Tea tree oil allergy: what is the offending agent? Report of three cases of tea tree oil allergy and review of the literature.

Tea tree oil is currently enjoying popularity as a 'cure-all' for a variety of skin conditions, from infections to psoriasis, and many household and personal products containing Melaleuca oil are available. However, despite its chemical complexities and enthusiastic use, there have been only a few reports of allergic reactions to tea tree oil. At the Skin and Cancer Foundation (Sydney, NSW, Australia), three of 28 normal volunteers tested strongly positive to patch testing with tea tree oil. Following further patch testing with tea tree oil constituents, all three patients reacted strongly to two preparations containing sesquiterpenoid fractions of the oil. Because patients often neglect to mention that they have used 'natural' remedies, it is important that physicians are aware of the potential adverse effects of these products. Furthermore, identification of the allergenic ingredients in tea tree oil may assist the growing industry to produce safer products.