Talk:Tea tree oil/Archive 2

Archive 1

Archive 2

Summary, weasel words about medical usage.

Summary: I've made several changes to the medical information to better reflect the citations. I have no idea why it was roll backed 'wholesale' instead of editted.

Tea tree oil is used in traditional medicine, this is the basis for it even having a medical section and what makes tea tree oil most notable. This should be included in the summary.

The mention of lice in the summary is not appropriate, there are many 'supposed' usages, about 15 or so in the source. Picking just lice to include summary is arbitrary. Cherry picking 1 detailed information to put in the summary should not be done unless it is the dominant detail pertaining to the subject.

The cited article states it is 'possibly effective' for 2 application, and cites 'insufficient evidence' not 'little evidence' for others. The prior phrase seems to cast tree tea oil as dubious, where as the medical community recognizes that a few usages have been shown possibly effective, where as the others need more researched.

Medical Subject:

The source referred to by the phrase "Despite its proponents.. it is not recommended for...", does not match its source. The 'proponent source' is not recommending people use it medically for these conditions. It state that there have been a studies that show it was effective.

The phrasing is not NPOV, and seems to try casting Tea tree oil as quackery, instead of presenting it of limited medical use with other uses requiring more research, which is the opinion of the present source.

This is my first post on this particular article and I'm hoping to fix the NPOV and weasel word problem. If someone chooses to revert again, please explain and so we can have a discussion here to work towards consensus or a form of arbitration.

Gsonnenf (talk) 19:04, 11 October 2013 (UTC)

Good luck with this work. Be sure to read WP:MEDRS. --Roxy the dog (quack quack) 21:47, 11 October 2013 (UTC)

I see you didn't take my advice. Please don't revert again, instead, suggest what you want to do here, and we can discuss it sensibly. Your changes will not stand up to scrutiny I'm afraid. Please think about it. --Roxy the dog (quack quack) 23:18, 11 October 2013 (UTC)

Hi Roxy, I am extremely familiar with WP:MEDRS and such other wiki guidelines. My edits are intended to bring the article within wiki guidelines. I have successfully brought edits on medical articles through discussion and RFCs. I have presented a discussion about my edits at the start of this section. I have been asking for discussion on my edits and have full confidence they will stand up to scrutiny. So far there have been only rollbacks with no discussion which is inappropriate. Gsonnenf (talk) 00:17, 12 October 2013 (UTC)

I have now mentioned the "promising" applications in the lede, added eczma to the list of things it isn't well-evidenced for treating, and added some stuff on MRSA (see below). I'm not seeing what the issue is here. There are obviously claims "out there" (as the ACS say) that TTO is some kind of natural cure-all, yet the research shows a lack of evidence for most of these claims and there are recommendations against ingestion or using it on children. We report these things from reliable sources. What's the problem? Alexbrn ^{talk|contribs|COI} 05:54, 12 October 2013 (UTC)

I agree with you that some of the claims are 'out there'. I think the changed summary is an improvement. I think its important to state and clearly communicate what evidence based medicine has found. We should avoid terms that are not found in the citations (scant evidence vs. insufficient evidence). Insufficient evidence would direct reflect article's authors intentions in this case. Also the passive 'has been claimed' is uninformative about who makes such claims. The article should state that practitioners of traditional medicine make such claims (sourced if necessary). Most of all, the article should reflect a neutral informative tone about the current state of tea tree oil in evidence based medicine rather than that of a persuasive essay designed to debunk claims of alternative medicine practitioners.Gsonnenf (talk) 08:16, 12 October 2013 (UTC)

We should faithfully paraphrase the sources we used to avoid WP:PLAGIARISM (talking of which I have excised some portions here which were just copy-pasted from an unattributed article). We don't know who the proponents are that claim the manifold benefits of TTO (ACS says just "proponents"), though we do know it's herbalists apparently making the claims about immune system boosting ... we could mention that, sure. WP:FRINGE means we need to juxtapose unverified medical claims with the mainstream view, and if that has the appearance of debunking then so be it: neutral articles often appear that way when dealing with such topics. Alexbrn ^{talk|contribs|COI} 08:30, 12 October 2013 (UTC)

We should certainly avoid WP:PLAGIARISM. Using a specific meaningful term such as insufficient evidence, where the author uses such term is not plagiarism. Also we have a small amount of flexibility in WP:FAIRUSE in using a short phrase or text fragment from an author (provided its not an 'Excessively long copyrighted excerpts.'). Also, I think we can do better than a tertiary source that just says 'proponents say'. I don't find that particular article by the ACS to be as authoritative as a peer reviewed journal. Gsonnenf (talk) 08:55, 12 October 2013 (UTC)

Also i noticed Alexbrn removed the usages of TTO that the NIH deemed possibly effective in the medical body. This doesn't appear to be a balanced approach presentation of the current medical consensus.Gsonnenf (talk) 09:12, 12 October 2013 (UTC)

On the contrary, on re-reading the sources and seeing ACS state "despite years of use, available clinical evidence does not support the effectiveness of tea tree oil for treating skin problems and infections in humans", our mentioning its "possible" effectiveness seemed non-neutral. Alexbrn ^{talk|contribs|COI} 09:17, 12 October 2013 (UTC)

While both the ACS and MedLine/NIH articles are tertiary sources, the source from NIH is far more current than the ACS one and reflects recent studies and it should take priority. Gsonnenf (talk) 09:33, 12 October 2013 (UTC)

They don't contradict one another. MedlinePlus says "possible". ACS says "evidence doesn't support". Cochrane are preparing a systematic review at the moment; when that appears it will be a good source. Alexbrn ^{talk|contribs|COI} 09:40, 12 October 2013 (UTC)

They obviously do contradict each other in the section you sited. ACS 2008 states " Despite years of use, available clinical evidence does not support the effectiveness of tea tree oil for treating skin problems and infections in humans." Whereas NIH 2012 states it is effective in treating Acne and Athletes foot as there OTC counterparts (5% benzoyl peroxide and tolnaftate 1% cream) respectively.Gsonnenf (talk) 09:52, 12 October 2013 (UTC)

No, MLP calls it "possibly effective" for the conditions you cite, which is two positions away from "effective" on their rating scale (it's not even "likely effective"). Eliding that difference would significantly misrepresent the source. Alexbrn ^{talk|contribs|COI} 10:04, 12 October 2013 (UTC)

The MLP clear states "Topical application of a 10% tea tree oil cream works about as well as tolnaftate 1% cream (Genaspor, Tinactin, Ting, and others) for relieving symptoms of athlete’s foot, including scaling, inflammation, itching, and burning." and "Applying a 5% tea tree oil gel appears to be as effective as 5% benzoyl peroxide (Oxy-5, Benzac AC, and others) for treating acne."Gsonnenf (talk) 20:26, 12 October 2013 (UTC)

right - that is them relaying the evidence that has led them to categorize it as "possibly effective", (not "effective"). The conclusion we present must be same as that of the source. What you've done is inserted the word "effective" (not in the source) and cherry-picked the evidence by leaving out the unfavourable comparisons with existing treatments. That is not neutral. Alexbrn ^{talk|contribs|COI} 20:49, 12 October 2013 (UTC)

LD50

Teapeat (talk · contribs) has re-included this content:

Tea tree oil can be toxic when swallowed. In rats the LD50 is 1.9-2.4 ml/kg.[11]

A few problems here: (1) there's an implication general toxicity can be stated from toxicity in rats (maybe so, but this is WP:SYN), (2) it's a primary source, and (33) since we have well-sourced mention of toxicity already in the article, why mention this rat figure, expecially as the first thing in the safety section? Alexbrn ^{talk|contribs|COI} 14:13, 12 October 2013 (UTC)

There's no such implication. It's perfectly normal to have LD50s in articles. This is an encyclopedia, it's supposed to contain information, not Alexbrn's personal healthy hints about what humans are or are not to use.

The concept of simple 'toxicity' is, to put it bluntly, a load of old crap. What makes something toxic, or not, is how much of it is taken or absorbed. Ethanol is toxic. Water is toxic. Everything is toxic in sufficient quantities.

Look, to the maximal extent, this is an academic-based encyclopedia. If you can't handle that, I suggest you go away. Most of the sources you're trying to force into the article as sources are not academic sources.Teapeat (talk) 14:32, 12 October 2013 (UTC)

And you appear to have a complete inability to know what a secondary source is! A "Clinical Microbiological Reviews: Melaleuca alternifolia (Tea Tree) Oil: a Review of Antimicrobial and Other Medicinal Properties" is a classic secondary source. The ACS article you love so much is a tertiary source!!!

Seriously, if you don't even know what a secondary source is, why are you here?Teapeat (talk) 14:36, 12 October 2013 (UTC)

Apologies - I assumed it was a primary for the LD50 without checking. However, the other points stand. Alexbrn ^{talk|contribs|COI} 14:51, 12 October 2013 (UTC)

(Add) Also, per WP:MEDMOS we should be writing for the general reader and avoiding technical terms like "LD50". Alexbrn ^{talk|contribs|COI} 15:03, 12 October 2013 (UTC)

I changed the running order and removed the tautology before seeing this. The LD50 stuff seems redundant to me. --Roxy the dog (quack quack) 15:17, 12 October 2013 (UTC)

I can only emphasise that the concept of 'toxicity' is an extremely bad one. Alcohol has an LD50 that is only a few times that of tea tree oil. The idea that tea tree oil is 'toxic' but alcohol is considered 'a drink' is fair enough due to alcohols overall effects, but it's not very scientific. Lead is toxic, but a gram of lead would kill you, but a gram of tea tree oil clearly wouldn't. I mean the literature has a person drinking a cupful of the stuff, and recovering without any apparent harm, although they were pretty sick.

It's toxic, but not very toxic. Orally, it's only a bit more toxic than alcohol.Teapeat (talk) 15:35, 12 October 2013 (UTC)

The LD50 is encyclopedic knowledge and should be included.Gsonnenf (talk) 21:01, 12 October 2013 (UTC)

The following is a quote from the LD 50 page ..

As a measure of toxicity, LD50 is somewhat unreliable and results may vary greatly between testing facilities due to factors such as the genetic characteristics of the sample population, animal species tested, environmental factors and mode of administration.[5]

There can be wide variability between species as well; what is relatively safe for rats may very well be extremely toxic for humans, and vice versa. For example, chocolate, harmless to humans, is known to be toxic to many animals. When used to test venom from venomous creatures, such as snakes, LD50 results may be misleading due to the physiological differences between mice, rats, and humans. Many venomous snakes are specialized predators on mice, and their venom may be adapted specifically to incapacitate mice; and mongooses may be exceptionally resistant. While most mammals have a very similar physiology, LD50 results may or may not be directly relevant to humans.

A low LD50 in animals may still be a cause for concern for humans, and a high animal value does not guarantee that a substance is similarly harmful to humans.

I searched for the LD 50 figure on the following pages ... water Aloe Vera Sodium Hydroxide Ethanol Talc Salt petrol laetrile and cyanide. Not very scientific I know, but a reasonable selection. A figure was only quoted on the petrol page. I suggest removing it. --Roxy the dog (quack quack) 21:51, 12 October 2013 (UTC)

There you go then, it's on the petrol page. Are you calling for its removal as well? What happens if a vet gets an animal poisoning incident. They'll google it and find it in the article and they can trace it back to the reference, and animal poisonings have happened. This is entirely relevant information; the rat is the model organism used for lots of toxicity work. It's entirely on topic; Wikipedia is a reference work, that's what Wikipedia is for.Teapeat (talk) 22:17, 12 October 2013 (UTC)

If a vet googles it, they'll get a page full of suggestions on what to do. The wiki page will be nowhere to be seen. --Roxy the dog (quack quack) 22:32, 12 October 2013 (UTC)

While we're on the subject of 'toxicity'; I noticed in the EU scientific 'opinion' they were really, really interested in TTO being an estrogen mimic in vitro tests, and the three boys that apparently (temporarily) grew boobs.

However, when they looked into it, they identified the estrogen fractions and discovered they weren't absorbed through the skin anyway; so it's mostly a non issue. All bets are off if you swallow it, but even then it should be metabolised away. And that's going to be why TTO is still on the market; if it was a significant estrogen mimic it should and would have been banned.

Ah... the ACS page hasn't been updated since Nov 2008; that explains it; they couldn't have read the EU's scientific opinion which was published in Dec 2008, so ACS is out of date on this.Teapeat (talk) 22:17, 12 October 2013 (UTC)

Right. The ACS article seems to be an out of date mediocre quality tertiary source. I'd support removing its recommendations in favor of more current, more authoritive, or higher quality sources.Gsonnenf (talk) 22:48, 12 October 2013 (UTC)

Misrepresenation of MRSA material?

Gsonnenf (talk · contribs) has sourced this text about TTO and MRSA

Studies have shown that it demonstrated similar rates of eradication when compared to treatment with mupirocin.

to this article (singular) which states:

Compared with mupirocin Tea tree oil cream plus tea tree oil body wash may be less effective than mupirocin nasal ointment plus chlorhexidine skin cleanser plus silver sulfadiazine cream at eradicating MRSA nasal colonisation at 14 days, but not in eradicating MRSA colonisation from all sites. We don't know whether tea tree oil nasal ointment plus tea tree oil body wash is more effective than mupirocin nasal ointment plus triclosan body wash at eradicating MRSA colonisation at any body site (very low-quality evidence).

That doesn't look like a fair representation. Alexbrn ^{talk|contribs|COI} 22:12, 12 October 2013 (UTC)

That statement is for nasal ointment which I agree is clearly less effective. I would certainly support putting an exception for nasal ointment in the statement. The comparison for general body sites is as follows:

It found that tea tree oil was significantly less effective in eradication of nasal colonization ... However, it found no significant difference between tea tree oil compared with mupirocin in eradication of MRSA from all sites 14 days after treatment (eradication from nose, throat, axillae, groin, and skin lesions : 46/110 [42%] with tea tree oil v 56/114 [49%] with mupirocin nasal ointment; P ~ 0.286 ).

Flaxman 2005 also came to the conclusion they are similar.Gsonnenf (talk) 22:35, 12 October 2013 (UTC)

I was quoting the conclusion from both the trials (the paragraph at the head of the section). You have cherry-picked the description of one RCT (omitting what the source itself chose to state first, about "significantly less effective") and then editorially broadened this into "studies have shown". This presents a POV that differs from that of the source. Furthermore you have substituted the very caveated language of the source ("may be", "we don't know") with a bold assertion that "studies have shown". Can't you see why this is problematic? Alexbrn ^{talk|contribs|COI} 05:02, 13 October 2013 (UTC)

Your entire cited conclusion refers to nasal ointment ". We don't know whether tea tree oil nasal ointment plus tea tree oil body wash...".Gsonnenf (talk) 06:19, 13 October 2013 (UTC)

"Your entire cited conclusion refers to nasal ointment" - No, as you can read it refers to "cream" and "body wash" in the first part of the conclusion, the ointment in the second half. You are making Wikipedia, in its own voice, draw a different conclusion to the source using a cherry-picked description of one trial, which is a problem. Alexbrn ^{talk|contribs|COI} 06:30, 13 October 2013 (UTC)

The first half refers specifically to MRSA nasal colonisation. We already discussed this and i said, yes put an exception for nasal colonization which you ignored then pointed to the second half. The second half is about effectiveness of nasal ointment, now you point to the first half again. You are going in circles. Please read the benefits section of the paper. The benefits section AND Flaxman 2005 both came to the conclusion I posted.Gsonnenf (talk) 03:36, 14 October 2013 (UTC)

AN/I

FYI, Teapeat (talk · contribs) has started a thread relating to this article at WP:AN/I. Alexbrn ^{talk|contribs|COI} 15:26, 22 October 2013 (UTC)

Sources

It seems that Alexbrn is deliberately biasing the lead in particular and the article in general. He's repeatedly edit warring away referenced material, adding weasel words, basing material on out of date studies, unreliable sources (a pedicurist association for safety information?), deleting reliable sourced material; apparently to suit his own OR and whims.

I don't think he's going to start editing responsibly.

As it stands I'm completely fed up with this. What do other people think, should we take him to ANI and get him topic blocked or do an RFC? I'm leading towards ANI, his editing is among the worst I've ever seen for raw bias.Teapeat (talk) 15:51, 21 October 2013 (UTC)

Au contraire. You managed to bring a report by an EU committee into the article (a usable source), completely ignore its conclusion and cherry-pick the one item out of it that dismissed a safety concern. The report's authors didn't see fit to include this factoid in their own conclusion so it is of questionable note anyway, let alone to put this in the lead as our principal representation of the report which is, in fact, extremely cautious in its approach to TTO: a fact which is now evident as I have included some material from the report's conclusion here. It would be completely non-neutral to try and represent the report's findings in a different way to how it does this itself. Alexbrn ^{talk|contribs|COI} 16:10, 21 October 2013 (UTC)

(add) Furthermore you keep removing content from the National Pediculosis Association with the bogus claim that it is not reliably sourced, when it obviously is. Alexbrn ^{talk|contribs|COI} 16:13, 21 October 2013 (UTC)

(add) And, err, you might want to look "pediculosis" up in the dictionary and then contrast it with "pedicurist". (If you've got those words mixed up I can see why you think my editing is odd!) Alexbrn ^{talk|contribs|COI} 16:45, 21 October 2013 (UTC)

It does appear that Alexbrn is following the sources accurately. It isn't clear to me why Teapeat objects to this. To suggest blocking, RFC or ANI is risible. --Roxy the dog (quack quack) 16:16, 21 October 2013 (UTC)

Really? Please explain how the introduction completely and pointedly fails to mention any of the uses for which tea tree oil compares well with standard treatments, while using deliberate weasel words: "there is insufficient evidence of its effectiveness for many of these claimed uses".

Many? What about the ones that there is good evidence for, like acne? But that's OK, alexbrn systematically deleted all those from the lead, I can only presume he did that to make tea tree oil look scary.

How is this supposed to be an unbiased summary of the article?

I mean, if you read the EU scientific analysis, they even had evidence about reproductive safety, like is it safe for pregnant women? Obviously they can't give it to pregnant women, but the rat-dose for which there was no evidence of issues was equivalent for human bodyweight to being over a gram per day; which is a huge amount.

And that's pregnant women! I mean no one at all is recommending it for pregnant women, but the scientific evidence is that for any normal use it's pretty safe.

And note that Alexbrn added: that some oil constituents may be absorbed by the skin, leading to "considerable systemic exposure" in the safety section. That wasn't actually the conclusion, if you actually read the whole paragraph this came from, it specifically applied to a case where a user might essentially drench their body in lotion and treat their feet, and even then they said they didn't have good enough data on the absorption. And even then, again, there were no safety conclusions from that dose!

For example the GP thing is a single sentence by a GP in an article in a magazine, and alexbrn is using this as being more reliable than the EU scientific committee, more reliable than all other primary and secondary sources. This has been deleted from the article and edit warred back in by alexbrn.

He's deliberately systematically cherry-picking scary-sounding phrases out of various sources, some reliable, some reasonably reliable, others totally unreliable, many out of date, and systematically in favour of later ones that are more reliable and in date.

In Wikipedia we don't pull this kind of shit. We show the unvarnished truth, and cite the best, most up-to-date sources.

Alexbrn has never, ever, ever done anything other than delete information that might show even the slightest positive property of tea tree oil and done anything other than edit war against anyone that tried to introduce it, even when this is based on good, reliable sources.

All that has happened where he has been forced to allow it to remain in the body of the article, he has used weasel words to systematically twist the introduction to hide any evidence of that from casual reader while lauding extremely marginal source. His approach is incredibly slanted.Teapeat (talk) 16:53, 21 October 2013 (UTC)

A lot of this is simply untrue. There is nothing in the conclusion of the EU report that says their concerns "specifically apply" to a case of "drenching". The paragraph in question states:

Following topical application of Tea Tree Oil and Tea Tree Oil containing products, percutaneous absorption of some constituents may occur, leading to a considerable systemic exposure, especially from neat oil, body lotion and foot spray/powder (see appendix). Because of inadequate dermal absorption studies available, the magnitude of systemic exposure to Tea Tree Oil from cosmetic products is uncertain. Only worst case estimations for NOAELs for general systemic and reproductive toxicity can be made. A Margin of Safety has not been calculated and the safety of Tea Tree Oil cannot be assessed.

We now mention this in the article.

As to "positive" things about TTO, I have included these where warranted. Which isn't very often according to the sources, and certainly a lot less than you evidently think it is. Alexbrn ^{talk|contribs|COI} 17:16, 21 October 2013 (UTC)

Yes, you see that little bit where it says "Because of inadequate dermal absorption studies available, the magnitude of systemic exposure to Tea Tree Oil from cosmetic products is uncertain.".

That says they don't know that there actually is a "considerable systemic exposure" whereas you wrote:

"Nevertheless, the committee concluded that some oil constituents are absorbed by the skin, leading to "considerable systemic exposure"!

You see the difference? One says it might cause a big exposure, the other says it definitely does cause exposure.

And note that the source doesn't actually say... and so it might cause toxicity. It doesn't even say that.

And you pull this kind of thing with every single edit; every edit vastly exaggerates theoretical dangers and completely removes any possible positives. For example the acne stuff, it's miraculously not in the lead. After you had edited the article it had completely disappeared.[1], and there was 'scant evidence' of it being useful for anything. Funny that!Teapeat (talk) 19:51, 21 October 2013 (UTC)

You wouldn't happen to want to declare a financial interest or other interest in people not use tea tree oil by any chance???? You don't (for example) supply benzoyl peroxide? Or is it all just a big coincidence that every part of a website you quote, and every part of reliable sources you quote just happen to be only the negative bits, and are often are being taken out of context?

I don't wish to make accusations at all, but I'm sort of detecting a completely consistent pattern here.Teapeat (talk) 19:51, 21 October 2013 (UTC)

You are correct in that my "are absorbed" text didn't reflect the source very well, for which I apologise; this is why I changed it to "may be absorbed" in replacement text. The acne potential of TTO is maybe promising, but the sources are tentative. We shouldn't be bigging these claims up like they're a done deal in the lede, if there isn't the strong sourcing to back that. As to interests, I happily declare I have zero interests - financial or otherwise - in TTO or any rival or associated substance ... or indeed of any medical or quasi-medical device, substance or practice of any kind. Alexbrn ^{talk|contribs|COI} 20:05, 21 October 2013 (UTC)

Look buster. You added something that said "this causes large systemic exposure" when the source actually didn't say that. When I complained you changed it to "this may cause large systemic exposure". The source doesn't, in context, even say that, you've taken it out of context. When I complain about this you bring up stuff about how 'promising' it is. I don't give a shit about that. I looked at what you wrote in the article, and first it's wrong, then it's still wrong, and now you're basically claiming that because it's 'promising' you can write almost anything.

Virtually every single single edit you make is like that. How much longer are we supposed to put up with this edit warring and your (what I can only suppose at this point) are deliberate distortions? Every single edit.

This article is not s health guide. It's an encyclopedia article about an industrially produced chemical oil. Wikipedia is not here to protect anyone from anything. It's a chemical. It has these following known chemical/biophysical properties (whatever they are). It's banned (wherever/if it is). It's related to these other chemicals etc. etc. You know, facts. Opinions (such and such don't think it should be used for this or that) may be facts as well, but they don't mean you get to remove the physical facts.

This garbage stops now.Teapeat (talk) 13:17, 22 October 2013 (UTC)

break

IN WHAT UNIVERSE IS THIS WEBSITE A RELIABLE SOURCE????: [2]

According to alexbrn who has revert warred it back in, it is a "this is pertintent, well-sourced health information".

Um.

No.

Note that alexbrn has revert warred it at least twice that I've counted, and I may have missed some: [3] [4].

It's not a reliable source, in Wikipedia we use secondary sources. That is some .org website of some organisation with no evidence whatever of editorial and academic reliability. It doesn't get Wikipedia's stamp of being a reliable source. It's not even a tertiary source.Teapeat (talk) 17:13, 21 October 2013 (UTC)

An independent medical/scientific organizations dedicated to pediculosis is going to be a good source for information on pediculosis per WP:MEDRS (you've realized this isn't foot care, right?). It is obviously reliable since the organization can be assumed to be capable of reliably stating its own view. Alexbrn ^{talk|contribs|COI} 17:19, 21 October 2013 (UTC)

I have returned the article to reflect the sources accurately. Teapeat, you really need to calm down and examine Alex's work dispassionately before making any more changes. It might be a good idea to propose changes here first in future, as what you have done recently wont wash. --Roxy the dog (quack quack) 17:49, 21 October 2013 (UTC)

No, YOU need to stop edit warring back in completely unreliably sourced material back into this article.

How is http://www.headlice.org/faq/treatments/alternatives.htm headlice.org a reliable source?

Is it published? NO!

Is it reliable? NO!

Is it a medical body? NO!

Has it been peer reviewed? PROBABLY NOT, WHO EVEN KNOWS?!

Do we have ANY reason to think it meets the criteria for a WP:RELIABLE source in Wikipedia for health or academic accuracy? NO!

If it changed would we know it has changed? Is there even version control? NO!

ABSOLUTELY WE DO NOT!!!

This isn't even in the ballpark, you can't see the ballpark.

I don't give a damn whether it's a pelicurist or a pedicurist, it has no bearing on safety AT ALL! It shouldn't even be in the article; not even in the external links section!

The fact that you clowns keep edit warring it back in says everything I need to know.

Where does it say on WP:MEDRS that websites like this are reliable sources for medical safety? I genuinely can't find it; BECAUSE IT'S NOT THERE.Teapeat (talk) 19:24, 21 October 2013 (UTC)

sources

I looked in the Cochrane library for research on this, I found only three articles that I could get and looked useful:

• PMID 15078424 - Herbal medicines for treatment of fungal infections: a systematic review of controlled clinical trials - 2004 - Conclusions: "There were few controlled clinical trials of herbal antifungal medicines, the most frequently evaluated being TTO, which holds some promise. All herbal remedies require further investigation in clinical trials."
• PMID 10800248 - Tea tree oil : a systematic review of randomized clinical trials (Structured abstract) - 2000 - "It is concluded that, so far, there is no compelling evidence to show that TTO is efficacious in any dermatological condition. However, in view of promising findings, TTO deserves to be investigated more closely."
• PMID 15824699 - Is tea tree oil effective at eradicating MRSA colonization? A review. - 2005 - "There is currently insufficient evidence to support the use of tea tree oil in clinical practice for the eradication of MRSA colonisation." (Currently used in article.)

I can provide copies of any of the Cochrane articles. Outside of that, the best resource available is probably this one, Botanicals in Dermatology: an evidence-based review by Juliane Reuter et al., PMID 20509719. Zad68 19:39, 21 October 2013 (UTC)

For the dermatological and fungal infection content, do you think we'd be better-off replacing what we've got with the Cochrane reviews? (executive summary: some promise; no firm evidence; more study needed) ?Alexbrn ^{talk|contribs|COI} 20:09, 21 October 2013 (UTC)

This doesn't seem to be a very well-researched area so an argument can be made that older meta-analyses may be used. The refrain of "no evidence of effectiveness strong enough to recommend but does look promising" seems to be repeated in the sources for years now. I'd really like to see what the full text of Reuter 2010 says, I suggest editors hit up their sourcing resources (mine's AWOL), or try WP:RX. Zad68 20:18, 21 October 2013 (UTC)

I can access the Reuter paper. It doesn't add a great deal. Some snippets (the article doesn't actually mention TTO that much):

• "Some botanicals, especially Oregon grape root, tea tree oil, Saccharomyces, and perhaps basil may have the potential to replace standard chemical therapy in mild to moderate cases [of acne] because of their good efficacy and higher tolerability. Further valid, controlled clinical studies that also consider optimization of pharmaceutical preparations are needed."
• "the sensitizing potential of tea tree oil and oxidized monoterpenes should be taken into account when using tea tree oil for the treatment of acne."
• "Tea tree oil has become one of the most common contact allergens. Moreover, tea tree oil and lavender oil have recently been reported to cause prepubertal gynecomastia."
• "tea tree oil (M. alternifolia) is not only effective in the topical therapy of acne as mentioned in section 1. It functions as a topical antiseptic with an efficacy superior to that of phenol and displays broad-spectrum antimicrobial activity in vitro"
• "antimycotic or antibacterial treatment using synthetic compounds is still the treatment of choice".

The article also mentions this paper by Ernst as a source of information on adverse TTO effects, which might be worth a look ... Alexbrn ^{talk|contribs|COI} 09:07, 22 October 2013 (UTC)

(add) this literature review also looks relevant. Unfortunately, it's in Swedish ... Alexbrn ^{talk|contribs|COI} 09:34, 22 October 2013 (UTC)

To put this irritation issue in perspective, it's used for mild-moderate acne as a replacement for 5% benzoyl peroxide. VIRTUALLY EVERY SINGLE PERSON THAT USES 5% BENZOYL PEROXIDE GETS SIGNIFICANT IRRITATION AND PEELING (often the skin adjusts, but still), but only one percent or so of 5% tea tree oil users get any irritation at all. And it works roughly the same (studies show varying effects). And about 30% of people are outright allergic to benzoyl peroxide and have a horrible time.Teapeat (talk) 13:38, 22 October 2013 (UTC)

And the 'prepubertal gynecomastia', that's the hormone thing, you know the thing that was debunked by the EU in 2008? The thing you just revert warred out of the lead? Three boys temporarily boobs grew when given TTO and lavender oil. The TTO is now in the clear, but the lavender oil has in vitro estrogenic effects and to my knowledge not been ruled out.Teapeat (talk) 13:38, 22 October 2013 (UTC)

These papers are virtually all out of date.Teapeat (talk) 13:38, 22 October 2013 (UTC)

The Reuter paper post-dates the deliberations of the EU committee, and in fact that case is mentioned quite a lot. Saying "TTO is now in the clear" on the basis of one committee's opinion while dismissing other, later, scholarship would seem to be a rather reckless approach to sourcing. So trumpeting that "TTO is now in the clear" (as you effectively did with your proposed lede edits) isn't a great idea ... quite apart from anything else it would seem undue to mention this wrinkle in the debate in the lede here. Alexbrn ^{talk|contribs|COI} 13:52, 22 October 2013 (UTC)

Just because they wrote it afterwards doesn't mean that they read the EU paper. That's the problem with tertiary sources (and to a lesser extent secondary sources.) You get an echo-chamber type effect going on. The purpose of the sourcing guidelines of Wikipedia is to minimise these things so that Wikipedia approaches the actual truth on a subject (whatever that may be). The EU paper actually looked at this issue, specifically, is a reliable source, and drew a conclusion based on primary sources. It is by far and away the most reliable source on this point we have.Teapeat (talk) 14:07, 22 October 2013 (UTC)

You said it was out-of-date, I was pointing out it wasn't. You say the Reuter paper is tertiary source, but in WP:MEDRS terms it's a secondary - a literature review making it an "ideal source". You say the EU document is our best source, but is it even peer-reviewed? We can't be cavalier about sourcing. Alexbrn ^{talk|contribs|COI} 14:15, 22 October 2013 (UTC)

Unfortunately, even if it was published after 2008 it doesn't necessarily mean it isn't out of date, unless it references the EU scientific opinion, scientists don't spend their whole time reading all the literature that is published. Unless it's referenced, it's reasonable to assume that it's unread by that author.

While I don't know the precise nature of the EU publication process, whether it specifically involves peer review as it would for publication in a journal or not, the EU's paper certainly meets Wikipedia's criteria for being published by a reliable source.Teapeat (talk) 15:19, 22 October 2013 (UTC)

Sure, but that doesn't mean other reliable sources can be just brushed aside. FWIW I think the text we have on this topic currently is about right. Alexbrn ^{talk|contribs|COI} 15:24, 22 October 2013 (UTC)

Hello, I agree this is a poorly sourced article. For example the claim that " is toxic when taken by mouth" is supported by the quoted article on the American Cancer Society, that has no pointers to support it's claim. None of the references in that article appear to support this claim.Ziounclesi (talk) 12:32, 4 December 2013 (UTC)

I added something from the National Capital Poison Center. Alexbrn ^{talk|contribs|COI} 13:27, 4 December 2013 (UTC)

That's better, at least it has one documented case, with authors, that I added a link to. I propose to remove the reference to the American Cancer Society in the heading, and leave it the Safety section, where it is clear that it is a volontary association with no medical obbligations.Ziounclesi (talk) 15:51, 9 December 2013 (UTC)

liver damage

Looking at the content from the National Pediculosis Association, they claim TTO can cause liver damage. They appear to be pretty much alone in making the claim and I propose we remove it. While the Association can be assumed, I think, to be a good source on pediculosis-related matters, we should do better for statements about subjects outside that area. Alexbrn ^{talk|contribs|COI} 16:24, 22 October 2013 (UTC)

I feel that the medical organization website content without direct citations are all acceptable under wp:med, but we should try to replace these with secondary sources (also according to wp:med). Most noticeably the American Cancer Association webpage is relied on heavily, but does not have inline citations. The ACS website is probably an excellent resource for general information on cancer, but I doubt they have expertise on TTO, especially not to the extent of authors publishing in academic papers on the subject. Further they haven't updated their TTO information since 2008. There have been numerous studies conducted in the past 6 years which they could not have accounted for.Gsonnenf (talk) 09:58, 29 October 2013 (UTC)