The effects of aromatherapy in children: a systematic review and a call for research in autism

Introduction Aromatherapy, the therapeutic use of essential oils, is a growing complementary practice in pediatric care. This systematic review analyzed the scientific evidence on its application and effects in children, with a secondary aim of exploring its use for children with autism spectrum disorder (ASD). Content Following the PRISMA guidelines, the screening was carried out in Rayyan by two researchers, with studies from the PubMed, Cochrane Library, BVS Library and Web of Science databases, including only clinical trials. The risk of bias assessment used the Cochrane RoB 2 tool. Summary Out of 1,089 identified studies, seven randomized controlled trials were included. The literature was predominantly focused on neurotypical children, revealing that acute inhalation of essential oils (mainly lavender and orange) was used for managing anxiety in specific settings, particularly dentistry. Findings showed a trend towards reduced anxiety and pain scores, alongside decreased heart rate. However, significant methodological heterogeneity and small sample sizes were noted. The secondary aim highlighted a pronounced evidence gap: only one small-scale study included children with ASD, which reported no significant benefits of aromatherapy. Outlook Preliminary evidence suggests potential benefits of aromatherapy for anxiety in neurotypical children within controlled contexts. However, the evidence base is limited and insufficient for robust clinical guidance. A critical scarcity of research exists on aromatherapy for children with ASD, underscoring the need for more rigorous and adequately powered future studies.