Be careful about what you wish for

The recent history of aromatherapy in the 21^st century has highlighted the difference between those set on an orthodox medical approach to therapy and those who relate more to complementary or alternative approaches. Much relates to essential oils and our understanding or beliefs about how they work within the body system.

I have always lamented that within aromatherapy, the power of smell has never been given the credence or the value that a smell has. Education about the olfactory system is quite limited for most students being quickly assessed as molecules passing through and affecting the hormone system before passing to the limbic area and imagination and dream.

The oral route, and I include inhalation in this approach via transmission across the lungs, gets more attention. Some therapists are for oral ingestion others against. Much of this argument revolves around the claims that are made. Medical claims are not allowed for essential oils sold over the counter to consumers and is disallowed by practioner organisations. I think that for the consumer a pill is seen as medical even if it is not the same applies to a teaspoon of something! This can be seen in the supplement industry for despite what any legislation may say a supplement is taken by consumers for health benefit an example would be glucosamine taken ‘against’ arthritis.

Safety has always been a concern when taking essential oils by mouth or by ingestion. Multi-level sellers have contributed greatly to misunderstandings about the safety, use and efficacy of essential oils. This is not necessarily the fault of the originating company but rather of the exaggerated claims by individual seller to meet targets and grow personal benefit and income. Sometimes this sales route produces almost evangelical beliefs that surpass reality.

At the time of writing, I have letter from a potential Fragrant Earth customer enquiring about whether their oils are suitable to replace a multi-level brand. The reason for her enquiry concerns her self-treatment of a cancer she is suffering from. Now for whatever reason or source she has gotten hold of some ideas that naturally offer hope, but the problem is that there is no management of the outcome by the seller which is my main objection. A sale has been made but such a disease, presumably already under some ‘normal’ treatment needs management or cooperation with other clinicians.

Turning briefly back to the supplement industry I have noticed an increasing number of French aromatherapy brands now offering gelules, syrups and bonbons containing or laced with essential oils for various named purposes. Certainly, I have benefited from some very good, sugar free soothing lozenges, propolis and eucalyptus, a great combination. Sometimes adventurous copy overcomes local registration problems for I am looking at a catalogue as I write from Belgium selling ‘sweets to suck when winter arrives’, the flavourings of course essential oils!

If one looks at the national official pharmacopeia’s from the 1930’s, which is not so long ago, although to generation Z it probably sounds like the Dark Ages, many essential oils are featured. These were the days before modern synthetic antibiotics so essential oils were a great first line of defence against infectious disease.  In the UK many branded products continue to promote and sell herbal essences, tinctures syrups using essential oils as actives.  These are registered medicines or licensed medicines.

How this came about is aptly described by the British Herbal Medical Association who write “From the early 1970s a herbal medicine making a medicinal claim on the label required a Product Licence. Acceptable products already on the market were granted Product Licences of Right (PLRs) with minimum formality at the time, but thereby became subject to general regulatory requirements for medicines including, for example, the premises in which they could be manufactured. The European Community Review of Medicines during the 1980s required such products to be reviewed for quality, safety and efficacy by 1990. Those that satisfied the requirements were granted a Product Licence (i.e. a full Marketing Authorisation) and can be identified by a “PL” number on the product pack. For the majority, the available evidence of efficacy was based more on human experience than formal clinical studies and therefore indications had to commence with the words “A traditional herbal remedy for……”

 This has of course, which is typical of the European regulatory scenario, stopped the development of new and effective plant based medicines. Remedies based upon further traditional use particularly from aromatherapy have generally been unable gain traction in the medical context. Why so? To obtain a license now requires the same level of cost and requirements including trials as the pharmaceutical industry. This cost is prohibitive as it was designed to be. Big Pharma, as it is known, is the most powerful lobby worldwide alongside the arms industry. Jealous of its reputation and with outstanding successes in the medicines field it is understandable that the drug industry is not going to give way to witches, herbalists and folk tradition even if the remedies are demonstrated to be successful.

Those companies that were in the herbal business at the time of the regulatory changes and who obtained their product licenses by right were lucky. Aromatherapy was not yet established enough to come into that category. The number of essential oil suppliers as compared to today was very small and the emphasis was not on product but rather establishing the legal right to practice as a therapist. Practice took precedence over product.

The common law of England hold that patients have the right to exercise autonomy over their own bodies and over the treatment they undergo. This does not come from the European Convention on Human Rights but is a common law right. Common law is a system of law based on custom, tradition, and court decisions rather than on written legislation. One could say it is part of the tradition of being a free willed human. It is clearly the right of humans to take advantage of the health and life benefits of the hedgerow and wild fields. Unfortunately, legislation often dressed up in favour of safety has limited this right as seen  in the many patented medicines based or drawn from nature.

The 1970’s and 80’s were a great time for legislators and new regulations for medicine and cosmetics grew like Topsy. It was into the latter category that aromatherapy sought shelter. Coincidentally the Spa industry came out from its image of cold water and exercise into the more leisure spas of today. Spas in some European countries had a special medical role or status and so in this area treatment became blurred and aromatherapy ‘British’ style with massage grew increasingly popular. The question remained as to whether aromatherapy was a ’proper’ treatment.  

There were two highly influential schools in England that kick started aromatherapy leading to its worldwide popularity. These were the London School of Aromatherapy and the Shirley Price School of Aromatherapy. Both had distance learning programmes and spawned eventually rival or associated schools in different countries but notably the USA and Japan. Europe was retarded from this growth by opposition from perfume companies. They were scared of aromatherpie as practiced in France which is part of orthodox trained  medicine, often with oral prescription, compromising their market. Individuals who used aromatherapy, even ‘British’ style were fearful of prosecution as non-licensed practitioners of medicine.

There were two available solutions. The first was to seek shelter under cosmetic legislation as distinct from perfumery. Today essential oils are very prevalent in skincare and toiletry products. Essential oils as actives are seen especially in the smaller independent brands which, much to the annoyance of major brands, almost seem to operate ‘under the radar’ with unsubstantiated claims. Oddly despite wanting to be seen as distinct from perfumery, blends with various claims in label copy, hide on the ingredient list using the term parfum. Strictly speaking the only use of this term should be applied to fragrance and certainly noy in suppor5tof other claims. C’est la vie for the present.

The other solution had to prioritise the therapy itself. It was necessary to establish standards of training and practice acceptable to government institutions for education and practice as well as independent exam bodies. Two primary aromatherapy practitioner organisations were formed each one biased to one of the original schools. These two were the International Federation of Aromatherapists (IFA) and the International Society of Professional Aromatherapists (ISPA) the SP part was always referenced to Shirley Price by the less commercial IFA membership! All thanks must be given to a band of hard-working volunteers at the time who helped establish what is now the worldwide aromatherapy phenomenon. of today. Few have been given the accolade they deserved being side-lined by the more commercially minded writers and producers.

With numerous amalgamations aromatherapy today is organised internationally but the old age split as to what it is; beauty, spa, therapy, medicine still exists. Most organisations still oppose oral use for the rather practical reasons mentioned within the article.

There is also some division due to the ambitions for the therapy amongst those with a bias toward the orthodox field or the desire to place science as the basis for the therapy. It seems more status is given to being a doctor or nurse rather than a therapist. If aromatherapy is seen as no more than smelly massage, then one can quite see their point. If a form of aromatic medicine is the goal, then legislation has to be unpicked which is highly unlikely. Equally the materials of aromatherapy would for the same legislative reasons have to be refined and standardised which some would see as a heresy.  

This heresy seen by some can be seen by examining one of the success story of the essential oil industry Tea Trea Oil (TTO). Arthur Penfold in Australia in the 1920’s had made reference to the different chemical constituents that could be found in Eucalypts of the same species growing close to each other. He acknowledged that whatever the constituent, the tree was the same species and had all the same botanical characteristics that its seed had foreordained in leaf, form and function. Whatever could be analysed in chemical terms its life form was a Eucalypt. Those who look beyond chemistry perfectly understand the meaning of this.

Penfold was also really the starting point for the development of the Tea Tree industry, and he promoted its use because he identified that it had antiseptic properties and had a history of traditional use. I do remember when the best tea tree species clones were being developed by Macquarie university that a terpineol4-ol type was identified as the epitome of the desired standard. The standard today sets the maxima and minima for the 14 components of the chemotype “Oil of Melaleuca—terpinen-4-ol type,”. Oddly the standard does not stipulate the species of melaleuca to be used. Some practitioners had a preference for wild sources rather than the standardised form but this is not the general view for legislation intervened.

Consumers today are likely to Google for information about tea tree and one of the first sites co come up will be Wikipedia. This how it is and is unfortunate in a world of information our lazy searching has become so limited.  By reading the entry one could soon be put off using it. The second section is headed Toxicity. There is plenty of data. Numerous traditional uses are mentioned but  “there is little evidence of efficacy” and “there is not enough evidence to support any of these claims due to the limited amount of research conducted on the topic”. My point is that in science which is often little more in academia an endless search for research grants, one should be wary of what one wishes for.

The lesson is, the more aromatherapy is proven to be effective the more restrictions will begin to be applied. This may seem jaundiced but that is the experience of much natural medicine and the evidence is all around you in pharmacies and as explained above. The balance between rights and freedoms has during the Covid period been heavily weighted against freedom. Many essential oils have been used in sanitisers to improve the characteristics of anti-viral and bacterial ethanol and propanol with great success with little publicity, for after all regulatory affairs would not allow such to be marketed without controls.  Nevertheless the financial might of the toiletry industry has elevated citrus essential oils into the same killing category all fully approved. I suppose one must assume that if ethanol does the trick with a bit of water, perfume, colour and gelling agent why bother for the profit margin has been brilliant.

Jan Kusmirek © February 2022