Peppermint essential oil is widely used and because of this, often misrepresented as being completely safe. It is safe when used diluted and with knowledge of cautions that apply to this oil. I was happy to see that the National Association of International Aromatherapists (NAHA) has felt it necessary to post a position statement on their website due to adverse events caused by perhaps well-meaning sellers of essential oils who know little to nothing about safely using essential oils. Here is NAHA's statement:

Peppermint (Mentha x piperita): relieves nausea, analgesic for muscular aches and pains, relieves/reduces migraines, energizing, antispasmodic, do not use on children under 30 months of age

NAHA Safety Note for Peppermint Essential Oil:

- Avoid use on children under 30 months of age. The nasal mucosa is an autonomic reflexogen organ, which has a distance action to the heart, lungs and circulation and may lead to sudden apnoea and glottal constriction.

- Direct application of peppermint oil to the nasal area or chest to infants should be avoided because of the risk of apnea, laryngeal and bronchial spasms, acute respiratory distress with cyanosis and respiratory arrest. (The Longwood Herbal Task Force)

- Do not apply undiluted peppermint essential oils to the feet, particularly on infants and children under the age of 12.

- Inhalation of larges doses of menthol may lead to dizziness, confusion, muscle weakness, nausea and double vision. (Natural Standard Research Collaboration, Peppermint oil. Evidence based monograph 2005; Medlineplus)

The information below has been taken from the European Medicines Agency: ASSESSMENT REPORT ON MENTHA X PIPERITA L., AETHEROLEUM

- When used orally, it may cause heartburn, perianal burning, blurred vision, nausea and vomiting. Heartburn is related with the release of the oil in the upper GI tract, which relaxes the lower oesophageal sphincter, facilitating the reflux. The same occurs in the cases of hiatal hernia. This particular undesirable effect is minimized by an appropriate pharmaceutical formulation.  **Peppermint essential oil should always be in an enteric-coated tablet or capsule for internal use.

- People with gallbladder disease, severe liver damage, gallstones and chronic heartburn should avoid the intake of peppermint oil.

- Menthol and peppermint oil caused burning mouth syndrome, recurrent oral ulceration or a lichenoid reaction, by contact sensitivity in the intra-oral mucosa, in sensitive patients.

- When applied on the skin, it may cause allergic reactions, as skin rashes, contact dermatitis and eye irritation.

- Use in infants or children is not recommended, when inhaled, taken by mouth or if applied on open skin areas, on the face or chest, due to the potential toxicity of the product.

- Peppermint oil should be used with caution. Doses of menthol over 1 g/Kg b.w. may be deadly.

For further research articles see:

A near fatal case of high dose peppermint oil ingestion- Lessons learnt

Acute allergic contact dermatitis of the lips from peppermint oil in a lip balm.