Safety and possible risks of tea tree oil from a toxicological perspective

Year 2024, Volume: 54 Issue: 3, 488 - 495, 30.12.2024

Sonia Sanajou , Rana Ülker Özkan , Pınar Erkekoğlu , Gözde Girgin , Terken Baydar

https://doi.org/10.26650/IstanbulJPharm.2024.1434421

Abstract

Tea tree oil (TTO) is a sophisticated essential oil extracted from the Melaleuca alternifolia plant. It comprises around 1,000 components with a significant presence of monoterpenes and their alcohols. Terpinen-4-ol, the monoterpene that makes up 30% to 48% of TTO essential oil, is the main factor responsible for its strong antibacterial properties. TTO has been extensively used in skin care products to treat many problems, including acne, eczema, and dandruff. TTO is included in products used by children and adults. Nevertheless, the reliability of TTO in cosmetic and dermatological or derma cosmetic formulations is contingent upon numerous influential aspects, underscoring the pivotal significance of formulation and production procedures. TTO can be taken orally, topically, or ocularly. However, it is important to exercise caution, as high levels of TTO may cause phytotoxic effects and result in negative consequences such as contact allergy, inflammation, irritation, and dermatitis. Though natural, this essential oil can be harmful if not used correctly, considering factors like the route of application, exposure dose, and poor-quality contents. This review thoroughly examines the negative consequences, considerations for safety, and regulatory factors related to the usage of TTO. The study emphasizes the importance of conducting thorough research to better understand the safe use of essential oils, especially TTO. It also calls for a full assessment of the possible negative effects on vulnerable populations. Given the increasing demand for products containing TTO, it is crucial to conduct ongoing research to improve recommendations and ensure the informed and safe use of this precious essential oil.

Keywords

tea tree oil, risk, safety, adverse effects, essential oil

References

• Ambrogio, F., Foti, C., Cazzato, G., Mortato, E., Mazzoccoli, S., De Caro, A. P., Cassano, N., Vena, G. A., Calogiuri, G., & Romita, P. (2022). Spreading allergic contact der-matitis to tea tree oil in an over-the-counter product ap-plied on a wart. Medicina (Kaunas, Lithuania), 58(5), 561. https://doi.org/10.3390/medicina58050561 google scholar
• Bekhof, A. M. W., van Hunsel, F. P. A. M., van de Koppel, S., & Woer-denbag, H. J. (2023). Safety assessment and adverse drug reaction reporting of tea tree oil (Melaleuca aetheroleum). Phytotherapy Research, 37(4), 1309-1318. https://doi.org/10.1002/ptr.7687 google scholar
• Caliskan, U. K., & Karakus M. M. (2020). Essential Oils as Skin Per-meation Boosters and Their Predicted Effect Mechanisms. Journal of Dermatology and Skin Science 2(3). google scholar
• Capasso, L., Abbinante, G., Coppola, A., Salerno, G., & De Bernardo, M. (2022). Recent evidence of tea tree oil effectiveness in blephar-itis treatment. BioMed Research International, 2022, 9204251. https://doi.org/10.1155/2022/9204251 google scholar
• Casalle, N., & de Andrade C.R. (2020). Cytotoxic and mutagenic ca-pacity of TTO and terpinen-4-ol in oral squamous cell carcinoma. BioRxiv. https://doi.org/10.1101/2020.01.03.893735. google scholar
• Chen, D., Wang, J., Sullivan, D. A., Kam, W. R., & Liu, Y. (2020). Effects of terpinen-4-ol on meibomian gland epithelial cells in vitro. Cornea, 39(12), 1541-1546. https://doi.org/10.1097/ICO.0000000000002506 google scholar
• Cross, S. E., Russell, M., Southwell, I., & Roberts, M. S. (2008). Hu-man skin penetration of the major components of Australian tea tree oil applied in its pure form and as a 20 solution in vitro. Eu-ropean Journal of Pharmaceutics and Biopharmaceutics, 69(1), 214-222. https://doi.org/10.1016/j.ejpb.2007.10.002 google scholar
• de Groot, A. C., & Schmidt, E. (2016). Tea tree oil: contact allergy and chemical composition. Contact Dermatitis, 75(3), 129-143. https://doi.org/10.1111/cod.12591 google scholar
• Del Beccaro M. A. (1995). Melaleuca oil poisoning in a 17-month-old. Veterinary and Human Toxicology, 37(6), 557-558. google scholar
• Elliott C. (1993). Tea tree oil poisoning. The Medical Journal of Australia, 159(11-12), 830-831. https://doi.org/10.5694/j.1326-5377.1993.tb141370.x google scholar
• Ergun, S. B., Saribas, G. S., Yarayici, S., Elmazoglu, Z., Cardak, A., Ozogul, C., Ilhan, M. N., Karasu, C., & Evren Kemer, O. (2020). Comparison of efficacy and safety of two tea tree oil-based formulations in patients with chronic blepharitis: a double-blinded randomized clinical trial. Ocular Immunology and Inflammation, 28(6), 888-897. https://doi.org/10.1080/09273948.2019.1644349 google scholar
• European Medicines Agency (2013). Assessment Report on Melaleuca Alternifolia (Maiden and Betch) Cheel, M. Linariifolia Smith, M. Dissitiflora F. Mueller and/or Other Species of Melaleuca, Aetheroleum. European Medicines Agency 44(July):73. google scholar
• Fletcher, J. P., Cassella J. P., Hughes D., and Cassella S. (2005). An Evaluation of the mutagenic potential of commercially available tea tree oil in the United Kingdom. International Journal of Aro-matherapy, 15(2):81-86. doi: 10.1016/j.ijat.2005.03.004. google scholar
• Gomes-Carneiro, M. R., Felzenszwalb, I., & Paumgartten, F. J. (1998). Mutagenicity testing (+/-)-camphor, 1,8-cineole, citral, citronellal, (-)-menthol and terpineol with the Salmonella/microsome assay. Mutation Research, 416(1-2), 129-136. https://doi.org/10.1016/s1383-5718(98)00077-1 google scholar
• IFRA (2022). The Complete IFRA Standards. https://ifrafragrance.org/docs/default-source/ifra-code-of-practice-and-standards/ifra-standards—50th-amendment/standards-compiled.pdf google scholar
• Infante, V. H. P., Maia Campos, P. M. B. G., Gaspar, L. R., Darvin, M. E., Schleusener, J., Rangel, K. C., Meinke, M. C., & Lade-mann, J. (2022). Safety and efficacy of combined essential oils for the skin barrier properties: In vitro, ex vivo and clinical stud-ies. International Journal of Cosmetic Science, 44(1), 118-130. https://doi.org/10.1111/ics.12761 google scholar
• Jacobs, M. R., & Hornfeldt, C. S. (1994). Melaleuca oil poison-ing. Journal of toxicology. Clinical Toxicology, 32(4), 461-464. https://doi.org/10.3109/15563659409011050 google scholar
• Lee C.J., Chen L.W., Chen L.G., Chang T.L., Huang C.W., Huang M.C., Wang C.C. (2013). Correlations of the components of tea tree oil with its antibacterial effects and skin irrita-tion. Journal of Food and Drug Analysis, 21 (2), 169-176. https://doi.org/10.1016/j.jfda.2013.05.007 google scholar
• Low, W. L., Kenward, K., Britland, S. T., Amin, M. C., & Martin, C. (2017). Essential oils and metal ions as alternative antimicrobial agents: a focus on tea tree oil and silver. International Wound Journal, 14(2), 369-384. https://doi.org/10.1111/iwj.12611 google scholar
• Mertas, A., Garbusinska, A., Szliszka, E., Jureczko, A., Kowalska, M., & Krol, W. (2015). The influence of tea tree oil (Melaleuca alternifolia) on fluconazole activity against fluconazole-resistant Candida albicans strains. BioMed Research International, 2015, 590470. https://doi.org/10.1155/2015/590470 google scholar
• Messaoud, R., El Fekih, L., Mahmoud, A., Ben Amor, H., Ban-nour, R., Doan, S., & Khairallah, M. (2019). Improvement in ocular symptoms and signs in patients with Demodex anterior blepharitis using a novel terpinen-4-ol (2.5%) and hyaluronic acid (0.2%) cleansing wipe. Clinical Ophthalmology, 13, 1043-1054. https://doi.org/10.2147/OPTH.S198585 google scholar
• Morris, M. C., Donoghue, A., Markowitz, J. A., & Osterhoudt, K. C. (2003). Ingestion of tea tree oil (Melaleuca oil) by a 4-year-old boy. Pediatric Emergency Care, 19(3), 169-171. https://doi.org/10.1097/01.pec.0000081241.98249.7b google scholar
• Oliva, A., Costantini, S., De Angelis, M., Garzoli, S., Bozovic, M., Mascellino, M. T., Vullo, V., & Ragno, R. (2018). High po- google scholar
• tency of Melaleuca alternifolia essential oil against multi-drug resistant gram-negative bacteria and methicillin-resistant Staphy-lococcus aureus. Molecules (Basel, Switzerland), 23(10), 2584. https://doi.org/10.3390/molecules23102584 google scholar
• Özfenerci, M. & Ufuk Koca Çalışkan U.K. (2018). Tea Tree Oil and Its Use in Aromatherapy. Current Perspective on Medicinals and Aromatic Plants. 90-102. google scholar
• Pazyar, N., Yaghoobi, R., Bagherani, N., & Kazerouni, A. (2013). A review of applications of tea tree oil in derma-tology. International Journal of Dermatology, 52(7), 784-790. https://doi.org/10.1111/j.1365-4632.2012.05654.x google scholar
• Russo, R., Corasaniti, M. T., Bagetta, G., & Morrone, L. A. (2015). Exploitation of cytotoxicity of some essential oils for translation in cancer therapy. Evidence-based Comple-mentary and Alternative Medicine: eCAM, 2015, 397821. https://doi.org/10.1155/2015/397821 google scholar
• SCCP. 2008. Scientific Committee on Consumer Products - OPINION ON Tea Tree Oil. https://ec.europa.eu/health/ph_risk/committees/04_sccp/docs/sccp _o_160.pdf google scholar
• Tabarraei H., Hassan J., Mosavi S.S. (2019). Determination of LD50 of some essential oils and histopathological changes in short-term exposure to one of them in rainbow trout (On-corhynchus mykiss). Toxicology Research and Application,3. doi:10.1177/2397847318820719 google scholar
• Thomas, J., Carson, C. F., Peterson, G. M., Walton, S. F., Hammer, K. A., Naunton, M., Davey, R. C., Spelman, T., Dettwiller, P., Kyle, G., Cooper, G. M., & Baby, K. E. (2016). Therapeutic potential of tea tree oil for scabies. The American Journal of Tropical Medicine and Hygiene, 94(2), 258-266. https://doi.org/10.4269/ajtmh.14-0515 google scholar
• Vatanen, T., Kostic, A. D., d’Hennezel, E., Siljander, H., Franzosa, E. A., Yassour, M., Kolde, R., Vlamakis, H., Arthur, T. D., Hâmâlâi-nen, A. M., Peet, A., Tillmann, V., Uibo, R., Mokurov, S., Dor-shakova, N., Ilonen, J., Virtanen, S. M., Szabo, S. J., Porter, J. A., Lâhdesmâki, H., . . . Xavier, R. J. (2016). Variation in microbiome LPS immunogenicity contributes to autoimmunity in humans. Cell, 165(4), 842-853. https://doi.org/10.1016/j.cell.2016.04.007 google scholar
• Zeiner, M., Cindric I.J., Kandler W., and Stingeder G. (2018). Trace determination of skin-irritating metals in tea tree oil by GFAAS. Microchemical Journal, 136:101-5. doi: 10.1016/j.microc.2016.12.016. google scholar