Tea Tree Oil (Melaleuca alternifolia [Maiden & Betche] Cheel)
  
Tea Tree Oil (Melaleuca alternifolia [Maiden & Betche] Cheel)
Background
Tea tree oil is obtained by steam distillation of the leaves of Melaleuca alternifolia. Tea tree oil is purported to have antiseptic properties, and has been used traditionally to prevent and treat infections. While numerous in vitro studies have demonstrated antimicrobial properties of tea tree oil (likely attributable to the constituent Terpinen-4-ol), only a small number of randomized, controlled human trials have been published. Human studies have focused on the use of topical tea tree oil for fungal infections (including onychomycosis and tinea pedis), acne, and vaginal infections. However, no definitive evidence exists for the use of tea tree oil in any of these conditions, and further study is warranted.
Tea tree oil should be avoided orally, as reports of toxicity after oral ingestion have been published. When used topically, tea tree oil is reported to be mildly irritating, and has been associated with the development of allergic contact dermatitis, which may limit its potential as a topical agent for some patients.
Synonyms
Australian tea tree oil, breathaway, cymene, M. alternifolia , malaleuca, melaleucae, melaleuca oil, oleum, Oleum melaleucae, T36-C7, tea tree oil, teebaum, terpinen, terpinen-4-ol, terpinenol-4, ti tree, Burnaid® (40mg/g of tea tree oil and 1mg/g of triclosan), oil of mela-leuca, Bogaskin® (veterinary formulation), Melaleuca Alternifolia Hydrogel® (burn dressing), Tebodont®.
Note : Should not be confused with cajeput oil, niauouli oil, kanuka oil, or manuka oil obtained from other Melaleuca species.
Evidence
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Uses based on scientific evidenceGrade*Acne vulgaris
Although available in many products, little information is available from human studies to evaluate the benefit of tea tree oil used on the skin for the treatment of acne. Tea Tree oil may reduce the number of inflamed and non-inflamed lesions.
C
Allergic skin reactions
One small study shows that topical tea tree oil may reduce histamine-induced skin inflammation. Further research is needed to confirm these results.
C
Dandruff
Preliminary research reports that the use of 5% tea tree oil shampoo on mild-to-moderate dandruff may be effective and well tolerated. Further research is needed to confirm these results.
C
Thrush (Candida albicans of the mouth)
In laboratory studies, tea tree oil can kill fungus and yeast such as Candida albicans. However, at this time there is not enough information available from studies in humans to make recommendations for or against this use of tea tree oil. Tea tree oil can be toxic when taken by mouth and therefore should not be swallowed.
C
Methicillin-resistant Staphylococcus aureus (MRSA) chronic infection (colonization)
Laboratory studies report that tea tree oil has activity against methicillin-resistant Staphylococcus aureus (MRSA) . It has been proposed that using tea tree oil ointment in the nose plus a tea tree body wash may treat colonization by this bacteria. However, there is currently not enough information from studies in humans to make recommendations for or against this use of tea tree oil.
C
Fungal nail infection (onychomycosis)
Although tea tree oil is thought to have activity against several fungus species, there is not sufficient information to make recommendations for or against the use of tea tree oil on the skin for onychomycosis.
C
Genital herpes
Tea tree oil has activity against some viruses in laboratory studies, and it has been suggested that a tea tree gel may be useful as a treatment on the skin for genital herpes. However, there is currently not sufficient information to make a recommendation for or against this use of tea tree oil.
C
Athlete's foot (tinea pedis)
Preliminary studies report tea tree oil to have activity against several fungal species. However, at this time there is not sufficient information to make recommendations for or against the use of tea tree oil on the skin for this condition.
C
Vaginal infections (yeast and bacteria)
In laboratory studies, tea tree oil can kill yeast and certain bacteria . However, at this time there is not enough information available from studies in humans to make recommendations for or against this use of tea tree oil for vaginal infections. Although tea tree oil may reduce itching caused by yeast or bacteria, it may cause itching from dry skin or allergy.
C
Plaque
One human study of a solution with tea tree oil, utilized as ordinary mouthwash, found no positive effect on the quantity or quality of supragingival plaque.
D
* Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).
Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Anti-bacterial, anti-inflammatory, antihistamine, antioxidant, antiseptic, body odor, boils, bronchial congestion, bruises, burns, carbuncles, colds, contraction cessation, corns, cough, dental plaque, eczema, furuncles, gingivitis, immune system deficiencies, impetigo, insect bites/stings, lice, lung inflammation, mouth sores, muscle and joint pain, nose and throat irritation, periodontal disease, psoriasis, ringworm, root canal treatment, scabies, sinus infections, skin ailments/infections, solvent, sore throat, tonsillitis, warts, wound healing.
Dosing
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Standardization
Standardization involves measuring the amount of certain chemicals in products to try to make different preparations similar to each other. It is not always known if the chemicals being measured are the "active" ingredients. The International Organization for Standardization has specified limits for 14 of the almost 100 ingredients that make up tea tree oil. By this standard, tea tree oil must contain terpinolene 1.5-5%, 1,8-cineole ≤15%, α-terpinene 5-13%, γ-terpinene 10-28%, p-cymene 0.5-12%, terpinen-4-ol ≥30%, α-terpineol 1.5-8%, limonene 0.5-4%, sabinene trace 3.5%, aromadendrene trace 7%, δ-cadinene trace 8%, globulol trace 3%, viridiflorol trace 1.5%, and α-pinene 1-6%. Prior to the development of the international standard (ISO 4730), an Australian standard existed (AS2782-1985) which required tea tree oil preparations to contain 30% terpinene-4-ol and <15% 1,8-cineole <15%.
Adults (18 years and older)
Note : Recommended doses are based on those used in studies. These doses have not necessarily been proven effective or safe. While 100% tea tree oil is sometimes used, it is often diluted with inactive ingredients. Due to reports of severe side effects after tea tree oil ingestion, it is strongly recommended that tea tree oil not be taken by mouth. Although tea tree oil solution has been used as a mouthwash, It should not be swallowed.
Acne : Tea tree oil 5% gel, applied to acne-prone areas of the skin daily.
Athlete's foot (tinea pedis) : 10% tea tree oil cream, applied twice daily to the feet after they have been thoroughly washed and dried or 25-50% tea tree oil solution applied twice daily to the affected area for 4 weeks.
Burns : It is recommended that tea tree oil products not be used on burn wounds due to the cytotoxicity of tea tree oil on human skin cells.
Dandruff : 5% tea tree oil shampoo daily for at least 4 weeks has been used.
Fungal nail infection (onychomycosis) : 100% tea tree oil, applied to the affected area twice daily for six months.
Genital Herpes : 6% tea tree oil gel has been used.
MRSA : 4% tea tree oil nasal ointment and 5% tea tree oil body wash has been used.
Thrush : Alcohol-based or alcohol-free solution four times daily for 2 to 4 weeks
Children (younger than 18 years)
There is insufficient research to recommend the safe use of tea tree oil in children.
Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Allergies
There are multiple reports of allergy to tea tree oil when taken by mouth or used on the skin. Skin reactions range from mild contact dermatitis to severe blistering rashes. People with a history of allergy to tea tree oil ( Melaleuca alternifolia ), to any of its components, or to plants that are members of the Myrtle ( Myrtaceae ) family should not use tea tree oil. People with a history of allergy to tincture of benzoin or colophony (rosin) should not use tea tree oil products because cross-reactions have been reported. There is a case report of a patient with linear IgA disease, a subepidermal blistering disorder which can be precipitated by contact with tea tree oil.
Use cautiously if allergic to eucalyptol as many tea tree preparations contain eucalyptol.
Side Effects and Warnings
Tea tree oil taken by mouth is associated with potentially severe reactions, even when used in small quantities. Several reports describe people using tea tree oil by mouth who developed severe rash, reduced immune system function, abdominal pain, diarrhea, lethargy, drowsiness, slow or uneven walking, confusion, or coma. There have also been reports of nausea, unpleasant taste, burning sensation, and bad breath associated with tea tree oil use. Many tea tree preparations contain large volumes of alcohol.
When used on the skin, tea tree oil may cause allergic rash, redness, blistering, and itching. Use of tea tree oil inside of the mouth or eyes can cause irritation. One report describes a person with long-standing eczema (atopic dermatitis) who developed a severe flare after applying 100% tea tree oil mixed in honey to the skin. Animal research suggests that tea tree oil used on the skin in large quantities can cause serious reactions such as difficulty walking, weakness, muscle tremor, slowing of brain function, and poor coordination. When applied in the ears of animals, 100% tea tree oil has caused reduced hearing, although a 2% solution has not led to lasting changes in hearing. Effects of tea tree oil on hearing when used in the ears of humans is not known.
Pregnancy and Breastfeeding
Not enough scientific information is available to recommend tea tree oil during pregnancy or breastfeeding. Animal studies suggest caution in the use of tea tree oil during childbirth because tea tree oil has been reported to decrease the force of spontaneous contractions, which theoretically could put the baby and mother at risk. Women who are breastfeeding should not apply tea tree oil to the breast or nipple since it may be absorbed by the infant.
References
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January 01, 2004 
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