About 29% to 49% of women are estimated to be affected by vulvovaginal candidiasis (VVC).1 Pregnancy and breastfeeding are associated with fluctuations in the hormonal balance.2 Under the impact of estrogen, the vaginal epithelium shows hypertrophy. The changes in acid content prevent the vagina from bacterial invasion during pregnancy but make it vulnerable to Candida albicans invasion.3

Melaleuca alternifolia (tea tree) has been used in aboriginal traditional medicine for the treatment of wounds and cutaneous infections. Tea tree essential oil has been used to treat conditions such as empyema, ringworm, paronychia, tonsillitis, stomatitis and vaginal infections.4 Tea tree oil has antiseptic and anti-inflammatory properties.5 On account of its antimicrobial properties, this oil is often used as the active ingredient in many topical formulations used to treat cutaneous infections. It has antibacterial, antifungal, antiviral, and antiprotozoal activities.5 A study has demonstrated that tea tree oil is effective in eradicating fungal colonization in vaginal candidiasis.1 Not only C. albicans, but a range of yeasts, dermatophytes, and other filamentous fungi have been found to be susceptible to tea tree oil. Tea tree oil has been shown to be effective in treating Trichomonas vaginalis infections as well.5

The antifungal actions of tea tree oil could be attributed to its ability to alter membrane properties and compromise membrane-associated functions. A study determined the mechanism of action of tea tree oil and its components against C. albicans, C. glabrata and Saccharomyces cerevisiae. The treatment of C. albicans with tea tree oil altered both permeability and membrane fluidity. Tea tree oil and components inhibited glucose-induced acidification of the external medium for all three organisms in a dose-dependent manner in the presence of 0.2%, 0.3% and 0.4% tea tree oil.6

Mondello et al4 investigated the in vitro activity of tea tree oil against 115 isolates of C. albicans, other Candida species and Cryptococcus neoformans. Tea tree oil was active in vitro against all tested strains, with MICs ranging from 0.03% to 0.25%. Tea tree oil accelerated C. albicans clearance from experimentally infected vagina.

Tea tree oil, on account of its antifungal activity, can be used as a potential agent to prevent and manage vaginal infections caused by fungi during pregnancy.

References

1. Di Vito M, Fracchiolla G, Mattarelli P, et al. Probiotic and Tea Tree Oil Treatments Improve Therapy of Vaginal Candidiasis: A Preliminary Clinical Study. Med J Obstet Gynecol 2016;4(4): 1090.
2. Bacterial vaginosis as a mixed infection. Hay PE (ed.). In: Polymicrobial Diseases. Brogden KA, Guthmiller JM(ed.). Washington (DC): ASM Press; 2002.
3. In: Maternal & Child Health Nursing: Care of the Childbearing & Childrearing Family. Pillitteri A (ed.).
4. Mondello F, De Bernardis F, Girolamo A, et al. In vitro and in vivo activity of tea tree oil against azole-susceptible and -resistant human pathogenic yeasts. Journal of Antimicrobial Chemotherapy 2003;51:1223–9.
5. Carson CF, Hammer KA, Riley TV. Melaleuca alternifolia (Tea Tree) Oil: a Review of Antimicrobial and Other Medicinal Properties. Clin Microbiol Rev. 2006;19(1):50-62.
6. Hammer KA, Carson CF, Riley TV. Antifungal effects of Melaleuca alternifolia (tea tree) oil and its components on Candida albicans, Candida glabrata and Saccharomyces cerevisiae. Journal of Antimicrobial Chemotherapy 2004;53(6):1081–5.