Efficacy, Safety and Tolerability of Aroma Massage with Lavender Essential Oil: an Overview

In the pursuit of wellbeing, relaxation, and health, mankind has resorted to massage since prehistoric times.(1) The term “massage”, probably derived from the Greek word “massein” (to knead), today indicates a wide range of therapeutic or relaxing techniques which uses body manipulation, alone or in combination with herbs, water, salts, and muds.(1) Aromatherapy massage (shortened to “aroma massage”) or massage with essential oils that are plant-derived oily substances with volatile and fragrant properties,(2) has been practiced for many years too, mostly by diluting essential oils into a massage carrier oil or diffusing them in the environment during the treatment.(3) In particular, among essential oils derived from plants with sedative and calming properties, lavender has always been known in traditional medicine as a remedy which helps to achieve psychophysical relaxation. Evidence from in vitro and in vivo laboratory studies indicates that lavender essential oil, whose main bioactive components are linalool and linalyl acetate, can interact with several neuropharmacological targets, including the serotonin transporter and the MAO-A, GABA-A, and NMDA ionotropic receptors, thus exerting a central anxiolytic, antidepressive, and relaxing action.(3) From a pharmacokinetic point of view, the two main bioactive compounds (linalool and linalyl acetate) of lavender essential oil administered through massage are absorbed both through inhalation and through skin penetration. Their blood concentrations can be detectable 5 minutes after the massage, they tend to peak after 20 minutes, and they are usually eliminated within 90 minutes after the end of the treatment.(4) In general, aromatherapy massage is quite popular as a relaxing technique and has been reported to be one of the most commonly used complementary therapy in the UK.(5) However, evidence on its efficacy is not fully clear to date, and some reports have cast doubts on its clinical safety.(6) The aim of the present work is to outline the efficacy, safety, and tolerability profile of aromatherapy massage with topically applied lavender essential oil, based on a critical overview of available scientific evidence on the topic.