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Aromatherapy: Cure or curse? A case report of allergic contact dermatitis caused by essential oils

CASE REPORT A 45-year-old woman presented at the outpatient clinic with dermatitis of the hands, forearms, legs, and face for the last 2 months (Figure 1). The patient reported an orthopedic surgery 3 months ago and using aromatherapy for pain relief on a regular basis afterwards. Clinical examination revealed erythema, itchy plaques, papules, and vesicles in the aforementioned areas. She also reported a history of allergic rhinitis with positive skin prick test in mite, dog epithelia, cat epithelia, and olive tree pollen; the personal medical history was otherwise unremarkable. Her dermatitis cleared after topical treatment with steroids but soon relapsed. Based on the history and examination she was referred for patch testing. A baseline series, a fragrance series, a hairdresser series (allergEAZE, SmartPractice, Calgary, Canada), as well as the essential oils that she used (R.C. oil, a blend of various oils including Gaultheria procumbens (wintergreen), Boswellia carterii (frankincense), Eugenia caryophyllus (clove), Lavandula angustifolia (lavender), Cupressus sempervirens (cypress), and Rosmarinus officinalis (rosemary) oils; see Table 1) were applied on the patient's back for 2 days. Readings were performed on day (D) 2 and D3, and the results are presented in Table 1. Contact allergies were directly related to the use of aromatherapy and she was advised to avoid these products.