An interview with aromatherapy experts

Maureen Anderson, DNP, RN and Megan E. Voss, DNP, RN are both licensed nurses with advanced training in aromatherapy. They advise children, adolescents, young adults, and families on the safe and effective use of essential oils before, during and after treatment for cancer or other serious diseases in their work at the University of Minnesota Masonic Children's Hospital.

First of all, what is aromatherapy?

Aromatherapy is the use of essential oils derived from plants to achieve therapeutic effects. 

These essential oils are extracted from plants and made into a concentrated product with therapeutic properties. So, aromatherapy is not the use of scented candles or cleaning products that simply smell nice.   

Speaking broadly, what are the benefits of aromatherapy? 

There is a growing body of scientific evidence that supports the use of essential oils for symptom management, though much more high quality scientific evidence is needed to understand its full potential. Some of the most promising studies have focused on the impact of aromatherapy for anxiety reduction and sleep promotion. Researchers have also looked at its use for pain and nausea.  Aromatherapy is never used as a curative treatment for any illness.

One of the things I love most about aromatherapy is that it can empower families to engage in self-care, something we could all use more of these days! Aromatherapy can help enhance other integrative practices, like meditation or yoga, by encouraging deep breathing and relaxation.

What are some of the biggest misconceptions about aromatherapy?

The biggest misconception I see with aromatherapy is that consumers want to believe that a natural plant-derived substance is 100% safe. In reality, these products are extremely potent. As much as they have the potential to provide therapeutic benefit, they also have potential to cause harm. Essential oils really can act like a medication in the body. They can cause allergic reactions and damage organs. They can even cause dangerous interactions with prescriptions or over-the-counter medications if used incorrectly. 

Another misconception about essential oils is that they are curative substances. Aromatherapy can help lessen severity of symptoms to a more manageable level, but it is still important to explore the underlying cause of the symptoms. For example, if you are experiencing nausea, aromatherapy may help lessen the nausea but it cannot address why the nausea is happening in the first place. 

Could you define clinical aromatherapy, and share a bit about your work with the practice in clinical settings?

Clinical aromatherapy is the use of essential oils for therapeutic purposes under the guidance of a clinician who has been trained in aromatherapy. Though there are a variety of programs that offer certification in aromatherapy, it is a good idea to seek clinical aromatherapy guidance from a licensed healthcare professional (such as a nurse, nurse practitioner, or physician) with aromatherapy training. Aromatherapy certification alone does not mean that an individual is a healthcare professional with clinical expertise. 

We work at the University of Minnesota’s Masonic Children’s Hospital in the pediatric blood and marrow transplant program. In our roles, we make recommendations for the safe and effective use of aromatherapy to manage symptoms such as anxiety, pain, nausea, and insomnia. In addition to recommending essential oils that may help, we spend a great deal of time educating our pediatric patients and their families on the safe use of essential oils when they leave the hospital setting. We also demonstrate how patients and families can receive the biggest benefit from using aromatherapy, which is most often when pairing it with another integrative therapy. Most commonly we pair aromatherapy with guided meditation, breathwork, massage therapy, and acupressure.

Are there any anecdotal examples you could share of instances when a patient benefitted from clinical aromatherapy as part of their treatment plan?

Some of our sickest patients remain in the hospital for many days. Teenagers especially begin to experience back, neck, and shoulder tension and pain. The biggest benefit I see from aromatherapy is using an essential oil blend that was created for musculoskeletal pain. We use a 2% dilution in massage oil and apply it to the areas of pain and tension with both massage and acupressure techniques. This combination typically offers more relief to my patients than medications. 

An important component of that therapeutic experience is the time, trust, and rapport built between nurse and patient. Sure, the essential oils are helping, but so is quieting the room and the mind for thirty minutes and encouraging my patient to focus on their breath and their body. It's all very synergistic. Integrative techniques like the one I’ve just described release physical tension from the body, but there is also a mental and emotional release that I observe. That’s the component that’s so hard to capture in a scientific study, but experience it once, and it’s undeniably real and powerful. 

Is there any sort of stigma in the medical world about using aromatherapy in a clinical setting? If so, would you say that's evolving?

There is some stigma, but it’s mostly associated with the improper use of essential oils. Most major health systems now have an aromatherapy program that is focused on educating staff and patients on the safe and effective use of essential oils. It helps to decrease the stigma when frontline nurses and doctors can observe some benefits and hear success stories from their patients. 

Does aromatherapy have both immediate and long-term effects?

This is a complex question. The short answer is that essential oils, when used topically or via inhalation, typically have a short onset and duration. However, because olfactory (smell) and memory are linked so closely in the brain, the effects of aromatherapy can intensify over time. This can be positive or negative. 

For example, if you meditate for 30 minutes three times a week and inhale lavender essential oil each time you do so, you will have increased effects from lavender essential oil over time, and that could be a really great thing. One day, you might not have time to meditate for 30 minutes, but if you take a few deep breaths inhaling lavender essential oil, you will reap many of the same benefits. 

Here is another example of how this can work against an individual. If a patient is offered peppermint essential oil for chemotherapy induced nausea every time she is admitted for chemotherapy, she may years down the road, experience nausea if she smells peppermint. That’s because the brain links these two powerful experiences together. The smell can forever be associated with the experience—positive or negative. 

Is there anything else you wish everyone knew about aromatherapy?

• A key principle of clinical aromatherapy is less is more. Start with very small amounts of essential oils. It is easy to add more, but it can be difficult to clear the air or clean the skin quickly if you use too much or too many essential oils and start to feel undesirable effects. 
• These products come from the earth, and they use valuable natural resources to produce. Some of these natural resources are in abundance, but others are endangered. Make sure to source products from an environmentally responsible manufacturer. Always avoid essential oils made from endangered species, such as sandalwood. To find out which species are endangered, you can visit the International Union for Conservation of Nature and Natural Resources website. Use only what you need to use. It isn’t wise to have essential oils in every cosmetic and cleaning product in the house. 
• You should buy blends of essential oils created by someone with a background in clinical aromatherapy who understands the chemistry of each oil. While blends can be great to use at home, it is best to buy pre-blended products when starting out. 
• Feel empowered to experiment with what you like! If you are a healthy adult looking to use aromatherapy inhalation as part of your own self-care, there is very little that could go wrong. Find an essential oil that resonates with you and your goals and have fun with it!

Here are some reliable resources for learning more about aromatherapy use at home:

In case of emergency: Call your healthcare provider or Poison Control Center: 1-800-222-1222

For more information:

• Alliance of International Aromatherapists (AIA)
• National Association for Holistic Aromatherapy (NAHA)
• National Institute of Health
• Taking Charge of Your Health and Wellbeing (from the University of Minnesota)