shop/aromatic-mind-book

Essential Oil Action

clary sage, grapefruit, jasmine,
neroli, rose, ylang-ylang
chamomiles, clary sage,
lavender, neroli, sweet
marjoram, sandalwood
Euphoric: uplifting to emotions,
enhances sensuality, lifts mild
depression, possible light narcotic
and euphoric effect
Sedatives: calms emotions,
relieves anxiety, reduces nervous
tension, sedates

bergamot, geranium, rose Balancing: regulating, uplifting

rosemary, basil, peppermint, Stimulant: awakening, mental

lemon stimulant

Table 2. Essential Oils Considered Safe for Pregnancy

(Guba, 2001)

Essential Oil Botanical Name

Cardamom Elettaria cardamomum
German and Roman chamomile Matricaria recutita, Anthemis noblis
Frankincense Boswellia carterii
Geranium Pelargonium graveolens
Ginger Zingiber officinale
Neroli or Orange Blossom Citrus aurantium bigaradia
Patchouli Pogostemon cablin
Petitgrain Citrus aurantium
Rose Rosa damascene
Sandalwood Santalum album
 

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 The Importance of Safety When Using Aromatherapy
by Sylla Sheppard-Hanger, LMT & Nyssa Hanger, MA LMT  

Table 3. Essential Oils Known to Cause Sensitization on

Skin
(Watt, 2013; Burfield and Sheppard-Hanger, 2005, Tisserand 2012)
Essential Oil Botanical Name
Cassia Cinnamomum cassia
Cinnamon bark Cinnamomum zeylanicum
Peru balsam Myroxylon pereirae
Verbena absolute, Lippia citriodora
Tea absolute Camellia sinensis
Lemon Myrtle Backhousia citriodora
Turpentine oil Pinus spp.
Inula Inula helenium

Table 4. Essential Oils Known to Cause Irritation (or mild

sensitizers) on Skin (Burfield, T. and Sheppard-Hanger, S.,2005)
This is a short list of commonly used oils that need caution on skin they are irritant or sensitizing, may
cause dermatitis; must be diluted. For a complete list see The Aromatherapy Practitioner Reference
Manual)
Essential Oil Botanical Name
Anise Pimpinella anisum
Bay laurel Laurus noblis
Bay oil West Indian Pimenta racemosa
Benzoin Styrax benzoin/ tonkeniesis
Cassia Cinamomum cassia
Catnip Nepeta cataria
Cinnamon bark and leaves Cinamonamum
Citronella Cymbopogon nardus
Clove (stem, leaf, bud) Syzygium aromaticum
Fennel Foneculum
Lemongrass Cymbopogon citrates
May chang Litsea cubeba
Melissa Melissa officinalis
Oakmoss Eveneria prunastri
Origano Origanum vulgare & other spp
Peru Balsam Myroxylon pereirae
Pimento berry & leaf Pimenta officinalis
Pine Pinus spp
Summer Savoury Satureja hortensis
Star Anise Alicium verum
Winter Savoury Satureja montana
Tagetes Tagete spp
Tea tree Melaleuca alternifolia
Thyme Thymus spp.
Turpentine Pinus spp.

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 The Importance of Safety When Using Aromatherapy
by Sylla Sheppard-Hanger, LMT & Nyssa Hanger, MA LMT  

Table 6: Essential Oils that are Photo-toxic ( Ford, 1991)(Tisserand 2014 )

Essential Oil Botanical Name

Amni visnaga Amni visnaga
Angelica root Angelica archangelica
Bergamot oil expressed Citrus aurantium ssp. bergamia
Cumin Cuminum cyminum
Fig leaf absolute Ficus carica
Grapefruit oil expressed Citrus paradisi
Lemon oil cold pressed Citrus limon
Lime oil expressed Citrus aurantifolia
Mandarin oil cold-pressed Citrus reticulata
Opoponax (oil, absolute, resinoid) Commiphora erythrea
Orange oil bitter Citrus aurantium
Petitgrain Mandarin oil Citrus reticulata var. mandarin
Parsley leaf oil Petroselinum crispum
Rue oil Ruta graveolens
Tagete (oil & absolute) Tagete spp.
Tangerine oil cold-pressed Citrus reticulata
Verbena oil Lippia citriodora

Table 5. Hazardous Toxic Oils

Essential Oil Botanical name

Almond oil bitter* (hydrocyanic acid) Prunus amygdalus
Armoise oil (thujones) Artemisia herba-alba
Boldo leaf oil (ascaridole) Peumus boldus
Calamus oil (β-asarone type) Acorus calamus
Chenopodium oil aka Wormseed Chenopodium ambrosioides
(ascaridole)
Croton Croton. tiglium & C. oblongifolius
Horseradish oil (allyl & phenylethyl Amoracia rusticana
isocyanates)
Lanyana oil (thujones) Artemisia afra
Mustard oil (allyl isocyanate) Brassica spp. esp. B. nigra & B.
juncea
Parsley herb oil (dill apiole) Petroselenium crispum
Pennyroyal oil (pulegone) Mentha pulegium
Perilla oil (perilla ketone – lung toxin)
Perilla frutescens
Savin oil (sabinyl acetate) Juniperus sabina
Sassafras oil (safrole) Sassafras albidum
Savoury oil, summer Satureja

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 The Importance of Safety When Using Aromatherapy
by Sylla Sheppard-Hanger, LMT & Nyssa Hanger, MA LMT  

Tansy oil (thujones) Tanacetum vulgare

Wintergreen oil (methyl salicylate) Gaultheria procumbens
Wormwood oil (thujones) Artemisia absinthium
* Almond oil FFPA is normally traded in aromatherapy = almond oil bitter Free From Prussic Acid
(hydrocyanic acid).

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 The Importance of Safety When Using Aromatherapy
by Sylla Sheppard-Hanger, LMT & Nyssa Hanger, MA LMT  

References
Ford R. (1991) The toxicology and safety of fragrances. In Muller PM, Lamparsky
D. (eds) Perfumes, Art, Science & Technology, pub. Elsevier New York pp441-
463.

Burfield, T. and Sheppard-Hanger, S. (2005). Aromatherapy Undiluted- Safety and Ethics

[modified from a previous article “A Brief Safety Guidance on Essential Oils” written for IFA,
Sept 2004].
Sheppard-Hanger, S. (2008). The Aromatic Mind Book. Tampa, FL: The Atlantic Institute of
Aromatherapy.

Tisserand, R., & Young, R. (2014). Essential Oil Safety, A guide for Health Care Professionals,
2nd Ed. New York: Elsevier.

Watt, M. (2013). Essential Oils during pregnancy: Myths Exposed and Some Facts. Retrieved
November 27, 2014, from http://aromamedical.org/PDF/oils-in-pregnancy.pdf

* * *

Provided by Atlantic Institute of Aromatherapy.

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practitioner-reference-manual

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