Sir, Olbas oil is a popular product used to relieve nasal congestion. The manufacturers describe it as a 'mixture of pure plant oils, with ingredients including clove oil, eucalyptus, juniper berry and cajuput'. It is recommended that a few drops are used on a handkerchief or in a bowl of hot water and inhaled.1

A 63-year-old female attended a general dental practice for a routine examination where the dentist observed a defect in the nasal septum. Upon closer examination the defect was revealed to be some 10 × 15 mm in size. The patient was somewhat embarrassed but, following reassurance about confidentiality, explained the origins of the defect. She reported that she had been applying one drop of Olbas oil to each nostril on a daily basis beginning some 20 years previously. She would place a drop on each side of the nasal septum which made her feel that she could breathe easily and that this cleared her head. One day, some ten years later, she blew her nose and found that she forced a hole in the nasal septum. This enlarged as it healed leaving the defect shown in Figure 1. The patient discontinued the use of Olbas oil in that way but did not report the damage to any health professional. It was only noticed on dental examination. The patient was encouraged to report this to her general medical practitioner but reassured that, given the appearance and clear history, there was no reason for undue concern.

Figure 1
figure 1

Hole in the nasal septum caused after prolonged Olbas oil use

Full size image

There is little published evidence about the safety and effectiveness of Olbas oil although one Polish study in 1997 reported no harmful effects when the product was inhaled, as recommended by the manufacturer, by healthy volunteers for a period of 28 days.2 In the case reported here, the product was applied directly to nasal mucosa on a daily basis for a period of ten years. Perforation of the nasal septum can occur for several reasons, notably chronic cocaine abuse, sarcoidosis and chronic granulomatous diseases. In this case, the features were strongly linked with the clinical history so the aetiology was identifiable, but colleagues should always consider onward referral via the patient's GP.