Tea Tree

Tea tree has been used in connection with the following conditions (refer to the individual health concern for complete information):

Rating	Health Concerns
	Acne (topical)
	Athlete’s foot (topical) Toenail fungal infection (topical)
	Chronic candidiasis (topical) Halitosis (tea tree oil rinse or toothpaste) HIV support Infection (topical) Vaginitis (topical) Wound healing (oil, topical) Yeast infection (topical)
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. An herb is primarily supported by traditional use, or the herb or supplement has little scientific support and/or minimal health benefit.

Historical or traditional use (may or may not be supported by scientific studies): Australian Aborigines used the leaves to treat cuts and skin infections. They would crush the leaves and apply them to the affected area. Captain James Cook and his crew named the tree “tea tree,” using its leaves as a substitute for tea as well as to flavor beer. Australian soldiers participating in World War I were given tea tree oil as a disinfectant, leading to a high demand for its production.

Active constituents: The oil contains numerous chemicals known as terpenoids. Australian standards were established for the amount of one particular compound, terpinen-4-ol, which must make up at least 30% and preferably 40–50% of the oil for it to be medically useful. Another compound, cineole, should make up less than 15% and preferably 2.5% of the oil. The oil kills fungus and bacteria, including those resistant to some antibiotics.¹ ² For common acne, a double-blind trial compared the topical use of 5% tea tree oil to 5% benzoyl peroxide.³ Although the tea tree oil was slower and less potent in its action, it had far fewer side effects and was thus considered more effective overall.

A double-blind trial found that a 10% tea tree oil cream was as effective as anti-fungal medicine at improving symptoms associated with athlete’s foot, though it was not more effective than a placebo for eliminating the fungal infection.⁴ A double-blind trial found 100% tea tree oil applied topically was as effective as the anti-fungal medicine clotrimazole (Lotrimin®, Mycelex®) for people with fungus affecting the toe nails, a condition known as onychomycosis.⁵ In another double-blind trial with toenail fungus sufferers, a combination of 5% tea tree oil and 2% butenafine (Mentax®), a synthetic anti-fungal drug, in a cream proved more effective than an unspecified concentration of tea tree oil in cream alone.⁶ The results are not entirely surprising, as the tea tree product alone was probably not at a sufficiently high enough concentration to be effective.

A preliminary trial found that rinsing the mouth with 1 tablespoon (15 ml) tea tree oil solution four times daily effectively treated thrush (oral yeast infections) in AIDS patients.⁷ Solutions containing no more than 5% should be used orally and should never be swallowed.

A concern for hospital staff and patients is the spread of the bacteria Staphylococcus aureus—sometimes referred to as a “staph infection.” One small clinical trial found that use of a 4% tea tree oil nasal ointment as well as a 5% tea tree oil body wash was slightly more effective than standard drugs used to prevent the spread of the bacteria.⁸

How much is usually taken? Oil at a strength of 70–100% should be applied moderately at least twice per day to the affected areas of skin or nail.⁹ For topical treatment of acne, the oil is used at a dilution of 5–15%. Concentrations as strong as 40% may be used—with extreme caution and qualified advice—as vaginal douches. For thrush in immune-compromised adults, tea tree oil diluted to 5% or less is used in the amount of 1 tablespoon (15 ml) four times daily (as a mouth rinse). Tea tree oil should never be swallowed.

Are there any side effects or interactions? While tea tree oil can be applied to minor cuts and scrapes, use caution for more extensive areas of broken skin or areas affected by rashes not due to fungus. The oil may burn if it gets into the eyes, nose, mouth, or other tender areas. Some people have allergic reactions, including rashes and itching, when applying tea tree oil.¹⁰ For this reason, only a small amount should be applied when first using it. Tea tree oil should never be swallowed, as it may cause nerve damage and other problems.

At the time of writing, there were no well-known drug interactions with tea tree.

References:

1. Carson CF, Riley TV. Antimicrobial activity of the essential oil of Melaleuca alternifolia—A review. Lett Appl Microbiol 1993;16:49–55.

2. Carson CF, Cookson BD, Farrelly HD, Riley T. Susceptibility of methicillin-resistant Staphylococcus aureus to the essential oil of Melaleuca alternifolia. J Antimicrobial Chemother 1995;35:421–4.

3. Bassett IB, Pannowitz DL, Barnetson RS. A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. Med J Austral 1990;153:455–8.

4. Tong MM, Altman PM, Barnetson RS. Tea tree oil in the treatment of tinea pedis. Austral J Dermatol 1992;33:145–9.

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

6. Syed TA, Qureshi ZA, Ali SM, et al. Treatment of toenail onychomycosis with 2% butenafine and 5% Melaleuca alternifolia (tea tree) oil in cream. Trop Med Intl Health 1999;4:284–7.

7. Jandourek A, Vaishampayan JK, Vazquez JA. Efficacy of melaleuca oral solution for the treatment of fluconazole refractory oral candidiasis in AIDS patients. AIDS 1998;12:1033–7.

8. Caelli M, Porteous J, Carson CF, et al. Tea tree oil as an alternative topical decolonization agent for methicillin-resistant Staphylococcus aureus. J Hospital Infect 2000;46:236–7.

9. Brown DJ. Phytotherapeutic approaches to common dermatological conditions. Quart Rev Natural Med 1998;Summer:161–73.

10. Knight TE, Hansen BM. Melaleuca oil (tea tree oil) dermatitis. Med J Australia 1994;30:423–7.

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2003.