Overall, the 5% TTO was well tolerated and appeared to be effective in the treatment of mild to moderate dandruff. There has been one short report of induced in vitro resistance to TTO in S. aureus (114). Abstr.

Lastly, a study comparing a 2.5% TTO gel, a 0.2% chlorhexidine gel, and a placebo gel found that although the TTO group had significantly reduced gingival index and papillary bleeding index scores, their plaque scores were actually increased (139). After treatment, of the 12 evaluable patients, 2 were cured, 6 were improved, 4 were unchanged, and 1 had deteriorated.

Follow-up swabs were taken at 2 and 14 days posttreatment, with the exception of 12 patients who were lost to follow-up.
Conversely, an upper limit of 15% and no lower limit were set for 1,8-cineole, although the rationale for this may not have been entirely sound.

Symp. Electron microscopy of terpinen-4-ol-treated S. aureus cells (34) revealed lesions similar to those seen after TTO treatment (127), including mesosome-like structures.

[8] It grows along streams and in swampy places. In addition, tea tree leaves are soaked to make an infusion to treat sore throats or skin ailments. These studies indicate that although TTO may cause decreases in the levels of oral bacteria, this does not necessarily equate to reduced plaque levels. Francesca watches the radio city Rocketter perform, Should I get circumcised?

Endemic to Australia, it occurs in southeast Queensland and the north coast and adjacent ranges of New South Wales where it grows along streams and on swampy flats, and is often the dominant species where it occurs. Control Nurses Assoc. In previous work with hydrocarbons not found in TTO (90, 146a) and with terpenes found at low concentrations in TTO (4, 146), lysis and the loss of membrane integrity and function manifested by the leakage of ions and the inhibition of respiration were demonstrated.

Dermal application of approximately 120 ml of undiluted TTO to three cats with shaved but intact skin resulted in symptoms of hypothermia, uncoordination, dehydration, and trembling and in the death of one of the cats (17).

Copyright © 2020 American Society for Microbiology | Privacy Policy | Website feedback, Print ISSN: 0893-8512; Online ISSN: 1098-6618, Sign In to Email Alerts with your Email Address. In all cases, patients responded to supportive care and recovered without apparent sequelae.

However, α-terpineol does not represent a significant proportion of the oil.

Essential Oils, p. 201-213, 1997). Its lipophilicity leads to miscibility problems in water-based products, while its volatility means that packaging must provide an adequate barrier to volatilization.

Issues of potential resistance are important if TTO is to be used more widely, particularly against antibiotic-resistant organisms. Once condensed, the clear to pale yellow oil is separated from the aqueous distillate. This same essential oil solution has now been shown to aid in the healing of malodorous malignant ulcers (154). However, activity has also been demonstrated using time-kill assays (34, 48, 80, 106), suspension tests (107), and “ex vivo”-excised human skin (108). The loss of viability, inhibition of glucose-dependent respiration, and induction of lysis seen after TTO treatment all occur to a greater degree with organisms in the exponential rather than the stationary phase of growth (67; S. D. Cox, J. L. Markham, C. M. Mann, S. G. Wyllie, J. E. Gustafson, and J. R. Warmington, Abstr. However, results from an animal (rat) model of vaginal candidiasis support the use of TTO for the treatment of this infection (111). Infect. TTO also alters the permeability of Candida glabrata (72). The provenance of TTO is not always clear from its common name or those of its sources. Stepwise exposure of five MRSA isolates to increasing concentrations of TTO yielded three isolates with TTO MICs of 1% and one isolate each with TTO MICs of 2% and 16%, respectively.

Comparison of the patient groups (each containing nine evaluable patients) at the end of the study showed that reepithelialization after treatment occurred after 9 days for the TTO group and after 12.5 days for the placebo group.

The activity of TTO was compared directly with that of phenol and rated as 11 times more active (121).

The TTO regimen consisted of 10% TTO nasal cream applied three times a day, 5% TTO body wash applied at least once daily and 10% TTO cream applied to skin lesions, wounds, and leg ulcers once a day, all for 5 days. Minor changes in TTO and α-terpineol susceptibilities have also been seen in S. aureus isolates with reduced susceptibility to household cleaners (53). These publications, as well as several others (60, 70, 84, 102, 120, 124, 152), describe a range of medicinal uses for TTO. Differences in clearance rates were not statistically significant, most likely due to the low patient numbers. The efficacy of TTO in dental applications has been assessed. [16], M. alternifolia (cultivated) growing in Menton, France, Proceedings of the Linnean Society of New South Wales, "Notes from the Botanic Gardens, Sydney No. The leaves are arranged alternately, sometimes scattered or whorled. Harvesting is by a coppicing process in which the whole plant is cut off close to ground level and chipped into smaller fragments prior to oil extraction. The primary uses of tea tree oil have historically capitalized on the antiseptic and anti-inflammatory actions of the oil. Annu.

In Australia, “tea trees” are also known as “paperbark trees,” and collectively these terms may refer to species in the Melaleuca or Leptospermum genera, of which there are several hundred.

Despite some progress, there is still a lack of clinical evidence demonstrating efficacy against bacterial, fungal, or viral infections. Even the term “melaleuca oil” is potentially ambiguous, since several chemically distinct oils are distilled from other Melaleuca species, such as cajuput oil (also cajeput or cajaput) from M. cajuputi and niaouli oil from M. quinquenervia (often misidentified as M. viridiflora) (51, 98).

Despite the inherent variability of commercial TTO, no obvious differences in its bioactivity either in vitro or in vivo have been noted so far.


Early clinical studies attempting to characterize the clinical efficacy of TTO (60, 120, 152) are not considered scientifically valid by today's standards and will therefore not be discussed further. With regard to fungi, an attempt to induce resistance to TTO in two clinical isolates of Candida albicans was largely unsuccessful, with isolates failing to grow in 2% (vol/vol) TTO after serial passage in increasing concentrations of TTO (111). Pretreatment of the Vero cells prior to virus addition or posttreatment with 0.1% TTO after viral absorption did not significantly alter plaque formation. Numerous recent studies now support the anecdotal evidence attributing anti-inflammatory activity to TTO. Antifungal ActivityComprehensive investigations of the susceptibility of fungi to TTO have only recently been completed. In field trials with Nicotiniana glutinosa, plants were sprayed with 100, 250, or 500 ppm TTO or control solutions and were then experimentally infected with tobacco mosaic virus. The seminal paper by Brophy and colleagues (25) examined over 800 TTO samples by gas chromatography and gas chromatography-mass spectrometry and reported approximately 100 components and their ranges of concentrations (Table 1). Dispersion of TTO in liquid media usually results in a turbid suspension that makes determination of end points in susceptibility tests difficult. Evaluation of the remaining 224 patients showed no significant differences between treatment regimens, with 49% of patients receiving standard therapy cleared versus 41% of patients in the TTO group. The commercial TTO industry was born after the medicinal properties of the oil were first reported by Penfold in the 1920s (121-124) as part of a larger survey into Australian essential oils with economic potential. In the first of the onychomycosis trials (26), 60% of patients treated with TTO and 61% of patients treated with 1% clotrimazole had full or partial resolution. In contrast, similar work found that TTO decreases the production of reactive oxygen species by both stimulated neutrophils and monocytes and that it also stimulates the production of reactive oxygen species by nonprimed neutrophils and monocytes (29). The terpinen-4-ol chemotype typically contains levels of terpinen-4-ol of between 30 to 40% (83) and is the chemotype used in commercial TTO production. In parallel with the characterization of the in vitro antimicrobial activity of TTO, the clinical efficacy of the oil has also been the subject of investigation. Given the numerous components of TTO, the scope for such effects is enormous, and much more work is required to examine this question. The small woody, cup-shaped fruit, 2–3 mm (0.08–0.1 in) in diameter are scattered along the branches. This raises the possibility that while cineole may not be one of the primary antimicrobial components, it may permeabilize bacterial membranes and facilitate the entry of other, more active components. The study found that both treatments reduced the numbers of inflamed lesions, although BP performed significantly better than TTO. For many years cineole was erroneously considered to be a skin and mucous membrane irritant, fuelling efforts to minimize its level in TTO. Data available today confirm that these two components contribute substantially to the oil's antibacterial and antifungal activities, with MICs and MBCs or MFCs that are generally the same as, or slightly lower than values obtained for TTO (36, 42, 48, 71, 117, 126). This activity was attributed primarily to terpinen-4-ol and α-terpineol. Typically, plantations are established from seedlings sowed and raised in greenhouses prior to being planted out in the field at high density. Of the 15 patients receiving conventional treatment, 2 were cleared and 8 remained colonized at the end of therapy; in the TTO group of 15, 5 were cleared and 3 remained colonized. [1][6] The specific epithet (alternifolia) is derived from the Latin alternus meaning "alternate" and folium meaning "leaf", referring to the leaf arrangement. Large randomized clinical trials are now required to cement a place for TTO as a topical medicinal agent. Instead, it sets out physical and chemical criteria for the desired chemotype. Similar to results found for bacteria, TTO also alters the permeability of C. albicans cells. From the early 1990s onwards, many reports describing the antimicrobial activity of TTO appeared in the scientific literature. [13] Tea tree oil is commonly used as a topical antiseptic agent because of its antimicrobial properties, especially in the treatment of acne. The benefits of using TTO in a handwash formulation include its antiseptic effects and increased handwashing compliance. (95). Amer.