Emily came to see me after a year-long bout with allergic reactions around her eyes that seemed to come out of the blue. She showed me pictures of severe swelling and redness; one reaction was so bad she could hardly open her eyelids.
What could be the cause?
It was clear Emily’s case didn’t fit the mould of a typical allergic reaction to makeup and skincare. Why? Because her flare-ups were sporadic, happening once a month or even less. And since allergies are all or nothing (meaning you can’t be allergic to something some days and not others), I could eliminate her everyday cosmetics as the source of her reactions.
When I see irritation around the eyes, my allergy spidey sense goes up that this may not be the result of something the patient is putting on their skin but rather something they’re exposed to in the air — something we call in allergy circles: Airborne Contact Allergy. This is because the skin around the eyes is very delicate and is often the first thing to be affected when exposed to an allergenic substance concentrated in the air.
So, what was Emily exposing herself to randomly that was potentially allergenic and could be circulating in high concentration? It was her essential oil diffuser — the popular new way of dispersing natural oils to scent or stimulate an atmosphere.
Now, Emily was not allergic to all of her 30 essential oils, only lavender and lemongrass as we found out. Her eyes would become irritated every time she used either one of them but they were difficult to pinpoint as the source of her problem.
Essential oils are being used by a growing number of people and causing reactions that include chemical burns, allergic reactions, respiratory issues and other side effects. In the U.S., sales of essential oils hit $133 million according to a market research firm SPINS.
This is concerning because many essential oils do have some credible science but they cannot be used indiscriminately and users must also be aware that many can cause reactions. There is a misconception by the public that these oils are pure and can be safely ingested and applied liberally to any area of the body and in any age. I would not use undiluted essential oils on babies or young children.
Essential oils and their uses have been documented as far back as AD 1000 where healers would use extracts from plants as treatment. These oils can be rubbed into the skin or diffused into the air where they can bind to receptors in the lungs as well as smell receptors that may stimulate the central nervous system. However, research about how they work is scarce. Only recently have some products been testing on humans with controlled trials.
Many citrus essential oils contain chemicals called furocoumarins which will increase sunburn or phytotoxicity when exposed to UV rays. There have been many consumer reports of patients developing blistering and browning of the skin after adding lemon oil, bergamot or orange essential oil to their skin and then exposing it to the sun. Interestingly, this can also occur if you drop concentrated lemon or lime juice from the fruit on the skin when out in the sun — a process called Phytophotodermatitis.
Essential oils can also cause reactions around the mouth from peppermint oil infused mouthwash and toothpaste or lip products. Peppermint essential oil is one of the worse offenders of allergic reactions.
Other essential oils commonly associated with allergy include but are not limited to the following:
Ylang yang oil
Bulgarian rose oil
Jasmine official oil
Lavender angustifolica oil
Sweat bay laurel oil
Tea Tree oil
My patient Emily was so grateful that I helped discover the cause of her reactions she welcomed a blog on the topic and the use of her photo to help anyone else who may be experiencing the same reactions.