Many skin care professionals have read about aromatherapy. Some of them have experienced it. Chances are that many people know what aromatherapy is because of its undoubted popularity. Yet, the question continues to arise: Does it work? There are still doubts of its effectiveness among the western medical population, stating that research must continue and insisting that there is no substantial evidence of its claims. Meanwhile, herbalists and professionals, under the umbrella of natural medicine and alternative health practices, continue to embrace this modality and demonstrate its value. WHAT IS AROMATHERAPY? It is important to first fully understand what aromatherapy is and how it works before one can review the various scientific studies found about this popular modality. Aromatherapy is the use of aromatic oils on the body, predominantly by inhalation or massage. These oils, essential oils, are extracted from plants. Dr. Jane Buckle, a critical care nurse trained in clinical aromatherapy and well known as an educator in the subject, indicates that essential oils have been used for therapeutic purposes for over 5,000 years. The ancient Chinese, Indians, Egyptians, Greeks, and Romans used plant oils in cosmetic, perfume, and drug preparations. The Egyptians applied them after bathing and for embalming mummies. The Ancient Chinese compiled a compilation of evidence and recipes, using plants, herbs, and different types of wood. In India, aromatic massage was a key treatment under Ayurvedic medicine. A Persian philosopher and scientist named Avicenna was the first to extract these oils from plants through distillation. By the 19th Century, René Maurice Gattefossé, a French chemist, originated aromatherapy as we know it today, including the name itself. He published his studies on the subject after seeing his burnt hand, due to a laboratory accident, heal with lavender oil. HOW DOES IT WORK? According to Yale Scientific Magazine’s review of the inhalation process in aromatherapy, once an essential oil is smelled, its scent travels through the nasal cavity and reaches the olfactory bulb by stimulating the olfactory receptors. From the olfactory bulb, the aroma is then sent directly to the limbic system, the center of the brain. The very interesting part of this process is that while the mistral cells carry the scent molecules into the olfactory cortex found in the limbic system, which is the part responsible for perception and recognition, there are other mistral cells that take the scent to other areas of the brain’s limbic system. Some mistral cells connect directly to the amygdala, a structure in the brain involved with emotions, memory, and feelings. Both the amygdala and the limbic system are involved in the primary processing pathway of the olfactory system, making it the only sensory system that does so. WHERE IS THE SCIENTIFIC EVIDENCE? A science student is taught that when it comes to the research industry, he or she should consider only valid and credible, published studies that come from reputable sources. With that said, exploring different studies on aromatherapy from various sources brings what seems to be contradicting conclusions. Therefore, the best that can be done is to review different studies from various international reputable sources and from different industries such as western medicine and naturopathic medicine, for example, and analyze their methodologies. Here are two studies from opposing views that can be analyzed in order to draw a conclusion. INHALATION AROMATHERAPY AND ITS EFFECTS ON ANXIETY Here are two studies from opposing views that can be analyzed in order to draw a conclusion. Evidence Actual Study and Results Comments and Reviews The negative study An Australian study, focusing on oncology patients, stated that with regards to depression and anxiety, there were no significant differences between the groups undergoing radiotherapy with inhalation aromatherapy.3 This study focused on the somatic nervous response system, including all the functions of the body that are done voluntarily, like moving a leg or finger. Method of inhalation: Through a paper bib like the one used in a dentist’s office. 1. Oncology patients go through physiological changes as a side effect from their dense treatment. According to the U.S. Department of Health & Human Services, some of these changes may involve a smell disorder.4 2. Emotions or memories associated with scent may also occur during a study. As the aromatherapy is being performed during radiotherapy, this association may be picked up by the brain, instantly inducing a negative and biased outcome. This may provoke anxiety instead of the contrary.1 3. There was a reduction in anxiety found in the study, but it was not significant enough for researchers to draw a positive conclusion. 4. Other variables were mentioned and the possibility of them affecting the results were in question. 5. Method of analysis used: HADS (Hospital Anxiety and Depression Scale), which is found to have evidence of reduced validity in some populations, particularly in the elderly. 6. This study is 12 years old. The positive study A study with inhalation aromatherapy demonstrated the reduction of anxiety on Taiwanese elementary school teachers, a stressed working population.5 This study focused on autonomic nervous response system, including all the functions of the body that are done involuntarily, like breathing or blinking. Method of inhalation: Through misting diffuser 1. It was focused on the short-term effects of aromatherapy rather than long-term.5 2. Data showed the experiment to be effective in promoting parasympathetic activation, reducing blood pressure and lowering heart rate. 3. Besides levels of anxiety, other subgroups were studied and analyzed to further validate these results, such as covariance between the different variables such as gender, age, and job position. 4. Other variables were not mentioned which may seem biased. 5. Method of analysis used: BAI (Beck Anxiety Inventory), which is similar to HADS but it is commonly used in various populations and different industries. 6. This study was preformed 2 years ago. Conclusion: The anxiety present in stressed elementary school teachers from Taiwan may not be comparable to the anxiety in cancer patients; however, this is not where the analysis should be focused on. The key is in the methodology used to execute the study and compare the variables that may contribute to any changes in the data. According to the U.S. National Center for Biotechnology Information, both methods have similarities. However, HADS is found to have evidence of reduced validity in some populations, particularly in the elderly. The cancer study was predominantly of elderly patients. Meanwhile, BAI is not used as much in the clinical setting as the HADS method. Other published studies on aromatherapy, particularly those used in massage treatments, will have similar contradicting results as the studies involve inhalations. The negative study for experiments on massage with the use of aromatherapy will support a belief that it is helpful for anxiety reduction for short-term periods and results can be attributed to the actual massage rather than the oil itself. Data has not undermined a hypothesis that aromatherapy massage is pleasant, possibly anxiolytic, and even enjoyable for patients under stress. Equally, such data will not support a hypothesis that there may be valid clinical indications for the need of aromatherapy in a healthcare setting. Flaws within a study are not uncommon. Questions about specific or non-specific effects seem impossible to resolve. Differentiation exists between effects through inhalation as opposed to transdermal absorption. It is also uncertain how important the psychological factors’ role is when using aromatherapy. For example, in a study published by the British Journal of General Practice, it was observed that pleasant memories triggered by a specific scent may be enough to cause a difference. Despite the disputing studies on aromatherapy and its effects, Yale Scientific Magazine concluded that there is aconsistent improvement on mood across most studies. As some researchers agree, a possible explanation for mood improvements and acclaimed pain reduction in some of these studies may be due to the placebo effect. Based on this theory, an individual’s expectations, instead of the aroma’s characteristics, define the effects of an aroma. They also mentioned that Monell Chemical Senses Center conducted an experiment where participants were informed that a scent would improve their performance in executing calculations correctly. This indicated that when people expect the scent to have the power to affect their health and behavior, it actually does, due to the placebo effect. Then again, a behavioral neuroscientist, Dr. Charles J. Wysocki, spent 30 years studying smell and believes that it may be difficult to demonstrate a positive effect due to a scent because the brain seems to be more focused on detecting bad odors and causing a negative reaction toward it. However, the reaction caused by a smell is also highly conditioned. "A child who experiences the smell of roses for the first time on a summertime walk in the garden with his mother will have different memories of the smell of roses than a child who first experiences the smell of roses at his mother's funeral," said Dr. Wysocki. Despite possible conditioning factors, aromatherapy is an ancient practice and continues to transcend with hundreds of aromatherapy practitioners around the world and countless positive testimonials. While some scientists may not seem to find aromatherapy a needed modality, the overwhelming anecdotal information and testimonials available should not be overlooked. Spa professionals have the commitment to contribute to their clients’ well-being, a key goal in every spa. Even though the evidence of aromatherapy may seem inconsistent throughout the studies found, how clients feel after they visit a spa is what truly matters. Whether some scientists have disbelief in its benefits, aromatherapy, at the very least, can complement spa services when giving clients an enjoyable experience. This allows them to associate the pleasurable aromatics in essential oils with being in the spa, causing a positive change of mood that may reduce stress and anxiety while they are there. Being at the spa is a time to disconnect from the outside world and relax. Besides massage and inhalation treatments, aromatherapy can be used in other beneficial ways in the spa environment. Through various media sources, aromatherapists share a plethora of information on essential oils, blends, and how they use them. Here are a few great ideas of ways to use essential oils: 1. Diffuse cinnamon essential oil in the air. It is known to have anti-microbial properties and can clean the air. 2. Add about 10 drops of a desirable essential oil, like lavender, to the washing machine when washing hand cloths and linens used on clients. This will give the cloth a nice calming scent, making it pleasant for your client to use. Blend two to four drops of lavender and peppermint essential oil in a tablespoon of a carrier oil and apply to the temples of the client. Rub some drops on the back of their neck, as this provides a cooling effect and relaxing sensation. Adding a few drops of lemon or eucalyptus oil in a foot bath, possibly during a pedicure, is refreshing to tired feet. Add a few drops of an energizing citrus essential oil to the air filter of the central air conditioner. This will create a refreshing ambiance and may improve the clients’ and the spa team’s mood. REFERENCES: 100 Different Creative Ways to use essential oils. (2015, January 23). Buckle, Jane, Ph.D. (2015). Clinical Aromatherapy: Essential oils in Healthcare (3rd Ed.) St. Louis, MO: Elsevier. Chang, K.M., Shen, C.W. (2013). Aromatherapy Benefits Autonomic Nervous System Regulation for Elementary School Faculty in Taiwan. The International Journal of Professional Holistic Aromatherapy, 1(4), 9-15. Cooke, B., and Ernst, E. (2000). Aromatherapy: A Systematic Review. British Journal of General Practice, 50, 493-496. Deng, C. (2011). Aromatherapy: Exploring Olfaction. Yale Scientific. Graham P.H., Browne, L., Cox, H., and Graham, J. (2003). Inhalation Aromatherapy During Radiotherapy: Results of a Placebo-Controlled Double-Blind Randomized Trial. Journal of Clinical Oncology, 21, 2372-76. Julian, L.J, Ph.D. (2011). Measures of Anxiety. National Institutes of Health. San Francisco California. doi: 10.1002/acr.20561. National Institutes of Health (2013). NIDCD Fact Sheet: Smell Disorders. Karym Urdaneta is a biomedical engineer and managing partner of Pink Horizons Botanical Skin Care, a Green America certified company that formulates safe, high-performance products for health practitioners and the end-consumer. They are considered industry leaders, proudly maintaining a “Champion” status with the Campaign for Safe Cosmetics, teaming with socially responsible organizations to educate the community on holistic living and sustainable business practices. For more information on toxin-free skin care, visit www.pinkhorizons.com.Want to read more? Subscribe to one of our monthly plans to continue reading this article.