Allergic contact dermatitis to essential oils.

What are essential oils?

Essential oils are aromatic substances obtained from plant material through various methods, including distillation and extraction. Essential oils have been used extensively for centuries in aromatherapy, balneotherapy, and perfumery (see perfumes and fragrances). During aromatherapy, essential oils are often applied directly to the skin or administered by inhalation methods. Essential oils are also increasingly used in household products and in spray diffusers. [1,2].

Commonly used essential oils include [1,3]:

• Tea tree oil (Melaleuca alternifolia Petroleum)

• Ylang-ylang oil (I and II) (Cananga odorata Petroleum)
• Lemongrass oil (Cymbopogon spp. Petroleum)
• Sandalwood oil (Santalum album wood oil)
• Clove oil (Eugenia caryophyllus Petroleum)
• Absolute jasmine oilJasminum officinale Petroleum)
• Sweet Laurel Oil (Laureal) (Laurel nobilis Petroleum)

• Cedar oilJuniperus virginiana wood oil)

• Patchouli oil (Cablin Pogostemon Petroleum)
• Neroli oil (Citrus aurantium flower oil)

• Peppermint oil (Mentha piperita Petroleum)

• Oil absolute daffodil (Poetic narcissus flower extract)

• Lemon oilCitrus medica limonum oil)

• Eucalyptus oil (Eucalyptus globulus Petroleum)
• Orange oilCitrus aurantium dulcis Petroleum)

What is allergic contact? dermatitis to essential oils?

Allergic contact dermatitis to essential oils is a form of dermatitis (eczema) that develops as a result of a delay hypersensitivity reaction when essential oils come into contact with the skin [4].

Various essential oils are known to be allergenic. Essential oils that commonly cause allergic contact dermatitis include [1–3]:

• Tea tree oil

• Ylang-ylang oil (I and II)
• Lemongrass oil
• Sandalwood oil
• Clove oil
• Absolute jasmine oil

• Absolute oil daffodil.

Who gets allergic contact dermatitis to essential oils?

Allergic contact dermatitis to essential oils occurs more commonly in people with occupational exposure to essential oils. [1,5]:

• Aromatherapists
• Masseuses
• Physiotherapists
• Barber Shop
• Estheticians
• Manufacturers of cosmetics.

Other groups at risk for allergic contact dermatitis to essential oils include [1,6]:

• People with atopic dermatitis
• Older patients
• Woman.

As a result of the increasing use of essential oils at home, there have been cases of air contact dermatitis caused by fragrance diffusers. [7.8].

Essential oils are used in many countries like Iran, India, China, and Thailand as a traditional method. current therapy for stomach pain and flatulence in babies. Located eczematous Reactions have been observed in the abdominal region of infants exposed to this therapy. [9].

What causes allergic contact dermatitis to essential oils?

Allergic contact dermatitis is a delayed hypersensitivity reaction (type 4) that generally occurs 24 to 72 hours after exposure to a allergen. The mechanism involves recognition of the allergen by T-pre sensitizedlymphocyteswhat a launch inflammatory cytokines they activate the skin's immune system and cause dermatitis [10].

Each essential oil can have more than 100 constituents [eleven]. Often, people with allergic contact dermatitis to essential oils react to many different oils, not just one, presumably due to shared components. [5].

What are the clinical features of essential oil allergic contact dermatitis?

The most common symptoms of allergic contact dermatitis are itching, redness, and climbing [4]. These symptoms generally occur at the site of contact with the essential oil, but can spread outside of this area.

In aromatherapists, the hands and forearms are more frequently affected with possible involvement of the face, neck and legs. [5,11,12]. Spread to other areas has also been reported. [13]. Symptoms generally improve with time spent away from work.

People who have been exposed to essential oils in the air may also have extended intervention [7,8].

What are the complications of allergic contact dermatitis to essential oils?

People who work in the aromatherapy and massage industry can experience serious consequences from sensitization to essential oils, which can result in them not being able to work [5]. There may also be an impact on social activities and even permanent disability. [6].

How is allergic contact dermatitis to essential oils diagnosed?

Clinical history and examination

A detailed history of exposure, along with clinical characteristics, morphologyand distribution of lesions are important in making the diagnosis of allergic contact dermatitis to essential oils.

In cases of occupational exposure to essential oils, symptoms often improve on vacation or on weekends. [14].

Patch tests

The patch test is used to determine the cause of allergic contact dermatitis. Patches containing small amounts of potential Allergens they are applied on the back and then removed after 48 hours to observe for a allergic reaction, which manifests as localized eczema. The test site is observed again after an additional 48-96 hours. [4].

Patients who are allergic to essential oils commonly have multiple sensitizations. [5]. Most patients with essential oil allergic contact dermatitis also have positive reactions to fragrance mixture I in the base Serie; however, an extended patch test is necessary, because not all affected patients are positive for fragrance mix I [13].

Other methods

Histology it can sometimes be helpful in distinguishing allergic contact dermatitis from other forms of dermatitis [14].

Gas chromatography and mass spectrometry have been used experimentally to analyze essential oils to identify common allergens within them. [fifteen].

Which is the differential diagnosis for allergic contact dermatitis to essential oils?

The main conditions that are confused with allergic contact dermatitis to essential oils are:

• Irritating contact dermatitis
• Contact urticaria
• Photocontact dermatitis
• Other types of dermatitis.

Irritant contact dermatitis

Irritating contact dermatitis to essential oils in high concentrations can coexist with allergic contact dermatitis. Irritant contact dermatitis is limited to the area of contact with the offending substance, while allergic contact dermatitis can extend beyond the area of direct contact. [14].

Contact urticaria

Contact urticaria presents as a bumpflare and flare reaction minutes after exposure to a substance and resolve minutes to hours [6].

Photocontact dermatitis

Photocontact dermatitis occurs when certain substances, including perfumes and fragrances, are applied to the skin and subsequently exposed to sunlight. [6].

What is the treatment for allergic contact dermatitis to essential oils?

Prevention and diagnosis.

Prevention of allergic contact dermatitis to essential oils is based on avoiding allergens. [14]. In particular, people should be advised not to apply clean, undiluted oils directly to the skin, as this can lead to sensitization. [3].

• Gloves should be considered for hand protection; however, they may not be appropriate in some occupations, such as in the massage industry. [14].

• Education is an essential part of prevention. It is important to advise patients on allergen prevention and barrier protection methods [14].
• The extended patch test for essential oils is important since patients who are allergic to essential oils generally have multiple sensitizations [13].

Treatment

Topical corticosteroids are the basis of treatment for active dermatitis.

• Moisturizers and barrier creams can be used to soothe, protect, reduce dryness, and minimize the amount of topical steroids used.

• Systemic Corticosteroids (eg, prednisone) and immunomodulatory agents can be used in cases of generalized dermatitis or in refractory cases.
• Oral antibiotics may be required in secondary cases bacterial infection.
• Oral antihistamines can be used for their sedative effects, but have no effect on dermatitis. [14].

What is the likely result of essential oil allergic contact dermatitis?

Avoiding allergenic essential oils generally results in resolution of skin symptoms. [13]. In some cases, symptoms persist and become chronic.