on May 26, 2026
Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common and debilitating side effects of cancer treatments, particularly those involving platinum-based drugs, taxanes, vinca alkaloids, and proteasome inhibitors.
It manifests as neuropathic pain, paresthesia, allodynia, and thermal hypersensitivity, significantly compromising quality of life, even in the long term. The damage primarily affects the sensory neurons of the dorsal root ganglia, which are more vulnerable than motor neurons.
CIPN pathophysiology: oxidative stress and neuronal damage
The biological mechanisms underlying CIPN include:
- direct damage to axons and myelin
- mitochondrial dysfunction
- increased oxidative stress
- neuroinflammation
- changes in ion channels and sensory receptors
Among these, receptors in the TRP (Transient Receptor Potential) family play a key role in pain signaling.
TRP receptors: key targets in neuropathic pain
TRP receptors are ion channels sensitive to temperature, oxidative stress, and chemical stimuli:
- TRPV1 → involved in thermal hyperalgesia and mechanical allodynia
- TRPA1 and TRPM8 → associated with cold-induced pain
- TRPV2 and TRPV4 → responses to warm thermal stimuli
Experimental evidence shows that:
- TRPV1 activation contributes to cisplatin- and paclitaxel-induced neuropathy
- TRPV1 antagonists reduce neuropathic pain
- TRPA1 and TRPM8 are modulated by oxidative stress
➡️ These receptors represent an emerging therapeutic target.
Limitations of conventional therapies
Standard drug treatments (antidepressants, anticonvulsants) show:
- variable efficacy
- side effects
- poor response in many patients
For this reason, interest is growing in integrated complementary strategies that can act on peripheral pain mechanisms.
Essential oils and aromatherapy: biological rationale
Essential oils (EOs) contain bioactive compounds (terpenes, phenols, aromatic alcohols) that can:
- modulate TRP receptors
- reduce oxidative stress
- exert anti-inflammatory and analgesic effects
- improve pain perception through sensory stimuli
Clinical evidence and practical applications
Topical application and sprays
Recent studies indicate that using topical sprays containing diluted EOs can significantly reduce neuropathic pain (Ahmadzadeh et al., 2024).
Aromatherapy massage
Massage with essential oils, particularly lavender, has been shown to:
- reduce neuropathic pain
- improve psychological and physical well-being
Evidence also comes from studies on diabetic neuropathy (Gok Metin et al., 2017; Rivaz et al., 2021).
Menthol and the TRPM8 receptor
Menthol, found in Mentha piperita and Mentha arvensis:
- is an agonist of the TRPM8 receptor
- reduces cold-induced pain and dysesthesia
Clinical application:
- concentration: 0.5–1%
- location: hands and feet
- frequency: 2 times a day
Clinical studies (Ozdemir et al., 2024; Li et al., 2022) show symptom improvement in cancer patients.
Safety and directions for use
Essential oils must be used with caution:
- always diluted in carrier oils (5–10%)
- avoid direct application to sensitive skin
- avoid contact with mucous membranes and eyes
➡️ Proper use reduces the risk of skin irritation and sensitization.
Integrated approach to NPIC
A modern model of neuropathy management includes:
- integration of pharmacological and complementary therapies
- multimodal interventions (topical, sensory, rehabilitative)
- personalized treatment
➡️ Goal: reduce pain, improve functionality and quality of life.
Chemotherapy-induced peripheral neuropathy is a complex condition in which TRP receptors and oxidative stress play a central role.
Essential oil-based complementary therapies, particularly through topical applications and massages, represent a promising option for modulating neuropathic pain, especially when integrated into a personalized, multidisciplinary clinical approach.
Scientific evidence
NPIC pathophysiology
- Argyriou AA et al. Nat Rev Neurol, 2024
- Starobova H, Vetter I. Nat Rev Neurosci, 2017
TRP receptors
- Kim M et al. Pain, 2023
- Singh AK et al. Front Physiol, 2021
- Petitjean H et al. Nat Rev Neurosci, 2022
Essential oils and neuropathy
- Ahmadzadeh A et al. Complement Ther Med, 2024
- Gok Metin Z et al. J Clin Nurs, 2017
- Rivaz M et al. Pain Manag Nurs, 2021
- Noh GO et al. J Altern Complement Med, 2019
Menthol and TRPM8
- Ozdemir L et al. Support Care Cancer, 2024
- Li Y et al. J Pain Symptom Manage, 2022
