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Tea tree oil in the treatment of tinea pedis
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Complementary Therapies in Medicine
organic substances and it is hardly surprising that they have at least some pharmacological effects. Peppermint oil ('Colpermin'), for example, is a standard treatment in irritable bowel syndrome. Constituents of essential oils are also used in preparations to treat gallstones ('Rowatinex'), gum disease ('Listerine') and muscle pain ('Deep Heat'). Clinical trials of such preparations have been largely favourable. More recently, trials have shown that essential oils of tea-tree, a traditional Australian remedy, has effects on ache and a number of fungal diseases. That said, there is very little evidence that the distinguishing feature of aromatherapy as practised the use of essential oils in massage - is of value. There are only a very few trials comparing the effects of massage with essential oils to that of massage with just plain oil and most of these were methodologically poor and inadequately reported. In sum, though aromatherapy appears theoretically to be a promising treatment, there is a dearth of good-quality empirical evidence justifying current aromatherapy practice. SELECTED REFERENCES Stevensen C. The psychophysiological effects of aromatherapy massage following cardiac surgery. Complementary Therapies in Medicine 1994; 2(1): 27-35. Aromatherapy and massage have gained wide popularity amongst nurses in their clinical practice in recent years. The intensive care setting offers a challenge to nurses to meet the psychological and physical needs of the patient within a highly technological environment. A randomized controlled trial was conducted to assess the effects of aromatherapy and massage on post-cardiac surgery patients. Foot massage given over 20 min, with or without the essential oil of neroli, on day 1 postoperatively showed that a statistically significant psychological benefit was derived from both the groups receiving massage, compared to controls; however, significant physiological differences were limited to respiratory rate as an immediate effect of massage with or without the essential oil. A further follow-up questionnaire on day 5 post surgery indicated a trend towards greater and more lasting psychological benefit from the massage with the neroli oil compared to the plain vegetable oil. Wilkinson S. Aromatherapy and massage in palliative care. International Journal of Palliative Nursing 1995; 1(1): 21-30. Aromatherapy and massage have gained wide popularity among nurses in clinical practice in recent years. Many nurses in palliative care settings are using these therapies with the assumption that they improve patients' quality of life, but no research has yet investigated their effectiveness. A study was set up to assess the effects of massage and aromatherapy massage on cancer patients receiving palliative care. Patients
received three full body massages over a three-week period, with or without the essential oil Roman chamomile. The measurements used were the Rotterdam Symptom Checklist (RSCL) and StateTrait Anxiety Inventory. Post-test scores for all patients improved. These were statistically significant in the aromatherapy group on the RSCL physical symptom subscale, quality of life subscale and state anxiety scale. Responses to the post-therapy questionnaire indicate that patients consider the massage or aromatherapy to be beneficial in reducing anxiety, tension, pain and depression. Tong M M, Altman PM, Barnetson RS. Tea tree oil in the treatment of tinea pedis. Australasian Journal of Dermatology 1992; 33(3): 145-149. Tea-tree oil (an essential oil derived primarily from the Australian native Melaleuca alternifolia) has been used as a topical antiseptic agent since the early part of this century for a wide variety of skin infections; however, to date, the evidence for its efficacy in fungal infections is still largely anecdotal. One hundred and four patients completed a randomized, double-blind trial to evaluate the efficacy of 10% w/w tea tree oil cream compared with 1% tolnaftate and placebo creams in the treatment of tinea pedis. Significantly more tolnaffate-treated patients (85%) than tea-tree oil (30%) and placebo-treated patients (21%) showed conversion to negative culture at the end of therapy (P < 0.001); there was no statistically significant difference between tea-tree oil and placebo groups. All three groups demonstrated improvement in clinical condition based on the four clinical parameters of scaling, inflammation, itching and burning. The teatree oil group (24/37) and the tolnaftate group (19/33) showed significant improvement in clinical condition when compared to the placebo group (14/34; P = 0.022 and P = 0.018 respectively). Tea-tree oil cream (10% w/w) appears to reduce the symptomatology of tinea pedis as effectively as tolnaftate 1% but is no more effective than placebo in achieving a mycological cure. This may be the basis for the popular use of tea-tree oil in the treatment of tinea pedis. Dew M, Evans BJ, Rhodes J. Peppermint oil for the irritable bowel syndrome: a multicentretrial. BritishJournal of Clinical Practice 1984;8: 4548. Engelstein D, Kahan E, ServadioC. Rowatinexfor the treatment of ureterolithiasis.Journal d'Urologie 1992;98(2): 98-100. Bassett IB, PannowitzDL, BarnetsonRS. A comparativestudy of tea-tree oil versus benzoylperoxidein the treatment of acne. Medical Journal of Australia 1990; 153(8):455-458. Finkelstein P, Yost KG, Grossman E. Mechanicaldevicesversus antimicrobial rinses in plaque and gingivitis reduction. Clinical PreventiveDentistry 1990; 12(3): 8-11.
Note: These abstracts are based on material first published in the Research Council for Complementary Medicine's Bulletin Research and Information in Complementary Medicine No. 26.
Complementary Therapies in Medicine
organic substances and it is hardly surprising that they have at least some pharmacological effects. Peppermint oil ('Colpermin'), for example, is a standard treatment in irritable bowel syndrome. Constituents of essential oils are also used in preparations to treat gallstones ('Rowatinex'), gum disease ('Listerine') and muscle pain ('Deep Heat'). Clinical trials of such preparations have been largely favourable. More recently, trials have shown that essential oils of tea-tree, a traditional Australian remedy, has effects on ache and a number of fungal diseases. That said, there is very little evidence that the distinguishing feature of aromatherapy as practised the use of essential oils in massage - is of value. There are only a very few trials comparing the effects of massage with essential oils to that of massage with just plain oil and most of these were methodologically poor and inadequately reported. In sum, though aromatherapy appears theoretically to be a promising treatment, there is a dearth of good-quality empirical evidence justifying current aromatherapy practice. SELECTED REFERENCES Stevensen C. The psychophysiological effects of aromatherapy massage following cardiac surgery. Complementary Therapies in Medicine 1994; 2(1): 27-35. Aromatherapy and massage have gained wide popularity amongst nurses in their clinical practice in recent years. The intensive care setting offers a challenge to nurses to meet the psychological and physical needs of the patient within a highly technological environment. A randomized controlled trial was conducted to assess the effects of aromatherapy and massage on post-cardiac surgery patients. Foot massage given over 20 min, with or without the essential oil of neroli, on day 1 postoperatively showed that a statistically significant psychological benefit was derived from both the groups receiving massage, compared to controls; however, significant physiological differences were limited to respiratory rate as an immediate effect of massage with or without the essential oil. A further follow-up questionnaire on day 5 post surgery indicated a trend towards greater and more lasting psychological benefit from the massage with the neroli oil compared to the plain vegetable oil. Wilkinson S. Aromatherapy and massage in palliative care. International Journal of Palliative Nursing 1995; 1(1): 21-30. Aromatherapy and massage have gained wide popularity among nurses in clinical practice in recent years. Many nurses in palliative care settings are using these therapies with the assumption that they improve patients' quality of life, but no research has yet investigated their effectiveness. A study was set up to assess the effects of massage and aromatherapy massage on cancer patients receiving palliative care. Patients
received three full body massages over a three-week period, with or without the essential oil Roman chamomile. The measurements used were the Rotterdam Symptom Checklist (RSCL) and StateTrait Anxiety Inventory. Post-test scores for all patients improved. These were statistically significant in the aromatherapy group on the RSCL physical symptom subscale, quality of life subscale and state anxiety scale. Responses to the post-therapy questionnaire indicate that patients consider the massage or aromatherapy to be beneficial in reducing anxiety, tension, pain and depression. Tong M M, Altman PM, Barnetson RS. Tea tree oil in the treatment of tinea pedis. Australasian Journal of Dermatology 1992; 33(3): 145-149. Tea-tree oil (an essential oil derived primarily from the Australian native Melaleuca alternifolia) has been used as a topical antiseptic agent since the early part of this century for a wide variety of skin infections; however, to date, the evidence for its efficacy in fungal infections is still largely anecdotal. One hundred and four patients completed a randomized, double-blind trial to evaluate the efficacy of 10% w/w tea tree oil cream compared with 1% tolnaftate and placebo creams in the treatment of tinea pedis. Significantly more tolnaffate-treated patients (85%) than tea-tree oil (30%) and placebo-treated patients (21%) showed conversion to negative culture at the end of therapy (P < 0.001); there was no statistically significant difference between tea-tree oil and placebo groups. All three groups demonstrated improvement in clinical condition based on the four clinical parameters of scaling, inflammation, itching and burning. The teatree oil group (24/37) and the tolnaftate group (19/33) showed significant improvement in clinical condition when compared to the placebo group (14/34; P = 0.022 and P = 0.018 respectively). Tea-tree oil cream (10% w/w) appears to reduce the symptomatology of tinea pedis as effectively as tolnaftate 1% but is no more effective than placebo in achieving a mycological cure. This may be the basis for the popular use of tea-tree oil in the treatment of tinea pedis. Dew M, Evans BJ, Rhodes J. Peppermint oil for the irritable bowel syndrome: a multicentretrial. BritishJournal of Clinical Practice 1984;8: 4548. Engelstein D, Kahan E, ServadioC. Rowatinexfor the treatment of ureterolithiasis.Journal d'Urologie 1992;98(2): 98-100. Bassett IB, PannowitzDL, BarnetsonRS. A comparativestudy of tea-tree oil versus benzoylperoxidein the treatment of acne. Medical Journal of Australia 1990; 153(8):455-458. Finkelstein P, Yost KG, Grossman E. Mechanicaldevicesversus antimicrobial rinses in plaque and gingivitis reduction. Clinical PreventiveDentistry 1990; 12(3): 8-11.
Note: These abstracts are based on material first published in the Research Council for Complementary Medicine's Bulletin Research and Information in Complementary Medicine No. 26.