SEARCHSYSTEMATIC_REVIEWdermatology, infectious disease

systematic_review·dermatology, infectious disease, ophthalmology, systematic review·PMC10080088

Efficacy and safety of Melaleuca alternifolia (tea tree) oil for human health—A systematic review of randomized controlled trials

Frontiers in Pharmacology · 6 authors, 2 centres

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TL;DR

The review found that while the evidence base has expanded substantially, many trials suffered from inadequate reporting of tea tree oil source and quality, limiting the certainty of efficacy and safety conclusions.

Full summary

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This prospectively registered systematic review (PROSPERO CRD42021285168) screened 974 records and included 46 RCTs across dentistry, dermatology, infectious disease, ophthalmology, podiatry, and anxiety/sleep quality. Key limitations included inadequate reporting of tea tree oil source and quality in many trials, difficulty blinding participants due to the oil's strong aroma, heterogeneous product formulations, and lack of adverse event assessment in most trials. Safety concerns included reports that 17% of adverse events due to essential oil exposure were caused by tea tree oil, and that oxidized tea tree oil is the primary driver of sensitization and skin irritation. The authors concluded that future rigorous trials are warranted for acne, molluscum contagiosum, microbial causes of tooth decay, periodontal disease, oral fungal conditions, antibiotic-resistant bacterial infections, and ocular Demodex infestation.

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systematic_review

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dermatology

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ORIGINAL PAPER

PMC10080088

Efficacy and safety of Melaleuca alternifolia (tea tree) oil for human health—A systematic review of randomized controlled trials

Frontiers in Pharmacology

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ABSTRACT

Abstract Introduction: Leaves of the Australian tea tree plant Melaleuca alternifolia were used traditionally by First Nations Australians for treating wounds, burns, and insect bites. Tea tree oil, the essential oil steam-distilled from M. alternifolia , is well-known for its medicinal properties, the evidence for most applications however is limited. This review aimed to critically appraise evidence from clinical trials examining the therapeutic efficacy and safety of tea tree oil on outcomes. Methods: Randomized controlled trials with participants of any age, gender, or health status, comparing tea tree oil to any control were included, without limit on publication date. Electronic databases were searched on 12 August 2022 with additional records sourced from article reference sections, reviews, and industry white papers. Risk of bias was assessed by two authors independently using the Cochrane risk-of-bias 1.0 tool. Results were summarized and synthesized thematically. Results: Forty-six articles were eligible from the following medical fields ( Dentistry n = 18, Dermatology n = 9, Infectious disease n = 9, Ophthalmology n = 6, Podiatry n = 3; and Other n = 1). Results indicate that oral mouthwashes with 0.2%–0.5% tea tree oil may limit accumulation of dental plaque. Gels containing 5% tea tree oil applied directly to the periodontium may aid treatment of periodontitis as an adjunctive therapy to scaling and root planing. More evidence is needed to confirm the benefits of tea tree oil for reducing acne lesions and severity. Local anti-inflammatory effects on skin, if any, also require further elucidation. Topical tea tree oil regimens show similar efficacy to standard treatments for decolonizing the body from methicillin-resistant Staphylococcus aureus , although intra-nasal use of tea tree oil may cause irritation to mucous membranes. Tea tree oil with added iodine may provide an effective treatment for molluscum contagiosum lesions in young children. More evidence on efficacy of tea tree oil-based eyelid wipes for Demodex mite control are needed. Side effects were reported in 60% of included studies and were minor, except where tea tree oil was applied topically in concentrations ≥ 25%. Discussion: Overall, the quality of research was poor to modest and higher quality trials with larger samples and better reporting are required to substantiate potential therapeutic applications of tea tree oil. Systematic Review Registration: PROSPERO, identifier [CRD42021285168]. Keywords: tea tree oil, Melaleuca alternifolia oil, essential oils, phytotherapy, systematic review, randomized controlled trials, anti-infective agents, human trial

CITATION EXPORT

Lana Kairey, Tamara Agnew, Esther Joy Bowles et al.. Efficacy and safety of Melaleuca alternifolia (tea tree) oil for human health—A systematic review of randomized controlled trials. Frontiers in Pharmacology. (2023). https://doi.org/10.3389/fphar.2023.1116077

AUTHORS

6 · 2 CENTRES

Lana Kairey, Tamara Agnew, Esther Joy Bowles, Bronwyn J Barkla, Jon Wardle, Romy Lauche

1 National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
2 Southern Cross Plant Science, Faculty of Science and Engineering, Southern Cross University, Lismore, NSW, Australia