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International Journal of Therapeutic Massage and Bodywork—Volume 13, Number 1, March 2020
COMMENTARIES
Efficacy, Safety and Tolerability
of Aroma Massage with Lavender
Essential Oil: an Overview
INTRODUCTION
In the pursuit of wellbeing, relaxation,
and health, mankind has resorted to mas-
sage 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 de-
rived from plants with sedative and calm-
ing properties, lavender has always been
known in traditional medicine as a remedy
which helps to achieve psychophysical re-
laxation. Evidence from in vitro and in vivo
laboratory studies indicates that lavender
essential oil, whose main bioactive com-
ponents are linalool and linalyl acetate,
can interact with several neuropharma-
cological targets, including the serotonin
transporter and the MAO-A, GABA-A, and
NMDA ionotropic receptors, thus exerting a
central anxiolytic, antidepressive, and relax-
ing action.(3) From a pharmacokinetic point
of view, the two main bioactive compounds
(linalool and linalyl acetate) of lavender es-
sential oil administered through massage
are absorbed both through inhalation and
through skin penetration. Their blood con-
centrations 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 evi-
dence on the topic.
EFFICACY OF AROMA MASSAGE WITH
LAVENDER OIL
Psychological Disturbances
The quantitative findings of a recently
published systematic review and meta-
analysis underscore the potential efficacy of
massage with lavender essential oil in the
reduction of anxiety levels, with a signifi-
cant result in favor of intervention (Hedges’
g = -0.66 [95% CI -0.97 to -0.35], p < .0001,
448 participants) after pooling data from
six randomized controlled trials.(3) The main
limitations of this result was the low aver-
age quality of evidence from included stud-
ies mostly due to the inherent difficulty in
blinding this type of research, and the pres-
ence of confounding factors, which didn’t
allow to quantify the exact contribution
to the observed anxiolytic effect of each
component of the treatment (body ma-
nipulation, lavender essential oil inhalation
and skin absorption, useful placebo effects
like the rituality of the treatment).(3) How-
ever, considering that lavender essential oil
administered orally has a significant effect
on anxiety levels(3) and that, after massage,
its bioactive compounds (linalool and lin-
alyl acetate) can also be detected into the
subject’s bloodstream,(4) it is plausible to
assume that a useful anxiolytic and relaxing
Michele Antonelli, MD,1,2,3* Davide Donelli, MD1,3
1Terme di Monticelli, Parma, 2Department of Medicine and Surgery, University of Parma, 3Servizio di
Consulenza in Medicina Integrativa e Complementare, Reggio Emilia, Italy
