Essential Oils & Black Salve DERRICK ADAMS, DO, FAOCD RED BLUFF, CA

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1 Essential Oils & Black Salve DERRICK ADAMS, DO, FAOCD RED BLUFF, CA

2 I have no relevant conflicts of interest

3 Overview DSHEA legislative issues Essential Oils (EO s) Escharotic Agents

7 How Did We Get Here?

9 Dietary Supplement Health and Education Act (DSHEA) Amendment to Federal Food, Drug, and Cosmetic Act of 1938 Dietary Supplements do not need FDA approval FDA does not receive info on safety and efficacy Eliminates regulatory standards for quality and purity Burden of proof is on consumer and FDA No premarket approval or premarket testing

10 1994 DSHEA

11 Dietary Supplement Safety Act of 2010 Empower FDA to remove dangerous supplements Remove adulterated products Set forth civil penalties Required reporting of non serious adverse events

14 Spotlight Health Conference I believe that the amount the Congress heard about this whole issue was greater than what they received about the Vietnam war. It was tremendous. (Jane Henney FDA) It makes [regulating] tobacco look easy.

15 What are Essential Oils? FDA or FTC has no definition Essene vs. Essential Hydrophobic & Volatile Oils we already use menthol, methyl salicylates, camphor Aromatherapy/Massage

16 Essential Oils in My Life Mouthwash Food Flavoring Vapor Rub Analgesic muscle creams Medicated Lip balm Tea Tree Shampoo Lavender moisturizer

17 Father of Aromatherapy Rene-Maurice Gattefosse

18 PubMed Listings for EO s and Specific Conditions Psoriasis 30 Seborrhea 12 Tinea 35 Antimicrobial 5,622 Alopecia 16 Rosacea 3

19 Do essential oils have antimicrobial properties?

20 Melaleuca alternifolia (Tea Tree) Reported Benefits Acne Antifungal Seborrhea Antibiotic Antiviral Thrush Attenuate nickel reactions Lice

Melaleuca alternifolia (Tea Tree) Equivalent to Phenol? Penfold, A. R., and R. Grant. 1925.

21 Melaleuca alternifolia (Tea Tree) Equivalent to Phenol? Penfold, A. R., and R. Grant The germicidal values of some Australian essential oils and their pure constituents, together with those for some essential oil isolates, and synthetics. Part III. J. R. Soc. New South Wales 59:

23 PubMed - Tea Tree Oil Studies Bassett IB, Pannowitz DL, Barnetson. A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. RSMed J Aust Oct 15; 153(8):455-8 Carson, C. F., L. Ashton, L. Dry, D. W. Smith, and T. V. Riley Melaleuca alternifolia (tea tree) oil gel (6%) for the treatment of recurrent herpes labialis. J. Antimicrob. Chemother. 48: Satchell, A. C., A. Saurajen, C. Bell, and R. S. Barnetson Treatment of dandruff with 5% tea tree oil shampoo. J. Am. Acad. Dermatol. 47: Buck, D. S., D. M. Nidorf, and J. G. Addino Comparison of two topical preparations for the treatment of onychomycosis: Melaleuca alternifolia (tea tree) oil and clotrimazole. J. Fam. Pract. 38:

24 PubMed - Tea Tree Oil Studies Bassett IB, Pannowitz DL, Barnetson. A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. RSMed J Aust Oct 15; 153(8):455-8 Carson, C. F., L. Ashton, L. Dry, D. W. Smith, and T. V. Riley Melaleuca alternifolia (tea tree) oil gel (6%) for the treatment of recurrent herpes labialis. J. Antimicrob. Chemother. 48: Satchell, A. C., A. Saurajen, C. Bell, and R. S. Barnetson Treatment of dandruff with 5% tea tree oil shampoo. J. Am. Acad. Dermatol. 47: Buck, D. S., D. M. Nidorf, and J. G. Addino Comparison of two topical preparations for the treatment of onychomycosis: Melaleuca alternifolia (tea tree) oil and clotrimazole. J. Fam. Pract. 38:

25 PubMed - Tea Tree Oil Studies Bassett IB, Pannowitz DL, Barnetson. A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. RSMed J Aust Oct 15; 153(8):455-8 Carson, C. F., L. Ashton, L. Dry, D. W. Smith, and T. V. Riley Melaleuca alternifolia (tea tree) oil gel (6%) for the treatment of recurrent herpes labialis. J. Antimicrob. Chemother. 48: Satchell, A. C., A. Saurajen, C. Bell, and R. S. Barnetson Treatment of dandruff with 5% tea tree oil shampoo. J. Am. Acad. Dermatol. 47: Buck, D. S., D. M. Nidorf, and J. G. Addino Comparison of two topical preparations for the treatment of onychomycosis: Melaleuca alternifolia (tea tree) oil and clotrimazole. J. Fam. Pract. 38:

26 PubMed - Tea Tree Oil Studies Bassett IB, Pannowitz DL, Barnetson. A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. RSMed J Aust Oct 15; 153(8):455-8 Carson, C. F., L. Ashton, L. Dry, D. W. Smith, and T. V. Riley Melaleuca alternifolia (tea tree) oil gel (6%) for the treatment of recurrent herpes labialis. J. Antimicrob. Chemother. 48: Satchell, A. C., A. Saurajen, C. Bell, and R. S. Barnetson Treatment of dandruff with 5% tea tree oil shampoo. J. Am. Acad. Dermatol. 47: Buck, D. S., D. M. Nidorf, and J. G. Addino Comparison of two topical preparations for the treatment of onychomycosis: Melaleuca alternifolia (tea tree) oil and clotrimazole. J. Fam. Pract. 38:

27 PubMed - Tea Tree Oil Studies Bassett IB, Pannowitz DL, Barnetson. A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. RSMed J Aust Oct 15; 153(8):455-8 Carson, C. F., L. Ashton, L. Dry, D. W. Smith, and T. V. Riley Melaleuca alternifolia (tea tree) oil gel (6%) for the treatment of recurrent herpes labialis. J. Antimicrob. Chemother. 48: Satchell, A. C., A. Saurajen, C. Bell, and R. S. Barnetson Treatment of dandruff with 5% tea tree oil shampoo. J. Am. Acad. Dermatol. 47: Buck, D. S., D. M. Nidorf, and J. G. Addino Comparison of two topical preparations for the treatment of onychomycosis: Melaleuca alternifolia (tea tree) oil and clotrimazole. J. Fam. Pract. 38:

29 PubMed Tea Tree Oil Studies Caelli, M., J. Porteous, C. F. Carson, R. Heller, and T. V. Riley Tea tree oil as an alternative topical decolonization agent for methicillin-resistant Staphylococcus aureus. J. Hosp. Infect. 46: Syed, T. A., Z. A. Qureshi, S. M. Ali, S. Ahmad, and S. A. Ahmad Treatment of toenail onychomycosis with 2% butenafine and 5% Melaleuca alternifolia (tea tree) oil in cream. Trop. Med. Int. Health 4: Tong, M. M., P. M. Altman, and R. S. Barnetson Tea tree oil in the treatment of tinea pedis. Aust. J. Dermatol. 33:

30 PubMed Tea Tree Oil Studies Caelli, M., J. Porteous, C. F. Carson, R. Heller, and T. V. Riley Tea tree oil as an alternative topical decolonization agent for methicillin-resistant Staphylococcus aureus. J. Hosp. Infect. 46: Syed, T. A., Z. A. Qureshi, S. M. Ali, S. Ahmad, and S. A. Ahmad Treatment of toenail onychomycosis with 2% butenafine and 5% Melaleuca alternifolia (tea tree) oil in cream. Trop. Med. Int. Health 4: Tong, M. M., P. M. Altman, and R. S. Barnetson Tea tree oil in the treatment of tinea pedis. Aust. J. Dermatol. 33:

31 PubMed Tea Tree Oil Studies Caelli, M., J. Porteous, C. F. Carson, R. Heller, and T. V. Riley Tea tree oil as an alternative topical decolonization agent for methicillin-resistant Staphylococcus aureus. J. Hosp. Infect. 46: Syed, T. A., Z. A. Qureshi, S. M. Ali, S. Ahmad, and S. A. Ahmad Treatment of toenail onychomycosis with 2% butenafine and 5% Melaleuca alternifolia (tea tree) oil in cream. Trop. Med. Int. Health 4: Tong, M. M., P. M. Altman, and R. S. Barnetson Tea tree oil in the treatment of tinea pedis. Aust. J. Dermatol. 33:

32 Lavender Oil Reported Benefits Acne Calm anxiety Alopecia Improve complexion Hair growth Hair removal Relieve pain Anti-Aging

The effect of topical application of lavender essential oil on the intensity of pain caused by the insertion of dialysis needles in hemodialysis

33 The effect of topical application of lavender essential oil on the intensity of pain caused by the insertion of dialysis needles in hemodialysis patients: A randomized clinical trial. Ghods AA, Abforosh NH, Ghorbani R, Asgari MR. Complement Ther Med Jun;23(3): doi: /j.ctim

34 Lavender Antioxidant and wound healing activity of Lavandula aspic L. ointment Ben Djemaa FG, Bellassoued K, Zouari S, El Feki A, Ammar E. J Tissue Viability Nov;25(4): doi: /j.jtv Epub 2016 Oct 5. Wound healing potential of lavender oil by acceleration of granulation and wound contraction through induction of TGF-β in a rat model. Mori HM, Kawanami H, Kawahata H, Aoki M. BMC Complement Altern Med May 26;16:144. doi: /s Hair Growth-Promoting Effects of Lavender Oil in C57BL/6 Mice.Lee BH, Lee JS, Kim YC. Toxicol Res Apr;32(2): doi: /TR Epub 2016 Apr 30.

Lavender Antioxidant and wound healing activity of Lavandula aspic L. ointment Ben Djemaa FG, Bellassoued K, Zouari S, El Feki A, Ammar E. J Tissue Viability. 2016 Nov;25(4):193-200. doi: 10.1016/j.

35 Lavender Antioxidant and wound healing activity of Lavandula aspic L. ointment Ben Djemaa FG, Bellassoued K, Zouari S, El Feki A, Ammar E. J Tissue Viability Nov;25(4): doi: /j.jtv Epub 2016 Oct 5. Wound healing potential of lavender oil by acceleration of granulation and wound contraction through induction of TGF-β in a rat model. Mori HM, Kawanami H, Kawahata H, Aoki M. BMC Complement Altern Med May 26;16:144. doi: /s Hair Growth-Promoting Effects of Lavender Oil in C57BL/6 Mice.Lee BH, Lee JS, Kim YC.Toxicol Res Apr;32(2): doi: /TR Epub 2016 Apr 30.

36 Side Effects: Gynecomastia Henley D, Lipson N, Korach K, Bloch C. Prepubertal Gynecomastia Linked to Lavender and Tea Tree Oils. New England Journal of Medicine, Feb. 1, The Endocrine Society. "Chemicals in lavender and tea tree oil appear to be hormone disruptors." ScienceDaily. 18 March Lavender oil poses potential environmental health concerns and should be investigated further, The Endocrine Society

40 Lemon Oil?

42 Eucalyptus oil Reported Benefits Itchy scalp Insect repellent Topical pain Antiseptic Sun screen Acne Moisturizer Enhance drug delivery

43 Saraf S. In vitro sun protection factor determination of herbal oils used in cosmetics. Pharmacognosy Res Jan- Feb; 2(1):

51 Peppermint Oil Reported Benefits Contains menthol & menthone Natural pesticide Irritable Bowel Syndrome Topical usage for nerve pain and muscle aches No FDA approvals European Medicines Agency approves topical usage

52 Camphor OTC Itch Creams OTC Topical Analgesics Seizures Khine H, Weiss D, Graber N, Hoffman RS, Esteban-Cruciani N, Avner JR. A cluster of children with seizures caused by camphor poisoning. Pediatrics. 2009; 123:

53 Oil of Wintergreen Reported Benefits Pain relief Improve digestion Antiseptic Counter-irritant to pain OTC muscle liniments

54 Oil of Wintergreen Methyl salicylate Ester of salicylic acid and methanol Metabolizes into salicylate 1 teaspoon = mg aspirin tablets

56 Frankincense and Cancer?

57 Frankincense and Cancer?

58 Frankincense and Cancer?

59 Frankincense and Cancer?

61 Side effects of topical essential oils Wintergreen oil death Gynecomastia Allergic or Irritant dermatitis Photodermatitis Systemic hypersensitivity Delay of diagnosis and treatment

62 Center for Poison Control If, for some reason, you have bottles of essential oils at home, consider discarding them (safely) if you have young children. Otherwise, they MUST be locked up, out of sight and reach of children and pets all the time.

63 Phototoxic & Photosensitive Reactions Bergamot Grapefruit Lemon Lime Bitter Orange Cumin

64 Random Interesting Studies EO s & Dermatology

75 So Do Topical EO s Work?

76 How can we use EO s in dermatology? Alleviate fear of injections? Post-herpetic neuralgia? Neuralgia Parathestica? Pruritic symptoms? Adjunct to Anti-parasitics? Adjunct in acne management? Uncomplicated tinea? Seborrhea? Alleviate side effects of other medications? Enhance penetration of topicals?

77 Commercial EO Companies What do these companies do well? Advocate caution (especially in children) Recommend dilution Recommend test spots Recognize possible irritant and allergic contact dermatitis Provide lists of photosensitizing agents Redefine evidence

78 Acceptable Claims for EO s Supports the health of the system Improve vitality Promote wellbeing Balance the system

81 FDA Crackdown!

82 The Business of Pseudoscience

83 EO Marketing - Appeal to Antiquity The Egyptians were some of the first people to use aromatic essential oils extensively in medical practice, beauty treatment, food preparation, and in religious ceremony.

84 Essential oil extracts were used throughout the dark ages in Europe for their anti-bacterial and fragrant properties.

85 History of the Escharotic Agents

86 Escharotic Agents Bloodroot Zinc Chloride Indian Mud Black Salve Curaderm-BEC5 QHS Cream Yellow Salve Compound X Hoxsey s paste Mohs paste

88 Recent articles McDaniel S. Consequences of using escharotic agents as primary treatment for nonmelanoma skin cancer. Arch Dermatol. 2002;138(12): Robbins A. The dangers of black salve. JAMA Dermatol. Obversations. 2018;154(5): Henley D, Lipson N, Korach K, Bloch C. Prepubertal Gynecomastia Linked to Lavender and Tea Tree Oils. New England Journal of Medicine, Feb. 1, 2007.

89 History of Escharotic Agents 2,500 years ago Indian uses of arsenic Eastern Native American tribes Ibn Sina of Persia Hildegard of Germany in the 12th century England first modern usage of zinc chloride Dr. J. Weldon Fell Harry Hoxsey Hoxsey s Paste Dr. Mohs American College of Chemosurgery Dr. Oz vs. Greg Caton Mohs surgeons & Naturopaths

92 Mohs Paste Chemical Charlatan! Cauterize, Kill, Fix 40.0 gm Stibnite, 10.0 gm Sanguinaria canadensis, 34.5 ml of saturated zinc chloride solution Mohs, Frederic Edward (1978). Chemosurgery: microscopically controlled surgery for skin cancer. Springfield, Ill: Thomas

93 Bloodroot Conspiracy? American Society for Mohs Surgery American College of Mohs Surgery Dr. Perry Robins Skincancer.org Nytimes obituary

95 Guess Who Loves Mohs Paste?

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103 Greg Caton I ve treated over 25,000 patients I know 5 where it didn t work. Cured mesothelioma on the FBI s 10 Most Wanted list Taken from online interview with Dr. M. Oz.

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Tea Tree Oil Fungus Fighter Skin And Scalp Treatment 2 Oz

Tea Tree Oil Fungus Fighter Skin And Scalp Treatment 2 Oz Tea tree oil is known for its topical antiseptic and anti-fungal treatment or It also has antibiotic properties and helps aid against aliments