Bitter orange peel and associated products is not recommended for use in pregnancy (Blumenthal etal 2000).
Orange essential oil used in recommended doses is generally safe in pregnancy, but general safety precautions apply. Citrus aurantium 275
PRACTICE POINTS/PATIENT COUNSELLING
• Bitter orange peel and associated products are used to improve digestion, relieve dyspeptic symptoms and improve appetite.
• Citrus aurantium extract is growing increasingly popular as an ingredient in weight loss products; however, controlled studies are required to determine its safety and effectiveness.
• The oil of bitter orange (Citrus aurantium var. amara) was an effective topical treatment in treatment-resistant superficial dermatophyte infection according to one study.
• Topical application of orange oil and bitter orange oil can induce skin sensitisation, which is more likely to occur if old orange essential oil is used because of its tendency to oxidise. Appropriate storage reduces oxidation. A patch test is recommended for atopic people or those who have a tendency to skin reactions to fragrance compounds, cosmetics or essential oils.
• Topical application of orange oil and bitter orange oil can induce photosensitivity in some individuals. After topical application, exposure to sunlight or UVB light should be avoided for at least 12 hours. The risk of photoxicity increases if high concentrations of phototoxic essential oils are used or a blend contains several phototoxic essential oils or if used by fair-skinned people.
ANSWERS TO PATIENTS' FREQUENTLY ASKED QUESTIONS
What will this herb do for me?
Orange essential oil can be used in a vapouriser or massage to aid focus and concentration and facilitate communication. It is also used to reduce stress and promote sleep and relaxation. In teas and tinctures, cut peel may aid digestion and relieve dyspeptic symptoms. There is some evidence that the oil may be an effective treatment for treatment-resistant fungal skin infections. When will it start to work?
When used in aromatherapy, it usually acts soon after inhalation. When the oil or oil products are applied topically to fungal infections, results may be seen within 1-2 weeks; however, 3-4 weeks of treatment may be required. Used internally, bitter orange peel products should provide dyspeptic symptom relief quickly. Are there any safety issues? Skin irritation and phototoxicity (chemical burn) is possible after topical application of the oil if the skin is exposed to UV light such as sunlight. Use in recommended doses and do not use more than 1 5% of orange essential oil in a blend. Oral use of bitter orange peel products is not recommended in pregnancy and Seville orange juice can Citrus aurantium 276
induce multiple drug interactions.
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