Tea tree oil: What can it do for your patients?

Tea tree oil is an essential oil that is obtained through steam distillation of the leaves of the native Australian coastal tree, Melaleuca alternifolia. M. alternifolia is an evergreen shrub with needle-like leaves that grows from 5 to 8 meters in height. Tea tree oil has been used in a wide variety of medicinal applications from coughs and colds to skin infections.¹ Relevant to dermatology, tea tree oil can be found in over-the-counter soaps, astringents and shampoos and is typically added to these products for its antimicrobial properties.  

Antimicrobial agent, MRSA fighter

There have been a number of papers describing the antiseptic properties of tea tree oil, which has potential antibacterial activity through disruption of bacterial membranes.² Terpin-4-ol is the component of tea tree oil that is thought to exhibit the anti-microbial activity.³

Checkout: Ancient medicine, modern MRSA cure?

Tea tree oil has also been shown to have antibacterial activity against methicillin-resistant Staphylococcus aureus (MRSA). One studied compared treatment with mupirocin 2% nasal ointment, chlorhexidine 4% soap and silver sulfadiazine 1% cream versus a tea tree oil regimen that included a tea tree 10% cream and tea tree 5% body wash. There was no significant difference in efficacy between the two programs and both were shown to be effective against MRSA.⁴ Tea tree containing products can be recommend to patients as adjunct treatments in MRSA therapy.

NEXT: Fungus and Acne

Fungus and acne

Studies are available that show promising application for various dermatologic infections such as bacterial and fungal conditions and molluscum as well as inflammatory conditions such as acne. A common “home remedy” patients will often ask about is whether or not there is a role for tea tree oil in treating nail fungus. Tea tree oil has been shown to have activity against dermatophytes, in vitro.⁵ And, in some studies, it has been shown to be clinically effective in treating onychomycosis and interdigital tinea pedis as compared to placebo.^{6, 7}

Checkout: Alternative treatment options for acne

Topical tea tree oil has also been looked at for application in acne therapy.

In one study, topical tea tree oil was shown to be superior to placebo in acne treatment.⁸ Another study compared tea tree oil with benzoyl peroxide and found them to be similarly effective, but tea tree oil was better tolerated by acne patients.⁹ 

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Next: Factors to consider

Factors to consider

It is often hard to identify the concentration and purity of tea tree oil in over-the-counter products so caution should be used in solely relying on these products for bacterial eradication. In addition, is important to counsel patients that tea tree oil can be very irritating and a source of allergic contact dermatitis.¹⁰ It is thought that 1,8-cineole is likely the compound in tea tree oil that causes dermatitis. Because tea tree oil may have an irritant effect it is also worth considering for the treatment of molluscum contagiosum.¹¹

Patients should be counseled to use tea tree with caution given the rate of irritant and contact dermatitis. In addition, it should be used with caution in children and pregnant or breastfeeding women and tea tree oil is not for oral ingestion as oral poisoning in children and adults has been observed.³

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References

• The Review of Natural Products. 7^th Edition. St. Louis: Wolters Kluwer Heath. 2012

• Carson CF, Hammer KA, Riley TV. Melaleuca alternifolia (Tea Tree   oil): a review of antibacterial and other medicinal properties. Clin Microbiol Rev. 2006;19(1):50-62.

• Pazyar N, Yaghoob R, Bagherani N. A review of applications of tea tree oil in dermatology. International Journal of Dermatology. 2013; 52: 784-790

• Dryden MS, Dailly S, Crouch M. A randomized, controlled trial of tea tree topical preparations versus a standard topical regimen for the clearance of MRSA colonization.. J Hosp Infect. 2004 Apr; 56(4):283-6

• Hammer KA, Carson FC, Riley TV. In vitro activity of Melaleuca alternifolia (tea tree) oil against dermatophytes and other filamentous fungi. J Antimicrob. Chemother. 2002 Aug; 50(2): 195-9  

• Buck DS, Nidorf DM, Addino JG. Comparison of two topical preparations for the treatment of onychomycosis: Melaleuca alternifolia (tea tree) oil and clotrimazole. J Fam Pract. 1994 Jun; 38(6):601-5

• Satchell AC, Saurajen A, Bell C, Barnestson RS Treatment of interdigital tinea pedis with 25% and 50% tea tree oil solution: a randomized, placebo controlled, blinded study. Austalas J Dermatol. 2002 Aug;43(3):175-8

• Enshaiieh S, Jooya A, Siadat AH, Iraji F. The efficacy of 5% topical tea tree oil gel in mild to moderate acne vulgaris: A randomized, double-blind placebo-controlled study. Indian J Dermatol Venereol Leprol. 200; 73(1):22-25

• Bassett IH, Pannowitz DL, Barnetson RS. A comparative study of tea-tree oil versus benzoyl peroxide in the treatment of acne. Med J Aust.1990;153(8):455-8

• Knight TE, Hausen BM. Melaleuca oil (tea tree oil) dermatitis. J. Am Acad Dermatol. 1994; 30: 423-7

• Markum E, Baille J. Combination of essential oil of Melaleuca alternifolia and iodine in the treatment of molluscum contagiosum in children. J. Drugs Dermatol. 2012 Mar; 11(3) 349-54