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Massage Today
May, 2006, Vol. 06, Issue 05

Client Sensitivities to Aroma

By Shellie Enteen, RA, BA, LMBT

Following the publication of my article on treating fibromyalgia (FM) with essential oils, several readers contacted me with questions about what to do when clients appear to have difficulty with scents.

Of course, this is a topic that has relevance for a broader population than those with FM.

I do not believe that sensitivity to aroma is a result of, or indicator for, FM, and so I would not consider aromatherapy a general contraindication for that diagnosis. In fact, Lynne K. Matallana, president of the National Fibromyalgia Association (NFA), has said the following:

"The National Fibromyalgia Association suggests that individuals who suffer with the symptoms of fibromyalgia implement a self-management program which incorporates both Western and complementary approaches to health care. Some people with FM are very sensitive to medicines and prefer to use more natural health care options. Dealing with the constant pain and fatigue of fibromyalgia can be quite stressful and finding ways to help relieve stress can also help to reduce the overall symptoms of this chronic illness. Since fibromyalgia involves an increase in neurological sensitivity, both physically and emotionally, practices that are calming can bring a sense of relief. To accomplish these goals, we suggest aromatherapy alone or in combination with massage and other relaxation techniques. The use of fragrant herbs or oils can help promote sleep, calm the mind, decrease muscle pain, increase circulation, relieve headaches and promote a general sense of well-being. To find credible information on aromatherapy, you can contact NAHA (National Association for Holistic Aromatherapy),"

It's important to know there are misconceptions about aromatherapy that have been communicated by people who have an agenda or have had insufficient education, or both. An agenda could involve the sale of essential oils, or it might arise from a competitive point of view from a practitioner of another modality. I can assure you there are wonderful scientists in the field of aromatherapy who are very up-to-date on contraindications, toxicity and safety issues, and the latest information from research being conducted throughout the world. The NAHA Web site has sections devoted to "frequently asked questions," safety and research. You can rest assured that the information you find there is credible.

People contact essences on a daily basis in food, as well as in cleaning and cosmetic products. Thus, it is not surprising that most of the research on essential oils has been conducted by the food and cosmetic industry, the largest users of essential oils. Issues of toxicity and sensitivity are important with distribution and accountability on such a large scale.

On the topic of sensitivity in general, I once heard a teacher who also sold essential oils falsely advise her students, "No one is allergic to true essential oils." There are times when a person can have sensitivity to the chemicals in synthetic fragrances and do well with true essential oils, but the truth is that a person can be allergic to anything. And there are essential oils that are known sensitizers. It's wise to consult a book such as The Aromatherapy Practitioner Manual, Vols. I and II, by Sylla Shepard Hanger, and learn possible contraindications for essential oils, particularly before using them on the skin. A proper client intake form should have a question about sensitivity to aromas and a place to list allergies. Case notes should list the essential oils (and the number of drops) used in a treatment, so the client has access to that information if a reaction occurs.

I have been fortunate; in more than 15 years, I have known only one client who appeared to have a reaction to a blend I used. What does a reaction look like? It can be a skin rash, a digestive response, nasal congestion/sneezing, or in this case, a headache. The good news is that once the client removes the blend and avoids additional exposure, the reaction goes away. There have been no cases of anaphylactic shock associated with the use of essential oils on the skin in the current research literature. So, while there is a chance of temporary discomfort resulting from an aromatherapy treatment, there will be no serious, lasting damage due to the application of diluted essential oils during a massage.

I interpret sensitivity to aromas as an aversion to inhaling fragrance. If this type of sensitivity were present, a way to add essential oils to the treatment would be to choose aromas that are commonly experienced on a daily basis and use them in high dilution. If they are not known allergens for the client, the citrus oils - orange, grapefruit, lemon, mandarin, lime, tangerine and bergamot - might easily be tolerated in high dilution (two or three drops to an ounce of carrier oil.) Citrus oils have an uplifting, encouraging effect, but also are soothing and relaxing. The essence of common cooking spices enhances circulation, bringing warming and a feeling of protection. Rosemary, thyme, ginger, cinnamon, nutmeg and even black pepper in high dilution (one drop per ounce of carrier oil) could be acceptable. And finally, a common wood aroma, such as pine or cedar, might be considered if these are not known allergens. Naturally, if the client refuses all aromas, you will have to do without this tool.

Please see prior articles on my columnist page ( for more information on the properties and use of relaxing and stimulating essential oils. In future articles, I will explore some of the other misconceptions about aromatherapy. As always, I welcome your questions and comments!

Click here for previous articles by Shellie Enteen, RA, BA, LMBT.


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