Indian Journal of Dermatology
: 2014  |  Volume : 59  |  Issue : 5  |  Page : 518-

Author's Reply

Chembolli Lakshmi 
 Department of Dermatology, PSG Hospitals and PSG Institute of Medical Sciences and Research (PSGIMSR), Coimbatore, Tamil Nadu, India

Correspondence Address:
Chembolli Lakshmi
Department of Dermatology, PSG Hospitals and PSG Institute of Medical Sciences and Research (PSGIMSR), Coimbatore, Tamil Nadu

How to cite this article:
Lakshmi C. Author's Reply.Indian J Dermatol 2014;59:518-518

How to cite this URL:
Lakshmi C. Author's Reply. Indian J Dermatol [serial online] 2014 [cited 2022 Jul 6 ];59:518-518
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Dear Editor,

I thank the authors for their observation on the above-mentioned article. [1] Although the practice of massage aromatherapy in Ayurveda dates several thousands of years, the rare instances of hypersensitivity may be underreported.

The authors mention that these also "can produce hypersensitivity of Type I-Type IV if they are not prescribed according to conditions of constitution, disease, season and Dosha." However, the treatment was advised from a registered Ayurvedic pharmacy [Figure 1]. To prove that hypersensitivity reactions are seldom seen, they need to conduct a study after recording for each subject the oil/oils prescribed, and the various parameters mentioned above (constitution, disease, season, dosha) and follow-up for at least 6 months for any adverse reactions. But to date there are no documented trials on the use of these oils.{Figure 1}

It is well known that type IV hypersensitivity develops only after repeated applications as it requires the process of sensitization. Isolation of the various ingredients of Ayurvedic preparations for allergy testing (patch test) is also recommended to pinpoint the incriminating allergen.

There are innumerable patients with varied causes of joint pains including rheumatoid arthritis who derive benefit from Abhyanga. This report serves to highlight that topical medication including application of oils over prolonged period may occasionally sensitize whether they are prescribed by authentic practitioners or otherwise and if so patch testing with the individual constituents may help isolate the offending allergen and allow the patient to continue the therapy after excluding it.


1Lakshmi C. Allergic Contact Dermatitis (type IV hypersensitivity) and type I hypersensitivity following aromatherapy with ayurvedic oils (Dhanwantharam thailam, Eladi coconut oil) presenting as generalized erythema and pruritus with flexural eczema. Indian J Dermatol 2014;59:283-6.