Herbal Monograph
English lavender
Lavandula angustifolia Mill.
Lamiaceae (Labiatae)
Clinically proven anxiolytic herb with Silexan oil rivaling benzodiazepines f...
Overview
Plant Description
Lavandula angustifolia is a compact, aromatic, evergreen subshrub growing 30-80 cm (12-32 inches) tall, forming dense, rounded mounds. Stems are woody at the base, becoming herbaceous above, with a distinctive square cross-section characteristic of the Lamiaceae family. Leaves are opposite, sessile, linear to linear-lanceolate, 2-6 cm long and 2-5 mm wide, with entire, revolute margins. Young leaves are grey-green and densely tomentose with stellate trichomes; older leaves become greener as pubescence diminishes. Inflorescences are terminal spikes on long, unbranched peduncles, 3-8 cm long, composed of 6-10 whorls (verticillasters) of 3-7 flowers each. Flowers are bilabiate, with a tubular, ribbed calyx (13-nerved) and a blue-violet corolla approximately 10-12 mm long. The upper lip has 2 lobes and the lower lip 3 lobes. Four nutlets develop within the persistent calyx. The entire plant is intensely aromatic due to oil glands (glandular trichomes) on leaves, stems, and especially calyces and corollas. The name 'Lavandula' derives from the Latin 'lavare' (to wash), reflecting its ancient use in bathing.
Habitat
Native to the western Mediterranean region, particularly mountainous areas of southern France, northeastern Spain, and northern Italy at elevations of 500-1700 m. Thrives in dry, well-drained, calcareous (alkaline) soils with full sun exposure. Characteristic of garrigue and maquis vegetation communities. Prefers poor, stony, or sandy soils with excellent drainage -- waterlogged conditions are fatal. Cold-hardy to approximately -15 degrees C (USDA zones 5-9) when established, making it more cold-tolerant than other Lavandula species.
Distribution
Naturally distributed across the western Mediterranean basin, principally in France (Provence), Spain, Italy, and the Balkans. Widely cultivated worldwide as an ornamental, aromatic, and medicinal crop. Major commercial essential oil production regions include France (Provence -- the historical and quality benchmark), Bulgaria (rapidly expanding production), United Kingdom (Norfolk, Surrey), United States (Pacific Northwest, especially Oregon and Washington), Australia (Tasmania), and New Zealand. France produces the highest quality pharmaceutical-grade oil (AOC Lavande de Haute-Provence), while Bulgaria has become the world's largest producer by volume.
Parts Used
Flower (dried) (Lavandulae flos)
Preferred: Dried flower spikes for infusion; essential oil by steam distillation; hydroethanolic tincture or liquid extract
The dried flower spikes (including the calyx, which contains the majority of essential oil glands) are the official drug in the European Pharmacopoeia, Commission E monograph, and EMA herbal monograph. Used as an infusion (tea), in sachets, as a bath additive, and as the source material for essential oil production by steam distillation. Minimum essential oil content per European Pharmacopoeia: not less than 13 mL/kg (1.3% v/w). The flowers also contain flavonoids, tannins, and coumarins that contribute to the overall therapeutic profile.
Essential oil (Lavandulae aetheroleum)
Preferred: Pure essential oil for topical dilution and inhalation; standardized encapsulated oil (Silexan 80 mg) for oral anxiolytic use
Obtained by steam distillation of the fresh or dried flowering tops. The essential oil is the most extensively studied lavender preparation and is the basis for the Silexan (Lasea) proprietary product used in clinical trials for generalized anxiety disorder. Composition is dominated by linalool (20-45%) and linalyl acetate (25-47%), whose ratio is used as a quality marker. European Pharmacopoeia specifies chromatographic fingerprint requirements. Used internally (Silexan 80 mg capsules), topically (diluted 1-3% in carrier oil for massage, wound care), and by inhalation (aromatherapy). The oil is colorless to pale yellow; deep blue or green-blue color suggests adulteration with lavandin or spike lavender oil.
Key Constituents
Monoterpene alcohols and esters (essential oil)
Linalool and linalyl acetate together comprise 50-80% of the essential oil and are the primary active constituents responsible for lavender's anxiolytic, sedative, and antispasmodic effects. The Silexan (Lasea) proprietary product is standardized to these two compounds. Pharmacological studies demonstrate that linalool modulates GABAergic, glutamatergic, and serotonergic neurotransmission. The synergistic action of multiple monoterpenoids contributes to lavender's broad therapeutic profile.
Monoterpene oxides and ketones (essential oil)
The low concentrations of cineole and camphor in true L. angustifolia oil are quality differentiators. High levels of these compounds indicate contamination with lavandin or spike lavender oils, which are less suitable for anxiolytic and nervous system applications. The minimal camphor content makes L. angustifolia safer for topical use on burns and sensitive skin compared to lavandin.
Sesquiterpenes (essential oil)
Sesquiterpenes are minor components of lavender essential oil but contribute to its anti-inflammatory and analgesic properties. Beta-caryophyllene's CB2 receptor agonism provides a unique mechanism of action complementing the GABAergic effects of linalool.
Flavonoids
Flavonoids in lavender flowers contribute to the anti-inflammatory and anxiolytic activity of aqueous preparations (infusions). While essential oil preparations lack flavonoids, tea and tincture preparations contain these compounds, providing additional therapeutic value beyond the volatile oil components.
Coumarins
Coumarins are minor constituents contributing to antispasmodic activity and fragrance. The coumarins present in lavender are simple hydroxycoumarins with no anticoagulant activity -- they are structurally unrelated to the 4-hydroxycoumarin anticoagulants (warfarin, dicoumarol).
Tannins and phenolic acids
Rosmarinic acid is a significant non-volatile active compound in lavender, contributing to the antioxidant and anti-inflammatory activity of aqueous and hydroethanolic extracts. It is well-extracted in infusions and tinctures. Rosmarinic acid provides a mechanism of anti-inflammatory activity distinct from the essential oil terpenoids.
Herbal Actions
Reduces anxiety
The most clinically validated action of lavender. Silexan (Lasea), a proprietary 80 mg lavender oil capsule standardized to linalool and linalyl acetate, has demonstrated anxiolytic efficacy comparable to lorazepam 0.5 mg/day (Woelk & Schlafke 2010) and paroxetine 20 mg/day (Kasper et al. 2014) in multiple randomized controlled trials for generalized anxiety disorder. Linalool modulates GABAergic neurotransmission by acting as a positive allosteric modulator at GABA-A receptors, inhibits glutamate NMDA receptor binding, and reduces serotonin transporter activity. A meta-analysis (Generoso et al. 2017) confirmed the anxiolytic efficacy of oral lavender oil across multiple trials. Importantly, Silexan demonstrates anxiolytic effects without the sedation, cognitive impairment, or dependence potential associated with benzodiazepines.
[2, 8, 9, 10]Promotes sleep and deep relaxation
Promotes sleep quality and reduces sleep onset latency. Lavender aromatherapy (inhalation of essential oil) has been shown to improve sleep quality in multiple clinical trials, including a systematic review by Lillehei & Halcon (2014). Linalool inhalation increases parasympathetic nervous system activity (increased heart rate variability, decreased cortisol) and promotes relaxation. Oral lavender oil (Silexan) improved sleep quality as a secondary outcome in GAD trials (Kasper et al. 2014). Commission E approved Lavandulae flos for restlessness and insomnia. The sedative action is distinct from benzodiazepine-type sedation -- it produces calming relaxation without next-day grogginess or cognitive impairment.
[1, 9, 11]Supports and calms the nervous system
Calms and supports the nervous system. Lavender is one of the premier nervine relaxants in Western herbal medicine, indicated for nervous exhaustion, agitation, and neurasthenia. The nervine action encompasses both anxiolytic and sedative effects but also includes a broader tonic quality for the nervous system during periods of chronic stress. Hoffmann classifies lavender as a nervine tonic and relaxant. The essential oil's effect on autonomic nervous system balance -- shifting from sympathetic to parasympathetic dominance -- underlies its calming action. Traditional use for nervous headaches, heart palpitations of nervous origin, and nervous digestive complaints.
[1, 3, 4]Relieves smooth muscle spasm
Relaxes smooth muscle, particularly in the gastrointestinal tract. Linalool and linalyl acetate demonstrate dose-dependent spasmolytic activity on isolated smooth muscle preparations, acting through both direct muscle relaxation and modulation of intracellular calcium. Commission E approved for functional circulatory disorders and functional abdominal complaints. Traditionally used for intestinal colic, flatulence, and abdominal cramping. Also relevant to the relief of tension headaches and muscle spasm (topical application).
[1, 3, 4]Kills or inhibits the growth of microorganisms
Lavender essential oil demonstrates broad-spectrum antimicrobial activity in vitro against both Gram-positive bacteria (Staphylococcus aureus including MRSA, Streptococcus pyogenes), Gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa), and fungi (Candida albicans, dermatophytes). Linalool and terpinen-4-ol are the primary antimicrobial compounds. The mechanism involves disruption of bacterial cell membrane integrity and inhibition of efflux pumps. Clinical antimicrobial relevance is primarily topical -- wound care, minor skin infections, and acne.
[4, 16]Reduces inflammation
Multiple anti-inflammatory mechanisms: linalool inhibits NF-kB signaling and reduces TNF-alpha, IL-6, and IL-1beta production; beta-caryophyllene acts as a CB2 cannabinoid receptor agonist; rosmarinic acid inhibits complement activation and lipoxygenase. Topical lavender essential oil has demonstrated anti-inflammatory effects in animal models of edema and in human clinical studies on wound healing. The anti-inflammatory action is relevant to both topical (wound care, dermatitis) and internal (GI inflammation) applications.
[3, 4, 18]Relieves pain
Topical and inhalational lavender oil demonstrates mild analgesic properties. Randomized controlled trials have shown lavender aromatherapy reduces pain perception in various clinical settings, including postoperative pain, labor pain, and needle insertion pain. The analgesic mechanism involves both peripheral (anti-inflammatory, local anesthetic effect of linalool) and central (opioidergic pathway modulation, GABAergic enhancement) components. Topical application provides local analgesic and mild counter-irritant effects useful for headaches, muscle aches, and minor injuries.
[3, 17]Promotes wound healing
Promotes wound healing through combined antimicrobial, anti-inflammatory, and tissue-regenerative activity. In vitro studies show linalool stimulates fibroblast proliferation and collagen synthesis. A randomized controlled trial (Vakilian et al. 2011) demonstrated that lavender essential oil enhanced episiotomy wound healing in postpartum women. Traditional use for burns, minor cuts, and insect bites is well documented. The antimicrobial action helps prevent wound infection while the anti-inflammatory action reduces excess inflammation that can delay healing.
[3, 12, 16]Relieves intestinal gas and bloating
Relieves intestinal gas and bloating through combined antispasmodic and aromatic volatile oil actions. Commission E lists functional abdominal complaints among approved indications. The volatile oil components relax intestinal smooth muscle and promote coordinated peristalsis. Traditionally combined with other carminative herbs (peppermint, fennel, chamomile) for digestive comfort.
[1, 3]Therapeutic Indications
Nervous System
Generalized anxiety disorder (GAD)
The most robustly studied indication for lavender. Silexan (80 mg oral lavender oil capsule) has been evaluated in multiple large RCTs: Woelk & Schlafke (2010, n=77) demonstrated non-inferiority to lorazepam 0.5 mg/day; Kasper et al. (2014, n=539) showed superiority to placebo and comparability to paroxetine 20 mg/day over 10 weeks. A meta-analysis by Generoso et al. (2017) confirmed significant anxiolytic effects across studies. EMA has granted a well-established use classification for Silexan in the treatment of anxiety and restlessness. Silexan has a favorable side-effect profile with no sedation, cognitive impairment, or dependence potential, distinguishing it from benzodiazepines.
[2, 8, 9, 10]Restlessness and agitation
Commission E approved indication for Lavandulae flos. EMA well-established traditional use. Long history of clinical and traditional use across European herbal medicine for nervous restlessness, agitation, and inability to relax. Lavender tea, tincture, and aromatherapy are all traditionally employed. Lavender-filled pillows and sachets are a widespread folk remedy for calming restlessness at bedtime. The well-established status reflects both the Commission E approval and extensive traditional documentation.
[1, 2, 3]Insomnia and sleep disturbance
Multiple clinical trials support lavender's sleep-promoting effects. A systematic review by Lillehei & Halcon (2014) found that inhaled lavender essential oil improved sleep quality across diverse populations. Kasper et al. (2014) reported improved sleep quality as a secondary outcome in the Silexan GAD trial. Mechanisms include reduction of sympathetic nervous system activation and promotion of parasympathetic tone, increasing slow-wave sleep. Most effective when insomnia is associated with anxiety or nervous tension.
[1, 9, 11]Tension headache
A randomized placebo-controlled trial by Sasannejad et al. (2012) found that inhalation of lavender essential oil significantly reduced migraine headache severity compared to placebo. Topical application of diluted lavender oil to the temples is a longstanding traditional remedy for tension headaches. The combined analgesic, anti-inflammatory, and nervine relaxant properties underpin this indication. Most effective for headaches associated with nervous tension and stress.
[3, 13]Perioperative anxiety
Several RCTs have demonstrated that lavender aromatherapy reduces preoperative anxiety scores, including Franco et al. (2016) who found inhaled lavender reduced anxiety before ambulatory surgery. The non-pharmacological nature of aromatherapy makes it an attractive adjunct in perioperative settings where drug interactions and sedation are concerns.
[14, 17]Skin / Integumentary
Minor wounds and burns (topical)
One of the oldest traditional uses of lavender. The famous account of Rene-Maurice Gattefosse (the founder of modern aromatherapy) plunging his burned hand into lavender essential oil and observing rapid healing is the founding narrative of aromatherapy. Vakilian et al. (2011) RCT demonstrated enhanced episiotomy wound healing with lavender oil. The combined antimicrobial, anti-inflammatory, and tissue-regenerative properties support wound healing. Traditional use for minor kitchen burns, cuts, scrapes, and insect bites is extensive.
[3, 12, 16]Acne vulgaris (topical)
Preliminary evidence suggests lavender essential oil may benefit acne through antimicrobial activity against Propionibacterium acnes and anti-inflammatory effects. In vitro studies demonstrate bactericidal activity against acne-associated bacteria. No large clinical trials. Often combined with tea tree oil in natural acne formulations. The low skin irritation potential of true lavender oil (compared to tea tree) makes it suitable for sensitive skin.
[4, 16]Digestive System
Functional dyspepsia and bloating
Commission E approved lavender for functional abdominal complaints. The antispasmodic and carminative properties relieve bloating, flatulence, and epigastric discomfort. Lavender tea after meals is a traditional European digestive remedy. Often combined with other carminative herbs (peppermint, fennel, chamomile) in digestive tea blends. The aromatic volatile oil stimulates gastric motility while the antispasmodic action reduces cramping.
[1, 3, 4]Nervous dyspepsia and stress-related GI symptoms
Particularly indicated when digestive complaints are associated with nervous tension and anxiety (the 'nervous stomach'). Lavender's combined nervine and carminative actions address both the psychological and somatic components of stress-related digestive dysfunction. Traditional use in German and French phytotherapy for this specific indication pattern.
[1, 3]Respiratory System
Upper respiratory tract support (steam inhalation)
Traditional use of lavender steam inhalation for nasal congestion, sinusitis, and upper respiratory tract irritation. The antimicrobial volatile oil components act directly on respiratory mucosa. Commission E lists respiratory tract inflammation (inhalation) as an application for aromatic Lamiaceae herbs generally. Less commonly used for respiratory complaints than eucalyptus or thyme, but provides a gentler alternative suitable for children and those sensitive to strong camphoraceous oils.
[3, 4]Musculoskeletal System
Muscle tension and pain (topical)
Topical application of diluted lavender essential oil (in massage oil) for muscle tension, stiffness, and minor musculoskeletal pain. The analgesic and anti-inflammatory properties of linalool and beta-caryophyllene provide local pain relief. Commission E approved for functional circulatory disorders, which traditionally included topical application for muscle complaints. Lavender massage oil is commonly combined with other analgesic essential oils (rosemary, peppermint, eucalyptus) for enhanced effect.
[1, 3, 17]Energetics
Temperature
cool
Moisture
slightly dry
Taste
Tissue States
hot/excitation, wind/tension, damp/stagnation
Lavender is classified as cool and slightly drying in Western herbal energetics. Its cooling nature makes it specific for conditions with signs of excess heat in the nervous system -- agitation, restlessness, irritability, hot-tempered insomnia, and inflammatory states. The pungent and aromatic qualities indicate its ability to move stagnant energy, particularly in the head (headaches) and digestive system (bloating, cramping). The bitter quality contributes to digestive stimulation. The combination of cooling and aromatic is distinctive -- lavender calms heat and tension without being overly sedating or dulling. This makes it ideal for 'hot, tense' constitutions with anxiety, irritability, and difficulty unwinding. In traditional Unani/Arabic medicine, lavender is classified as warm in the first degree and dry in the second degree, reflecting a different interpretive framework. CAVEAT: Herbal energetics are interpretive frameworks within Western herbalism, not standardized across all practitioners.
Traditional Uses
Ancient Roman and Greek use
- Added to bathwater for cleansing and fragrance (the Latin name derives from 'lavare,' to wash)
- Used to scent linens, clothing, and living spaces
- Strewing herb for floors to purify air and repel insects
- Wound dressing and antiseptic for soldiers
- Perfumery and cosmetic applications
"The Romans used lavender extensively in their public baths, giving the herb its name from the Latin 'lavare' (to wash) or 'livendula' (bluish). Dioscorides (De Materia Medica, 1st century CE) mentioned lavender for internal use as a laxative and for topical application on wounds. Pliny the Elder recorded lavender's use in perfumery and as an insect repellent. Roman soldiers carried lavender to dress battlefield wounds."
Medieval European herbalism
- Nervine and carminative in monastic medicine gardens
- Strewing herb and fumigant during plague outbreaks
- Treatment of headaches, fainting, and 'swooning'
- Digestive aid for colic and flatulence
- Added to washing water for linens and hands
- Ward against evil spirits and attract love (folk magic)
"Hildegard von Bingen (12th century) recommended lavender for maintaining a pure character and included it in her medicinal garden prescriptions. During the Great Plague of 1665, lavender was a component of 'Four Thieves Vinegar,' a prophylactic preparation. The Elizabethan herbalist John Gerard (1597) described lavender as useful for 'the panting and passion of the heart' and for headaches caused by cold."
European phytotherapy (modern herbal medicine)
- Anxiety, restlessness, and nervous tension (infusion, tincture, essential oil)
- Insomnia and sleep disturbance (essential oil inhalation, pillow sachet, infusion)
- Functional GI complaints: bloating, flatulence, nervous stomach
- Tension headaches and migraine (topical essential oil, inhalation)
- Minor wounds, burns, and insect bites (topical essential oil)
- Functional circulatory disorders (Commission E indication)
- Nervous heart palpitations
- Bath additive for nervous exhaustion and circulatory support
"The German Commission E (1984) issued a positive monograph for Lavandulae flos, approving its use for restlessness, insomnia, functional abdominal complaints, functional circulatory disorders, and as a bath additive. Lavender is one of the most prescribed herbs in European clinical phytotherapy, particularly in France, Germany, and the United Kingdom. The British Herbal Pharmacopoeia (BHP) includes lavender as a carminative and spasmolytic."
Aromatherapy
- Anxiety reduction and stress management (inhalation, diffusion, massage)
- Sleep promotion (pillow spray, diffusion at bedtime)
- Pain management (topical massage for headaches, muscle aches)
- Wound healing and skin care (topical application diluted in carrier oil)
- Emotional balancing and mood support
- Perioperative anxiety reduction (clinical aromatherapy)
"Lavender is considered the foundational and most versatile essential oil in modern aromatherapy. Rene-Maurice Gattefosse, a French chemist, coined the term 'aromatherapy' in 1937 after reportedly experiencing the healing properties of lavender oil on a burn injury. Lavender essential oil is the most commonly used oil in clinical aromatherapy programs in hospitals and healthcare settings worldwide. Its gentle profile and wide therapeutic window make it suitable for use with children, elderly, and sensitive populations."
Modern Research
Silexan (lavender oil capsules) vs lorazepam for generalized anxiety disorder
Randomized, double-blind, active-comparator trial comparing Silexan (80 mg/day lavender oil capsule) to lorazepam (0.5 mg/day) in 77 adults with generalized anxiety disorder (ICD-10) over 6 weeks.
Findings: Silexan reduced Hamilton Anxiety Rating Scale (HAM-A) scores by 11.3 points vs 11.6 points for lorazepam, demonstrating non-inferiority (P = 0.003 for non-inferiority). Both groups showed clinically significant improvement. Silexan did not produce sedation, cognitive impairment, or withdrawal symptoms upon discontinuation, unlike lorazepam. Sleep quality also improved in the Silexan group.
Limitations: Moderate sample size (n=77). Active-comparator design without placebo arm. Low lorazepam dose (0.5 mg/day) -- higher benzodiazepine doses may have greater efficacy. Single-center study. Short treatment duration (6 weeks).
[8]
Silexan vs paroxetine and placebo for GAD: large multicenter trial
Multicenter, randomized, double-blind, placebo-controlled trial comparing Silexan 80 mg/day, Silexan 160 mg/day, paroxetine 20 mg/day, and placebo in 539 adults with GAD (DSM-IV criteria) over 10 weeks.
Findings: Silexan 160 mg/day reduced HAM-A total scores by 14.1 points vs 9.5 points for placebo (P < 0.001), with an effect size comparable to paroxetine 20 mg/day (14.0 points reduction). Silexan 80 mg/day also showed significant superiority over placebo (12.8 points, P = 0.004). Response and remission rates were significantly higher with both Silexan doses vs placebo. Adverse events were mild -- predominantly GI discomfort (eructation/nausea) with Silexan, versus sexual dysfunction and discontinuation syndrome with paroxetine.
Limitations: Industry-sponsored trial (Schwabe Pharmaceuticals). Paroxetine included as reference arm, not direct comparator (study not powered for Silexan vs paroxetine comparison). 10-week duration -- longer-term efficacy and safety data needed. GI side effects (eructation with lavender odor) may have partially unblinded the study.
[9]
Meta-analysis of oral lavender for anxiety disorders
Systematic review and meta-analysis evaluating the efficacy and safety of oral lavender oil preparations (primarily Silexan) for anxiety disorders, synthesizing data from randomized controlled trials.
Findings: Pooled analysis demonstrated a significant anxiolytic effect of oral lavender oil compared to placebo, with a standardized mean difference indicating a clinically meaningful reduction in anxiety symptoms. The effect size was consistent across trials and populations. No serious adverse events were reported. The meta-analysis supported oral lavender oil as an effective anxiolytic with a favorable safety profile.
Limitations: Limited number of included trials at time of publication. Most evidence derived from Silexan (single proprietary product). Heterogeneity in anxiety assessment tools across studies. Most trials were sponsored by the manufacturer.
[10]
Lavender aromatherapy for sleep quality: systematic review
Systematic review of clinical studies evaluating inhaled lavender essential oil on sleep quality, encompassing diverse populations including hospitalized patients, elderly, students, and women with insomnia.
Findings: The majority of reviewed studies (10 of 11) reported positive effects of inhaled lavender on at least one sleep outcome measure. Improvements were observed in self-reported sleep quality (Pittsburgh Sleep Quality Index), sleep onset latency, sleep duration, and daytime well-being. Studies used various delivery methods (cotton ball, diffuser, pillow spray). The evidence was most consistent for improved subjective sleep quality.
Limitations: High heterogeneity in study designs, lavender preparations, delivery methods, doses, and outcome measures. Several studies had small sample sizes. Few studies used objective sleep measures (polysomnography, actigraphy). Blinding challenges with aromatic interventions. Most studies short-term.
[11]
Lavender aromatherapy for anxiety: systematic review and meta-analysis
Systematic review and meta-analysis of randomized controlled trials examining the anxiolytic effects of inhaled or topically applied lavender essential oil (aromatherapy) in clinical populations, including pre-surgical, dental, and general anxiety settings.
Findings: Pooled analysis of multiple RCTs found that lavender aromatherapy significantly reduced anxiety scores compared to controls. The effect was observed across diverse clinical settings including preoperative anxiety, dental anxiety, and general stress-related anxiety. Both inhalation and topical massage with lavender oil demonstrated anxiolytic effects. Effect sizes were moderate.
Limitations: Heterogeneity in aromatherapy protocols (concentration, duration, delivery method). Blinding is inherently challenging in aromatherapy trials due to the distinctive scent. Expectation bias cannot be fully excluded. Many included trials had modest sample sizes. Short-term interventions in most studies.
[17]
Topical lavender oil for wound healing (episiotomy)
Randomized controlled trial assessing the effect of topical lavender essential oil (diluted in sesame oil) on episiotomy wound healing in 120 primiparous women, compared to povidone-iodine and control groups.
Findings: Lavender oil application significantly improved wound healing scores (REEDA scale: Redness, Edema, Ecchymosis, Discharge, Approximation) at 5 days postpartum compared to controls. The lavender group showed reduced redness, edema, and wound discharge. No adverse effects or allergic reactions were observed.
Limitations: Single-center study. Specific to episiotomy wounds -- generalizability to other wound types uncertain. Lavender diluted in sesame oil (cannot isolate lavender-specific effects from carrier oil). Short follow-up (5 days). Subjective wound assessment scale.
[12]
Lavender aromatherapy for perioperative anxiety
Randomized controlled trial examining the effect of inhaled lavender essential oil on preoperative anxiety in 100 patients undergoing ambulatory surgery, using a visual analog scale for anxiety and physiological measures.
Findings: Patients exposed to lavender aromatherapy in the preoperative holding area had significantly lower anxiety scores compared to controls. The intervention was well-received by patients and nursing staff. No adverse events were observed. The non-pharmacological nature of the intervention makes it suitable as an adjunct to standard preoperative care.
Limitations: Blinding limitations inherent to aromatherapy. Single-center. Anxiety measured at a single time point. Cannot distinguish specific lavender pharmacological effects from general relaxation response to pleasant scent. Ambulatory surgery setting -- may not generalize to major surgery.
[14]
Lavender essential oil headache/migraine reduction
Randomized placebo-controlled trial evaluating the efficacy of inhaled lavender essential oil for acute migraine management in 47 patients over multiple migraine attacks.
Findings: Inhalation of lavender essential oil for 15 minutes during migraine attacks significantly reduced headache severity compared to placebo (liquid paraffin). Of 129 headache attacks in the lavender group, 92 (71%) responded partially or entirely to lavender, compared to 32 of 68 attacks (47%) in the placebo group (P = 0.001).
Limitations: Small sample size (n=47). Crossover design with potential carryover effects. Self-reported outcomes. Blinding challenges -- lavender has a distinctive scent vs liquid paraffin. Mechanism not elucidated.
[13]
Preparations & Dosage
Infusion (Tea)
Strength: 1-2 g dried flowers per 150 mL water (approximately 0.7-1.3% infusion)
Pour 150 mL (approximately 5 oz) of freshly boiled water over 1-2 teaspoons (1-2 g) of dried lavender flowers. Cover and steep for 5-10 minutes. Strain before drinking. Covering the cup during steeping is essential to prevent loss of volatile oil components. The infusion should be a pale green-yellow color with a strong floral aroma.
1 cup (150-250 mL) 2-3 times daily
2-3 times daily for therapeutic effect. For sleep: 1 cup 30-60 minutes before bedtime.
May be used long-term as a daily tea. For specific therapeutic purposes, reassess after 4 weeks. No established maximum duration.
Children 4-12 years: 50-100 mL standard infusion 1-2 times daily. Not well-studied in children under 4 for internal use.
The traditional preparation for mild anxiety, restlessness, and functional GI complaints. Commission E recommended dosage: 1-2 teaspoons (approximately 1-2 g) per cup. The infusion extracts flavonoids (luteolin, apigenin), rosmarinic acid, tannins, and some volatile oil components. Some volatile oil is lost during steeping even with a lid, making the infusion less concentrated in essential oil components than tincture or essential oil preparations. For sleep, often combined with other sedative herbs (valerian, passionflower, lemon balm). For digestive complaints, combine with chamomile, peppermint, or fennel.
Essential Oil
Strength: 100% essential oil (Lavandulae aetheroleum). Quality markers: linalool 20-45%, linalyl acetate 25-47%, camphor < 1.2%, 1,8-cineole < 2.5% (European Pharmacopoeia standards for L. angustifolia).
For topical use: Dilute 1-3% in a carrier oil (jojoba, sweet almond, coconut, or olive oil). For a 1% dilution, add approximately 6 drops of essential oil per 30 mL (1 oz) of carrier oil. For inhalation: Add 3-5 drops to a bowl of steaming water and inhale with a towel draped over the head, or add 2-3 drops to an aromatherapy diffuser. For bath: Add 5-8 drops mixed with a dispersant (milk, Epsom salt, or unscented bath gel) to warm bathwater. NOT for undiluted oral use.
Topical: 1-3% dilution in carrier oil, applied to affected area or used in massage 2-3 times daily. Inhalation: 3-5 drops in steam or diffuser, 15-30 minutes, up to 3 times daily. Bath: 5-8 drops per bath. Internal (Silexan capsules only): 80-160 mg standardized lavender oil once daily -- see capsule preparation below.
2-3 times daily (topical or inhalation). Single application for bath.
Short-term topical application for acute conditions. May be used ongoing for aromatherapy/inhalation. Reassess if skin condition does not improve within 2 weeks.
Topical only for children over 2 years: 0.5-1% dilution. Diffusion in well-ventilated room acceptable for children over 2 years. Not for internal use in children. Avoid in infants under 2 years.
Lavender essential oil is the most widely used and versatile essential oil in clinical aromatherapy. Ensure the oil is genuine Lavandula angustifolia -- not lavandin (L. x intermedia), spike lavender (L. latifolia), or synthetic. The ISO standard 3515 specifies composition limits for lavender essential oil. Always dilute before topical application. Patch test recommended for first use. For burns, traditional use supports neat (undiluted) application of a single drop to minor burns, but current aromatherapy practice recommends dilution. Avoid contact with eyes and mucous membranes. Store in dark glass bottles away from heat and light.
Tincture
Strength: 1:5, 60% ethanol (dried flower spikes)
Hydroethanolic extraction of dried lavender flowers. Standard ratio 1:5 in 60% ethanol. Macerate dried flowers in the menstruum for 2-4 weeks with regular agitation (shake daily), then press and filter through muslin or coffee filter. Store in dark glass bottles.
1-4 mL (20-80 drops) three times daily, diluted in water
Three times daily, or as needed for acute anxiety/agitation
May be used for extended periods. Reassess therapeutic need periodically.
Children 4-12 years: 0.5-1 mL diluted in water, 2-3 times daily (consult practitioner). Glycerite preferred for young children.
The tincture provides good extraction of both lipophilic (essential oil components, coumarins) and hydrophilic (flavonoids, rosmarinic acid, phenolic acids) constituents. The 60% ethanol strength ensures efficient extraction of the volatile oil compounds while also capturing water-soluble polyphenols. For those avoiding alcohol, the tincture dose can be added to hot water to evaporate some ethanol before consumption. British Herbal Pharmacopoeia (BHP) lists the tincture dosage as 1-4 mL 3x daily. The tincture is particularly useful for acute anxiety -- 30-60 drops in a small amount of water provides relatively rapid onset of calming effects.
Capsule / Powder
Strength: 80 mg standardized lavender essential oil per capsule (Silexan/Lasea). Drug-extract ratio 1:1. Standardized to linalool 20-45% and linalyl acetate 25-46%.
Silexan (Lasea) is a proprietary product containing 80 mg of specially prepared, standardized lavender essential oil (Lavandula angustifolia, drug-extract ratio 1:1) in a soft gelatin capsule. Standardized to contain 20-45% linalool and 25-46% linalyl acetate. Swallow whole with water; do not crush or chew.
80 mg once daily (standard dose used in most clinical trials). 160 mg once daily has been used in the Kasper et al. (2014) trial for GAD with greater efficacy and acceptable tolerability.
Once daily, with or without food
Clinical trials used 6-10 weeks of continuous treatment. Long-term safety data are available for up to 10 weeks from controlled trials. No dependence or withdrawal effects reported upon discontinuation.
Not established for children. Clinical trials enrolled adults 18+ years only.
Silexan is the only orally administered lavender essential oil product with robust clinical trial evidence. It has been approved as a medicinal product in Germany (Lasea) for the treatment of anxiety and restlessness. The most common side effect is GI discomfort, particularly eructation (burping) with a lavender taste, reported in 4-8% of patients in clinical trials. This can be minimized by taking the capsule with food. Do NOT substitute generic lavender essential oil capsules for Silexan -- the proprietary purification and standardization process is specific to this product, and other lavender oils may not have equivalent safety profiles for oral ingestion.
Safety & Interactions
Class 1
Can be safely consumed when used appropriately (AHPA Botanical Safety Handbook)
Contraindications
Allergic reactions including contact dermatitis, urticaria, and very rarely anaphylaxis have been reported with lavender essential oil. Individuals with established allergies to other Lamiaceae plants (rosemary, sage, mint, thyme, basil) may be at increased risk, though cross-reactivity within the Lamiaceae family is less common than within the Asteraceae family. Patch testing is recommended before first topical use in individuals with a history of fragrance sensitivity or contact dermatitis.
Drug Interactions
| Drug / Class | Severity | Mechanism |
|---|---|---|
| Benzodiazepines, barbiturates, and other CNS depressants (CNS depressants) | minor | Lavender acts on GABAergic neurotransmission (linalool enhances GABA-A receptor activity). Additive sedation is theoretically possible when combined with pharmaceutical CNS depressants. Silexan demonstrated anxiolytic effects comparable to lorazepam 0.5 mg but produced less sedation than the benzodiazepine. |
| CYP3A4 substrates (cyclosporine, certain statins, calcium channel blockers) (CYP3A4 substrates) | theoretical | In vitro studies suggest that linalool and other lavender oil constituents may inhibit CYP3A4. However, in vivo clinical significance has not been demonstrated at typical lavender doses. The Silexan clinical trials did not report clinically meaningful drug interactions in patients on concomitant medications. |
Pregnancy & Lactation
Pregnancy
likely safe
Lactation
likely safe
Lavender tea and culinary use have a long history of consumption during pregnancy without documented teratogenic or adverse fetal effects. The Commission E does not list pregnancy as a contraindication. EMA notes that safety during pregnancy has not been specifically studied but traditional use does not suggest concern. The AHPA Botanical Safety Handbook classifies lavender as Class 1 (can be safely consumed when used appropriately) without specific pregnancy warnings. Concentrated essential oil and high-dose oral preparations (e.g., Silexan 160 mg) should be used with caution during pregnancy due to insufficient specific safety data at these doses. The traditional emmenagogue reputation of lavender is based on historical texts and is not supported by pharmacological evidence of uterotonic activity at normal doses. Lavender aromatherapy has been used in labor and delivery settings to reduce maternal anxiety without reported adverse fetal effects. For breastfeeding: lavender tea is considered compatible with lactation. Topical lavender oil should not be applied to the breast/nipple area when nursing to avoid infant oral exposure to essential oil.
Adverse Effects
References
Monograph Sources
- [1] German Commission E (Bundesinstitut fur Arzneimittel und Medizinprodukte). Commission E Monograph: Lavandulae flos (Lavender Flowers) -- Positive. Bundesanzeiger (Federal Gazette) (1984)
- [2] Committee on Herbal Medicinal Products (HMPC), European Medicines Agency. Community Herbal Monograph on Lavandula angustifolia Mill., aetheroleum and Lavandula angustifolia Mill., flos. European Medicines Agency (2012)
- [3] Hoffmann D. Medical Herbalism: The Science and Practice of Herbal Medicine. Healing Arts Press, Rochester, VT (2003) . ISBN: 978-0892817498
- [4] Bone K, Mills S. Principles and Practice of Phytotherapy: Modern Herbal Medicine (2nd edition). Churchill Livingstone / Elsevier, Edinburgh (2013) . ISBN: 978-0443069925
- [5] Blumenthal M, Busse WR, Goldberg A, Gruenwald J, Hall T, Riggins CW, Rister RS (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council, Austin, TX (1998) . ISBN: 978-0965555500
- [6] Gardner Z, McGuffin M (eds). American Herbal Products Association's Botanical Safety Handbook (2nd edition). CRC Press, Boca Raton, FL (2013) . ISBN: 978-1466516946
- [7] British Herbal Medicine Association. British Herbal Pharmacopoeia. British Herbal Medicine Association, Bournemouth (1983)
Clinical Studies
- [8] Woelk H, Schlafke S. A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder. Phytomedicine (2010) ; 17 : 94-99 . DOI: 10.1016/j.phymed.2009.10.006 . PMID: 19962288
- [9] Kasper S, Gastpar M, Muller WE, Volz HP, Moller HJ, Schlafke S, Dienel A. Lavender oil preparation Silexan is effective in generalized anxiety disorder -- a randomized, double-blind comparison to placebo and paroxetine. Int J Neuropsychopharmacol (2014) ; 17 : 859-869 . DOI: 10.1017/S1461145714000017 . PMID: 24456909
- [10] Generoso MB, Soares A, Taiar IT, Cordeiro Q, Shiozawa P. Lavender oil preparation (Silexan) for treating anxiety: An updated meta-analysis. J Clin Psychopharmacol (2017) ; 37 : 115-117 . DOI: 10.1097/JCP.0000000000000615 . PMID: 27811554
- [11] Lillehei AS, Halcon LL. A systematic review of the effect of inhaled essential oils on sleep. J Altern Complement Med (2014) ; 20 : 441-451 . DOI: 10.1089/acm.2013.0311 . PMID: 24720812
- [12] Vakilian K, Atarha M, Bekhradi R, Chaman R. Healing advantages of lavender essential oil during episiotomy recovery: a clinical trial. Complement Ther Clin Pract (2011) ; 17 : 50-53 . DOI: 10.1016/j.ctcp.2010.05.006 . PMID: 21168115
- [13] Sasannejad P, Saeedi M, Shoeibi A, Gorji A, Abbasi M, Foroughipour M. Lavender essential oil in the treatment of migraine headache: a placebo-controlled clinical trial. Eur Neurol (2012) ; 67 : 288-291 . DOI: 10.1159/000335249 . PMID: 22517298
- [14] Franco L, Blanck TJ, Dugan K, Kline R, Shanmugam G, Galotti A, von Bergen Granell A, Wajda M. Both lavender fleur oil and unscented oil aromatherapy reduce preoperative anxiety in breast surgery patients: a randomized trial. J Clin Anesth (2016) ; 33 : 243-249 . DOI: 10.1016/j.jclinane.2016.02.024 . PMID: 27555173
Traditional Texts
- [15] Grieve M. A Modern Herbal: The Medicinal, Culinary, Cosmetic and Economic Properties, Cultivation and Folk-Lore of Herbs, Grasses, Fungi, Shrubs & Trees with Their Modern Scientific Uses. Jonathan Cape, London (1931)
Pharmacopeias & Reviews
- [16] Cavanagh HM, Wilkinson JM. Biological activities of lavender essential oil. Phytother Res (2002) ; 16 : 301-308 . DOI: 10.1002/ptr.1103 . PMID: 12112282
- [17] Lakhan SE, Sheafer H, Tepper D. The effectiveness of aromatherapy in reducing pain: a systematic review and meta-analysis. Pain Res Treat (2016) ; 2016 : 8158693 . DOI: 10.1155/2016/8158693 . PMID: 28070420
- [18] Silva GL, Luft C, Lunardelli A, Amaral RH, Melo DA, Donadio MV, Nunes FB, de Azambuja MS, Santana JC, Moraes CM, Mello RO, Cassel E, Bianchi SE, de Oliveira JR. Antioxidant, analgesic and anti-inflammatory effects of lavender essential oil. An Acad Bras Cienc (2015) ; 87 : 1397-1408 . DOI: 10.1590/0001-3765201520150056 . PMID: 26247152
Last updated: 2026-03-01 | Status: published
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