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Lavender

Lavender

Common Names

  • Aspic
  • Lavandin
  • Spike lavender

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For Patients & Caregivers

How It Works

Lavender may be helpful in the treatment of anxiety and depression. It may also improve breathing, relaxation, and sleep. However, massage that accompanied lavender aromatherapy in some studies may be more responsible for such benefits.

Several studies suggest that some lavender formulations can help to alleviate anxiety and depression. However, benefits seen in other studies might instead be due to massage administered with lavender, rather than the lavender itself. Only a few studies have evaluated lavender for cancer and related symptoms. In the lab, lavender shows anticancer properties against several different types of human cancers, but these effects need to be confirmed in human studies. In addition, lavender oil has weak hormonal activity, which may or may not be beneficial in hormonal cancers. A compound called POH found in lavender and several other botanical plants has been found effective as an intranasal spray for palliative care in patients with a certain type of brain tumor, but it is uncertain whether the POH was extracted from lavender itself.

Lavender can cause allergic contact dermatitis and may increase the effect of sedatives. It may also cause enlarged breasts in boys who have not reached puberty. Because it has weak hormonal activities, long-term oral consumption or long-term topical application of lavender should be avoided in patients with hormone-sensitive cancers.

Purported Uses
  • Anxiety
    Studies show that certain oral lavender formulations can relieve anxiety in several populations. Inhaled lavender reduced anxiety during a procedure to test bladder control, but it also raised blood pressure and was therefore not an appropriate option. Animal models suggest that inhaled lavender can either enhance calmness or increase nervousness in sheep, depending on whether they tend to have calm or nervous personalities.
  • Cancer treatment
    A few laboratory studies suggest anticancer activity, but no studies have been conducted on cancer in humans with lavender. A compound called POH that may have come from lavender or other plants was developed as a nasal spray and showed safety and efficacy in palliative care patients with recurrent gliomas.
  • Cancer symptom control
    Lavender was not found to reduce anxiety during radiation treatment. Two studies that used lavender aromatherapy along with massage did not find that the use of lavender increased the beneficial effects. However, aromasticks used at a UK cancer center found lavender to be among the most popular, without ill effects or disturbance to others, and improved breathing and relaxation. Given that lavender has been identified as having weak hormonal effects, long-term oral consumption or long-term topical application should be avoided in patients with hormonal cancers.
  • Depression
    Several studies have demonstrated that lavender can aid in the treatment of depression.
  • Insomnia
    Several studies show that lavender can improve sleep in various populations. For one trial in which lavender improved sleep patterns in cancer patients however, the effect was more likely due to the massage that accompanied the aromatherapy.
  • Migraines
    One study showed that inhaling lavender oil may reduce migraine headaches.
  • Pain
    A few studies have shown that lavender oil is effective in treating chronic pain although the effects are short-term. In two studies with children however, even though lavender inhalation lowered heart rate and reduced the use of postoperative pain medications, it did not reduce pain intensity or perception.
  • Spasms
    One study showed inhaled lavender relieved menstrual cramps and emotional symptoms, but the effects did not last long.

Do Not Take If
  • You are pregnant and nursing: Excessive internal use of lavender should be avoided.
  • You are allergic to lavender: Skin rash has been reported.
  • You have a hormone-sensitive cancer: In laboratory studies, lavender showed very weak estrogenic and antiandrogenic activities, and it is unclear whether this would lead to any positive or negative effects with long-term oral or topical use.
  • You are taking sedatives or hypnotic drugs: Lavender may increase their effects.
  • You are taking CNS depressants, anticonvulsants: Lavender may increase or potentiate narcotic and sedative effects.
  • You are taking anticoagulants: Lavender may increase the risk of bleeding.
  • You are taking cholesterol-lowering drugs (statins, nicotinic acid, fibric acid derivatives): Lavender may produce additional cholesterol-lowering effects.

Side Effects
  • Oral: Nausea, confusion
  • Topical: Allergic skin reactions and sensitivity to sunlight

Although lavender appears to be well tolerated, it may have weak hormonal effects.

Case Reports
Excessive breast development in preteen boys with repeated application of lavender and tea tree oils, as well as perfumes with lavender as a main component.

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For Healthcare Professionals

Scientific Name
Lavandula angustifolia

Clinical Summary

Derived from the flowering tops of the plant, lavender oil is used in lotions and perfumes, in aromatherapy, as a topical treatment, and as an oral supplement for a wide variety of symptoms.

In vitro studies indicate that lavender has antimicrobial (4) (27) (28), antioxidant (29), and neuroprotective (21) effects. Animal models further suggest anxiolytic (30) (31), anti-inflammatory (22), neuroprotective (32) (33), anticonvulsant (26) (34), and cardioprotective effects (35). Lavender oil inhalation reversed spatial memory loss in dementia models (23).

In human adult studies, inhaled lavender improved sleep quality among college students (36), and alleviated dysmenorrhea and emotional symptoms in young women (37) (38). Lavender aromatherapy reduced the number of migraine headaches reported (19) and prevented agitation and falls in older individuals (20). It also improved symptoms in patients with dementia (5) (15), whereas dermally-applied lavender did not (39). Although inhaled lavender reduced anxiety during urodynamic assessments, it was found to be inappropriate for this procedure because it increased blood pressure (40).

Two trials of an ingested lavender formula suggest anxiolytic effects in healthy men (41) and in general and psychiatric outpatients with anxiety-related restlessness and disturbed sleep (42) . Other oral lavender preparations were effective as adjuvant therapy for moderate to severe depression (43), mild to moderate depression (7), and for generalized anxiety disorder (16) (18). In addition, aromatherapy massage with lavender and geranium oil relieved anxiety and decreased heart and respiratory rates among patients hospitalized with personality disorders, although it is unclear whether or not the benefits weren’t fully attributable to massage (44).

In pediatric patients undergoing tonsillectomy, inhaled lavender oil decreased postoperative analgesics (45). Lavender aromatherapy also decreased autonomic response to painful stimuli in diabetic children (46).

Only a few studies have evaluated lavender for cancer and related symptoms. In laboratory studies, lavender exerts cytotoxic and apoptotic effects on human hepatoma, Hodgkin’s lymphoma, and cervical and breast carcinoma cell lines (47) (48) (49). Early animal studies of the monocyclic terpene perillyl alcohol (POH) derived from several herbs including lavender also suggest tumor inhibition and regression (50) (51).

In studies to treat cancer symptoms, lavender did not reduce anxiety during radiotherapy (6), and lavender aromatherapy did not increase the beneficial effects of massage in patients with advanced cancer (8). Another clinical trial did show improved sleep patterns in cancer patients with massage and lavender oil aromatherapy, but the effect was also more likely due to the massage component as the combination arm did not differ from the massage-only arm (52).

Lavender has estrogenic activity. There are reports that prolonged use can cause gynecomastia in prepubertal boys (14) (53).

Purported Uses
  • Anxiety
  • Cancer symptom control
  • Cancer treatment
  • Depression
  • Insomnia
  • Migraine treatment
  • Pain
  • Spasms

Mechanism of Action

The anti-inflammatory and analgesic effects of lavender are attributed to the constituent 1,8-cineole or eucalyptol (2). Other dominant constituents include linalool and linalyl acetate, which are thought to relax blood vessels and induce anxiolytic effects (30) (40) (54).

In vitro, lavender essential oil reversed bacterial resistance to piperacillin in multi-drug-resistant Escherichia coli, perhaps via alterations of outer membrane permeability and bacterial quorum sensing inhibition (27). Antimicrobial activity was found to be synergistic or additive when combined with other essential oils in an equal ratio, with the most favorable combinations tested being cinnamon or sweet orange oil against C. albicans and S. aureus, respectively (28). Lavender oil also has broad-spectrum antibacterial activity (22). It has been shown to prevent immediate-type allergic reactions by inhibiting mast cell degranulation in vitro and in vivo (25).

Data indicate that lavender oil has a depressive effect on the central nervous system (3). In animal models, it displays neuroprotective effects by attenuating neuronal damage, upregulating catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) activities, and the glutathione (GSH)/glutathione disulfide (GSSG) ratio (21). Antiepileptic effects are due to suppression of nitric oxide level in the brain. Lavender has also shown to be superior to valproate, a major antiepileptic drug (26). Other purported neuroprotective mechanisms in stroke models include increased endogenous antioxidant defense, oxidative stress inhibition, and increased VEGF expression, but there was no evidence of apoptotic pathway suppression (33). In an Alzheimer’s disease model, lavender extract improved spatial performance by diminishing beta-amyloid production in the hippocampus (32). Cardioprotective effects against myocardial infarction are attributed to its antioxidant properties (35). In wound healing models, lavender oil accelerates reepithelialization and wound closure via enhanced epidermal growth factor (EGF) secretion, but has no effect on platelet-derived growth factor A (PDGF-A) release as does the more effective transcutaneous electrical nerve stimulation (TENS) (55). In mice with anosmia, anxiolytic effects with lavender inhalation were still apparent, indicating that olfactory activation was not responsible for these effects (30), which may rather be due to serotonergic mechanisms (31). However, whether lavender alleviates or exacerbates anxiety or its associated endocrine markers may actually be determined by genetic influences on temperament in calm versus nervous sheep, as these behaviors were respectively amplified after exposure to lavender inhalation (56).

Human studies suggest lavender inhalation may increase the high frequency component of heart rate variability, reflecting parasympathetic nervous system activity in young women with premenstrual syndrome (37). Although lavender reduced anxiety during urodynamic assessments by increasing the effects of inhibitory neurotransmitter c-aminobutyric acid in the amygdala, it also increased blood pressure, which was attributed to its potential diuretic activity (40). Anxiolytic effects of a proprietary lavender essential oil shown on positron emission tomography suggests this occurs through reductions in serotonin-1A receptor binding potential (41). The use of aromasticks including lavender among cancer patients may be a mechanism for improved conscious breathing leading to induced relaxation and emotion/mood alterations (57), although in other studies massage appeared to be the more likely mechanism of this effect (8) (44) (52).

Among a sampling of essential oils tested, lavender was found to have one of the highest rates of antiradical activity (58). Preliminary data suggest that an aqueous lavender extract inhibited lymphocyte proliferation in Hodgkin’s lymphoma cell lines via apoptosis (47). Ethanol and n-hexane lavender extracts and essential oil exhibit significant cytotoxicity to malignant cells but marginal cytotoxicity to human fibroblasts in vitro, upregulating Bax expression and induced PARP cleavage in HeLa cells, and inducing a sub-G1 peak in treated cells compared with controls (48). The properties of perillyl alcohol (POH), a chemopreventive and chemotherapeutic constituent derived from lavender as well as other botanicals, may affect transforming growth factor (TGF)-beta and/or Ras signaling pathways (59) and Na/K-ATPase inhibition (60).

In vitro studies have shown that lavender oil has weak estrogenic and antiandrogenic activities that may alter estrogen and androgen signaling pathways (14).

Contraindications
  • Individuals allergic to lavender, as dermatitis has been reported (61).
  • Excessive internal use should be avoided by pregnant and nursing women (61).
  • Long-term oral consumption or long-term topical application should be avoided in patients with hormonal cancers (14).

Adverse Reactions

Oral: Nausea, confusion (43)
Topical: Allergic contact dermatitis (17) (24) and photosensitivity (61).

Although lavender appears to be well tolerated, it may have weak hormonal effects (14).

Case Reports

Prepubertal gynecomastia (topical): With repeated application of lavender and tea tree oils (14). At the same time, there was considerable discourse as to whether or not other co-ingredients could have been the cause of enlarged breasts (62) (63) (64) (65). In 3 additional boys who were chronically exposed to lavender, two used a cologne, one of which was confirmed to contain lavender. Symptoms improved after the exposure was discontinued (53).

Herb-Drug Interactions

Sedatives: Lavender may potentiate their sleep-inducing effects (3).
CNS depressants, anticonvulsants: Lavender may increase or potentiate narcotic and sedative effects (66). Anticoagulants: Lavender may increase the risk of bleeding (66).
Cholesterol-lowering drugs (statins, nicotinic acid, fibric acid derivatives): Lavender may produce additional cholesterol-lowering effects (61).

Dosage (OneMSK Only)

References

  1. PDR for Herbal Medicines. Montvale, NJ: Medical Economics, 1998.

  2. Hajhashemi V, Ghannadi A, Sharif B. Anti-inflammatory and analgesic properties of the leaf extracts and essential oil of Lavandula angustifolia Mill. J Ethnopharmacol. 2003;89:67-71.

  3. Gyllenhaal C, Merritt SL, Peterson SD, Block KI, Gochenour T. Efficacy and safety of herbal stimulants and sedatives in sleep disorders. Sleep Med Rev. 2000;4:229-51.

  4. Takarada K, Kimizuka R, Takahashi N, Honma K, Okuda K, Kato T. A comparison of the antibacterial efficacies of essential oils against oral pathogens. Oral Microbiol Immunol. 2004;19:61-4.

  5. Holmes C, Hopkins V, Hensford C, MacLaughlin V, Wilkinson D, Rosenvinge H. Lavender oil as a treatment for agitated behaviour in severe dementia: a placebo controlled study. Int J Geriatr Psychiatry. 2002;17:305-8.

  6. Graham PH, Browne L, Cox H, Graham J. Inhalation Aromatherapy During Radiotherapy: Results of a Placebo-Controlled Double-Blind Randomized Trial. J Clin Oncol. 2003;21:2372-6.

  7. Akhondzadeh S, Kashani L, Fotouhi A, Jarvandi S, Mobaseri M, Moin M et al. Comparison of Lavandula angustifolia Mill. tincture and imipramine in the treatment of mild to moderate depression: a double-blind, randomized trial. Prog Neuropsychopharmacol Biol Psychiatry 2003;27:123-7.

  8. Soden K, Vincent K, Craske S, Lucas C, Ashley S. A randomized controlled trial of aromatherapy massage in a hospice setting. Palliat Med. 2004;18:87-92.

  9. Buckle J. Use of aromatherapy as a complementary treatment for chronic pain. Altern.Ther.Health Med 1999;5:42-51.

  10. Hay IC, Jamieson M, Ormerod AD. Randomized trial of aromatherapy. Successful treatment for alopecia areata. Arch Dermatol. 1998;134:1349-52.

  11. Sarrell EM, Cohen HA, Kahan E. Naturopathic treatment for ear pain in children. Pediatrics. 2003;111:e574-e579.

  12. DerMarderosian A. The Review of Natural Products. St. Louis: Facts and Comparisons, 1999.

  13. MICROMEDEX(R) Healthcare Series. 120. 2004. Thomson MICROMEDEX.

  14. Henley DV, Lipson N, Korach KS, et al. Prepubertal gynecomastia linked to lavender and tea tree oils. N Engl J Med. 2007;356(5):479-85.

  15. Jimbo D, Kimura Y, Taniguchi M, Inoue M, Urakami K. Effect of aromatherapy on patients with Alzheimer’s disease. Psychogeriatrics. 2009 Dec;9(4):173-9.

  16. Woelk H, Schläfke S. A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder. Phytomedicine. 2010 Feb;17(2):94-9.

  17. Goiriz R, Delgado-Jiménez Y, Sánchez-Pérez J, García-Diez A. Photoallergic contact dermatitis from lavender oil in topical ketoprofen. Contact Dermatitis. 2007 Dec;57(6):381-2.

  18. Kasper S, Gastpar M, Müller WE, et al. Efficacy and safety of silexan, a new, orally administered lavender oil preparation, in subthreshold anxiety disorder - evidence from clinical trials. Wien Med Wochenschr. 2010 Dec;160(21-22):547-56.

  19. Sasannejad P, Saeedi M, Shoeibi A, Gorji A, Abbasi M, Foroughipour M. Lavender essential oil in the treatment of migraine headache: a placebo-controlled clinical trial. Eur Neurol. 2012;67(5):288-91.

  20. Sakamoto Y, Ebihara S, Ebihara T, et al. Fall prevention using olfactory stimulation with lavender odor in elderly nursing home residents: a randomized controlled trial. J Am Geriatr Soc. 2012 Jun;60(6):1005-11.

  21. Wang D, Yuan X, Liu T, et al. Neuroprotective activity of lavender oil on transient focal cerebral ischemia in mice. Molecules. 2012 Aug 15;17(8):9803-17.

  22. Altaei DT. Topical lavender oil for the treatment of recurrent aphthous ulceration. Am J Dent. 2012 Feb;25(1):39-43.

  23. Hritcu L, Cioanca O, Hancianu M. Effects of lavender oil inhalation on improving scopolamine-induced spatial memory impairment in laboratory rats. Phytomedicine. 2012 Apr 15;19(6):529-34.

  24. Posadzki P, Alotaibi A, Ernst E. Adverse effects of aromatherapy: a systematic review of case reports and case series. Int J Risk Saf Med. 2012 Jan 1;24(3):147-61.

  25. Kim HM, Cho SH. Lavender oil inhibits immediate-type allergic reaction in mice and rats. J Pharm Pharmacol. 1999 Feb;51(2):221-6.

  26. Rahmati B, Khalili M, Roghani M, Ahghari P. Anti-epileptogenic and antioxidant effect of Lavandula officinalis aerial part extract against pentylenetetrazol-induced kindling in male mice. J Ethnopharmacol. 2013 Jun 21;148(1):152-7.

  27. Yap PS, Krishnan T, Yiap BC, et al. Membrane disruption and anti-quorum sensing effects of synergistic interaction between Lavandula angustifolia (lavender oil) in combination with antibiotic against plasmid-conferred multi-drug-resistant Escherichia coli. J Appl Microbiol. May 2014;116(5):1119-1128.

  28. de Rapper S, Kamatou G, Viljoen A, et al. The In Vitro Antimicrobial Activity of Lavandula angustifolia Essential Oil in Combination with Other Aroma-Therapeutic Oils. Evid Based Complement Alternat Med. 2013;2013:852049.

  29. Gismondi A, Canuti L, Grispo M, et al. Biochemical composition and antioxidant properties of Lavandula angustifolia Miller essential oil are shielded by propolis against UV radiations. Photochem Photobiol. May-Jun 2014;90(3):702-708.

  30. Chioca LR, Antunes VD, Ferro MM, et al. Anosmia does not impair the anxiolytic-like effect of lavender essential oil inhalation in mice. Life Sci. May 30 2013;92(20-21):971-975.

  31. Chioca LR, Ferro MM, Baretta IP, et al. Anxiolytic-like effect of lavender essential oil inhalation in mice: participation of serotonergic but not GABAA/benzodiazepine neurotransmission. J Ethnopharmacol. May 20 2013;147(2):412-418.

  32. Zali H, Zamanian-Azodi M, Rezaei Tavirani M, et al. Protein Drug Targets of Lavandula angustifolia on treatment of Rat Alzheimer’s Disease. Iran J Pharm Res. Winter 2015;14(1):291-302.

  33. Vakili A, Sharifat S, Akhavan MM, et al. Effect of lavender oil (Lavandula angustifolia) on cerebral edema and its possible mechanisms in an experimental model of stroke. Brain Res. Feb 22 2014;1548:56-62.

  34. Koutroumanidou E, Kimbaris A, Kortsaris A, et al. Increased seizure latency and decreased severity of pentylenetetrazol-induced seizures in mice after essential oil administration. Epilepsy Res Treat. 2013;2013:532657.

  35. Ziaee M, Khorrami A, Ebrahimi M, et al. Cardioprotective Effects of Essential Oil of Lavandula angustifolia on Isoproterenol-induced Acute Myocardial Infarction in Rat. Iran J Pharm Res. Winter 2015;14(1):279-289.

  36. Lillehei AS, Halcon LL, Savik K, et al. Effect of Inhaled Lavender and Sleep Hygiene on Self-Reported Sleep Issues: A Randomized Controlled Trial. J Altern Complement Med. Jul 2015;21(7):430-438.

  37. Matsumoto T, Asakura H, Hayashi T. Does lavender aromatherapy alleviate premenstrual emotional symptoms?: a randomized crossover trial. Biopsychosoc Med. 2013;7:12.

  38. Raisi Dehkordi Z, Hosseini Baharanchi FS, Bekhradi R. Effect of lavender inhalation on the symptoms of primary dysmenorrhea and the amount of menstrual bleeding: A randomized clinical trial. Complement Ther Med. Apr 2014;22(2):212-219.

  39. O’Connor DW, Eppingstall B, Taffe J, et al. A randomized, controlled cross-over trial of dermally-applied lavender (Lavandula angustifolia) oil as a treatment of agitated behaviour in dementia. BMC Complement Altern Med. 2013;13:315.

  40. Seol GH, Lee YH, Kang P, et al. Randomized controlled trial for Salvia sclarea or Lavandula angustifolia: differential effects on blood pressure in female patients with urinary incontinence undergoing urodynamic examination. J Altern Complement Med. Jul 2013;19(7):664-670.

  41. Baldinger P, Hoflich AS, Mitterhauser M, et al. Effects of Silexan on the serotonin-1A receptor and microstructure of the human brain: a randomized, placebo-controlled, double-blind, cross-over study with molecular and structural neuroimaging. Int J Neuropsychopharmacol. Feb 2015;18(4).

  42. Kasper S, Anghelescu I, Dienel A. Efficacy of orally administered Silexan in patients with anxiety-related restlessness and disturbed sleep - A randomized, placebo-controlled trial. Eur Neuropsychopharmacol. Aug 7 2015.

  43. Nikfarjam M, Parvin N, Assarzadegan N, et al. The Effects of Lavandula Angustifolia Mill Infusion on Depression in Patients Using Citalopram: A comparison Study. Iran Red Crescent Med J. Aug 2013;15(8):734-739.

  44. Domingos Tda S, Braga EM. Massage with aromatherapy: effectiveness on anxiety of users with personality disorders in psychiatric hospitalization. Rev Esc Enferm USP. May-Jun 2015;49(3):450-456.

  45. Soltani R, Soheilipour S, Hajhashemi V, et al. Evaluation of the effect of aromatherapy with lavender essential oil on post-tonsillectomy pain in pediatric patients: a randomized controlled trial. Int J Pediatr Otorhinolaryngol. Sep 2013;77(9):1579-1581.

  46. Malachowska B, Fendler W, Pomykala A, et al. Essential oils reduce autonomous response to pain sensation during self-monitoring of blood glucose among children with diabetes. J Pediatr Endocrinol Metab. Aug 15 2015.

  47. Dalilan S, Rezaei-Tavirani M, Nabiuni M, et al. Aqueous Extract of Lavender Angustifolia Inhibits Lymphocytes Proliferation of Hodgkin’s Lymphoma Patients. Iran J Cancer Prev. Fall 2013;6(4):201-208.

  48. Tayarani-Najaran Z, Amiri A, Karimi G, et al. Comparative studies of cytotoxic and apoptotic properties of different extracts and the essential oil of Lavandula angustifolia on malignant and normal cells. Nutr Cancer. 2014;66(3):424-434.

  49. Zhao J, Xu F, Huang H, et al. Evaluation on bioactivities of total flavonoids from Lavandula angustifolia. Pak J Pharm Sci. Jul 2015;28(4):1245-1251.

  50. Ziegler J. Raloxifene, retinoids, and lavender: “me too” tamoxifen alternatives under study. J Natl Cancer Inst. Aug 21 1996;88(16):1100-1102.

  51. Lantry LE, Zhang Z, Gao F, et al. Chemopreventive effect of perillyl alcohol on 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone induced tumorigenesis in (C3H/HeJ X A/J)F1 mouse lung. J Cell Biochem Suppl. 1997;27:20-25.

  52. Soden K, Vincent K, Craske S, et al. A randomized controlled trial of aromatherapy massage in a hospice setting. Palliat Med. Mar 2004;18(2):87-92.

  53. Diaz A, Luque L, Badar Z, et al. Prepubertal gynecomastia and chronic lavender exposure: report of three cases. J Pediatr Endocrinol Metab. Sep 3 2015.

  54. Lakusic B, Lakusic D, Ristic M, et al. Seasonal variations in the composition of the essential oils of Lavandula angustifolia (Lamiacae). Nat Prod Commun. Jun 2014;9(6):859-862.

  55. Koca Kutlu A, Cecen D, Gurgen SG, et al. A Comparison Study of Growth Factor Expression following Treatment with Transcutaneous Electrical Nerve Stimulation, Saline Solution, Povidone-Iodine, and Lavender Oil in Wounds Healing. Evid Based Complement Alternat Med. 2013;2013:361832.

  56. Hawken PA, Fiol C, Blache D. Genetic differences in temperament determine whether lavender oil alleviates or exacerbates anxiety in sheep. Physiol Behav. Mar 20 2012;105(5):1117-1123.

  57. Dyer J, Cleary L, Ragsdale-Lowe M, et al. The use of aromasticks at a cancer centre: a retrospective audit. Complement Ther Clin Pract. Nov 2014;20(4):203-206.

  58. Kacaniova M, Vukovic N, Horska E, et al. Antibacterial activity against Clostridium genus and antiradical activity of the essential oils from different origin. J Environ Sci Health B. 2014;49(7):505-512.

  59. da Fonseca CO, Schwartsmann G, Fischer J, et al. Preliminary results from a phase I/II study of perillyl alcohol intranasal administration in adults with recurrent malignant gliomas. Surg Neurol. Sep 2008;70(3):259-266; discussion 266-257.

  60. Garcia DG, Amorim LM, de Castro Faria MV, et al. The anticancer drug perillyl alcohol is a Na/K-ATPase inhibitor. Mol Cell Biochem. Dec 2010;345(1-2):29-34.

  61. Basch E, Foppa I, Liebowitz R, et al. Lavender (Lavandula angustifolia Miller). J Herb Pharmacother. 2004;4(2):63-78.

  62. Kemper KJ, Romm AJ, Gardiner P. Prepubertal gynecomastia linked to lavender and tea tree oils. N Engl J Med. Jun 14 2007;356(24):2541-2542; author reply 2543-2544.

  63. Kalyan S. Prepubertal gynecomastia linked to lavender and tea tree oils. N Engl J Med. Jun 14 2007;356(24):2542; author reply 2543-2544.

  64. Kurtz JL. Prepubertal gynecomastia linked to lavender and tea tree oils. N Engl J Med. Jun 14 2007;356(24):2542-2543; author reply 2543-2544.

  65. Dean CJ. Prepubertal gynecomastia linked to lavender and tea tree oils. N Engl J Med. Jun 14 2007;356(24):2543; author reply 2543-2544.

  66. Denner SS. Lavandula angustifolia Miller: English lavender. Holist Nurs Pract. Jan-Feb 2009;23(1):57-64.

  67. Kasper S, Gastpar M, Muller WE, et al. Silexan, an orally administered Lavandula oil preparation, is effective in the treatment of ’subsyndromal’ anxiety disorder: a randomized, double-blind, placebo controlled trial. Int Clin Psychopharmacol. Sep 2010;25(5):277-287.

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