Lavender (Lavandula angustifolia Miller)

Category

Synonyms

Common lavender, English lavender, garden lavender, Lavandula burnamii, Lavandula dentate, Lavandula dhofarensis, Lavandula latifolia, Lavandula officinalis L., Lavandula stoechas, limonene, NHED (contains Allium sativum, Verbascum thapsus, Calendula flores, Hypericum perfoliatum, lavender, and vitamin E in olive oil), perillyl alcohol, pink lavender, POH, true lavender, white lavender.

Background

Lavender is native to the Mediterranean, the Arabian Peninsula, Russia, and Africa. It has been used cosmetically and medicinally throughout history. In modern times, lavender is cultivated around the world and the fragrant oils of its flowers are used in aromatherapy, baked goods, candles, cosmetics, detergents, jellies, massage oils, perfumes, powders, shampoo, soaps, and tea. English lavender (Lavandula angustifolia) is the most common species of lavender used, although other species are in use, including Lavandula burnamii, Lavandula dentate, Lavandula dhofarensis, Lavandula latifolia, and Lavandula stoechas.

Many people find lavender aromatherapy to be relaxing and it has been reported to have anxiolytic (anti-anxiety) effects. Overall, the evidence suggests a small positive effect, although additional data from well-designed studies are required before the evidence can be considered strong.

Lavender aromatherapy is also used as a hypnotic, although there is insufficient evidence in support of this use.

Small phase I human trials of the lavender constituent perillyl alcohol (POH) for cancer have suggested safety and tolerability, although efficacy has not been demonstrated.

Evidence

Anxiety (lavender aromatherapy): Lavender aromatherapy is traditionally used for relaxation. It is reported to help relieve anxiety in several small studies, although negative results have also been reported. Better research is needed before a strong recommendation can be made.
Grade: B

Aggressive behavior (in elderly Alzheimer's dementia patients): Small human trials looking at the effects of lavender aromatherapy on agitation and behavior in patients with Alzheimer's dementia report conflicting results. Better quality studies are needed before a firm conclusion can be drawn.
Grade: C

Agitated behavior (lavender aromatherapy): Small studies of patients with severe dementia in nursing homes have found that lavender aromatherapy or pinning a cloth to the patient with lavender oil on it may help to decrease agitated behavior. Further well-designed studies are needed in this area before a firm conclusion can be drawn.
Grade: C

Alopecia/hair loss (lavender used on the skin): Small trials have shown that patients who massage essential oils (thyme, rosemary, lavender, and cedarwood) into their scalps daily showed more improvement than the control group. More research of lavender alone is needed before a strong recommendation can be made.
Grade: C

Antibacterial (lavender used on the skin): Early laboratory studies suggest that lavender oils may have antibiotic activity.However, this has not been well tested in animal or human studies.
Grade: C

Cancer (perillyl alcohol): Perillyl alcohol (POH), derived from lavender, might be beneficial in the treatment of some types of cancer. This research has focused on cancers of the pancreas, breast, and intestine. Preliminary small studies in humans suggest safety and tolerability of POH, but effectiveness has not been established.
Grade: C

Dementia: Small trials investigating the effects of lavender aromatherapy on agitation and behavior in patients with Alzheimer's dementia report conflicting results. Further well-designed studies are needed before a conclusion can be drawn.
Grade: C

Depression: Preliminary research suggests that lavender may be helpful as an adjunct to prescription antidepressant medications. Additional research is necessary before a firm conclusion can be drawn.
Grade: C

Ear pain: A small clinical trial used a naturopathic eardrop called NHED (containingAllium sativum,Verbascum thapsus,Calendula flores,Hypericum perfoliatum, lavender, and vitamin E in olive oil) with and without an antibiotic and topical anesthetic. It was found that the ear pain was self-limiting and resolved after a few days with or without antibiotics. This evidence is preliminary and further research is needed before a conclusion about this treatment can be made.
Grade: C

Hypnotic/sleep aid (lavender aromatherapy): Lavender aromatherapy is often promoted as a sleep aid. Although early evidence suggests possible benefits, more research is needed before a firm conclusion can be drawn.
Grade: C

Improved workplace efficiency: Although lavender is a sedative-type aroma, use during recess periods in a work environment after accumulation of fatigue seemed to prevent deterioration of performance in subsequent work sessions. Further well-designed research is needed to confirm these results.
Grade: C

Low back pain: Early research suggests that the impression of pain intensity and unpleasantness may be reduced after treatment with lavender therapy. Other research has shown that lavender aromatherapy may be effective when used with acupressure for short-term relief of lower back pain. Further research is needed before firm conclusions can be drawn.
Grade: C

Neck pain: Early human studies indicate a potential role for lavender aromatherapy in combination with massage in the short-term treatment of neck pain. More studies are needed.
Grade: C

Overall wellbeing (lavender used in a bath): Preliminary evidence has shown that lavender oil in combination with grape seed oil used in a bath may help to improve overall wellbeing, and decrease anger and frustration. Lavender oil used as aromatherapy has also been shown to increase overall mood. Further well-designed research is needed to confirm these results.
Grade: C

Pain (lavender aromatherapy): Preliminary research suggests that the impression of pain intensity and unpleasantness may be reduced after treatment with lavender therapy. Other research has shown that lavender aromatherapy may be effective when used with acupressure for short-term relief of lower back pain. Further research is needed before firm conclusions can be drawn.
Grade: C

Perineal discomfort after childbirth (lavender added to bath): Lavender has been evaluated as an additive to bathwater to relieve pain in the perineal area (between the vagina and anus) in women following birth. Preliminary poor-quality research reports no benefits. Better research is needed before a firm conclusion can be drawn.
Grade: C

Quality of life (postpartum): Early evidence suggests a potential role for lavender aromatherapy, especially in combination with massage or acupressure, in the improvement of measures of quality of life among new mothers. More studies are needed.
Grade: C

Rheumatoid arthritis pain: Early human studies have found conflicting results on the use of massage with lavender aromatherapy in this condition. There is not enough scientific evidence to recommend lavender aromatherapy for rheumatoid arthritis pain.
Grade: C

Spasmolytic (oral): Early laboratory and animal studies indicate a potential spasmolytic effect of lavender oil inhalation. However, human evidence is lacking.
Grade: C

Eczema: In a small clinical trial, essential oils were used in combination with massage to treat childhood atopic eczema. It was found that there was deterioration in the patient's eczema, which may have been due to possible allergic contact dermatitis provoked by the essential oils themselves. More study on the effect of lavender essential oil alone is needed before any firm conclusions can be made.
Grade: D

Tradition

Dosing

Adults (18 years and older)

Lavender has been taken by mouth as a tea prepared from 1 to 2 teaspoons (5 to 10 grams) of leaves steeped in 1 cup (250 milliliters) of boiling water for 15 minutes. As a tincture, a dose of 60 drops (1:5 in 50% alcohol) per day has been used.

Lavender oil has been used in aromatherapy (inhaled) and massage therapy (applied on the skin). A naturopathic eardrop called NHED, which includes lavender, has been used at a dose of 5 drops three times a day with or without an antibiotic and topical anesthetic.

To reduce perineal discomfort after childbirth, 6 drops of lavender oil have been added to a bath. Another technique reported is to add 1/4 to 1/2 cup of dried lavender flowers to hot bath water.

Early cancer studies report doses of 800 to 1,200 milligrams per square meter of body surface, taken by mouth, four times daily in a 50:50 perillyl alcohol (a derivative of lavender):soybean oil preparation.

Children (younger than 18 years)

There is not enough scientific evidence to safely recommend lavender for children.

Safety

Allergies

People with allergies to lavender may experience skin irritation after contact, and should avoid lavender in all forms.

Side Effects and Warnings

Mild rash can develop after applying lavender oil. Reports describe increased sun sensitivity and changes in skin pigmentation after applying products containing lavender oil. Nausea, vomiting, loss of appetite, constipation, headache, chills, confusion, and drowsiness are sometimes reported after inhaling lavender, absorbing it through the skin, or after large doses of lavender or perillyl alcohol (derived from lavender) are taken by mouth. The essential oil of lavender may be poisonous if taken by mouth.

Drowsiness can occur after lavender aromatherapy. More severe drowsiness or sedation may occur when lavender is used with other sedating agents. Use caution if driving or operating heavy machinery.

In theory, lavender used by mouth may increase the risk of bleeding. Individuals with bleeding disorders or taking drugs that may increase bleeding should use caution. Dosing adjustments may be necessary.

Some cancer patients have experienced low blood cell counts (neutropenia) after taking high doses of perillyl alcohol by mouth.

Pregnancy and Breastfeeding

Lavender is not recommended during pregnancy or breastfeeding.

Interactions

Interactions with Drugs

Animal studies suggest that lavender used as aromatherapy or by mouth may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Drowsiness caused by some seizure medicines may also be increased. Caution is advised while driving or operating machinery.

In theory, lavender may add to the effects of cholesterol-lowering drugs.

Lavender may have additive effects when used with prescription antidepressant medications, such as the tricyclic antidepressant imipramine.

Lavender may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Interactions with Herbs and Dietary Supplements

Lavender used as aromatherapy or by mouth may increase the amount of drowsiness caused by some herbs or supplements, such as valerian. Caution is advised while driving or operating machinery.

In theory, lavender may add to the cholesterol-lowering effects of some herbs or supplements such as fish oil, garlic, guggul, and niacin.

Lavender may interact with herbs and supplements taken for depression; use cautiously.

Lavender may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Attribution

This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Ivo Foppa, MD, PhD (Harvard University); Jenna Hollenstein, MS, RD (Natural Standard Research Collaboration); Eileen Kingsbury, PharmD (University of Rhode Island); Richard Liebowitz, MD (Duke University); Jamie Nelson, PharmD (University of Rhode Island); Michael Smith, MRPharmS, ND (Canadian College of Naturopathic Medicine); David Sollars, MAC, HMC (New England School of Acupuncture); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Nancy Tannous, PharmD (Northeastern University); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration).

Bibliography

Akhondzadeh S, Kashani L, Fotouhi A, 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(1):123-127.

Anderson C, Lis-Balchin M, Kirk-Smith M. Evaluation of massage with essential oils on childhood atopic eczema. Phytother Res 2000;14(6):452-456.

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

D'Auria FD, Tecca M, Strippoli V, et al. Antifungal activity of Lavandula angustifolia essential oil against Candida albicans yeast and mycelial form. Med Mycol 2005 Aug;43(5):391-6.

Dale A, Cornwell S. The role of lavender oil in relieving perineal discomfort following childbirth: a blind randomized clinical trial. J Adv Nurs 1994;19(1):89-96.

Graham PH, Browne L, Cox H, et al. Inhalation aromatherapy during radiotherapy: results of a placebo-controlled double-blind randomized trial. J Clin Oncol 6-15-2003;21(12):2372-2376.

Holmes C, Hopkins V, Hensford C, et al. Lavender oil as a treatment for agitated behaviour in severe dementia: a placebo controlled study. Int J Geriatr Psychiatry 2002;17(4):305-308.

Lewith GT, Godfrey AD, Prescott P. A single-blinded, randomized pilot study evaluating the aroma of Lavandula augustifolia as a treatment for mild insomnia. J Altern Complement Med 2005 Aug;11(4):631-7.

Moss M, Cook J, Wesnes K, et al. Aromas of rosemary and lavender essential oils differentially affect cognition and mood in healthy adults. Int J Neurosci 2003;113(1):15-38.

Prashar A, Locke IC, Evans CS. Cytotoxicity of lavender oil and its major components to human skin cells. Cell Prolif 2004;37(3):221-229.

Rho KH, Han SH, Kim KS, et al. Effects of aromatherapy massage on anxiety and self-esteem in korean elderly women: a pilot study Int J Neurosci 2006 Dec;116(12):1447-55.

Snow LA, Hovanec L, Brandt J. A controlled trial of aromatherapy for agitation in nursing home patients with dementia. J Altern.Complement Med 2004;10(3):431-437.

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

Yip YB, Tse SH. An experimental study on the effectiveness of acupressure with aromatic lavender essential oil for sub-acute, non-specific neck pain in Hong Kong. Complement Ther Clin Pract. 2006 Feb;12(1):18-26.

Yip YB, Tse SH. The effectiveness of relaxation acupoint stimulation and acupressure with aromatic lavender essential oil for non-specific low back pain in Hong Kong: a randomised controlled trial. Complement Ther Med 2004;12(1):28-37.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.