Geranium Oil

• Small human evidence for topical analgesia in neuropathic pain (PHN): A double-blind, randomized, crossover study in adults with post-herpetic neuralgia (a classic neuropathic pain) found that topical geranium oil produced rapid, short-term pain reduction vs placebo/mineral oil. Effects were evident within minutes but were temporary (hours). The American Journal of Medicine
• Active constituents with antinociceptive/anti-inflammatory activity (preclinical): Geranium oil is rich in geraniol, citronellol, and linalool, terpenes that show antinociceptive effects in rodent pain models and may modulate pain targets such as adenosine A2A receptors and TRP channels (e.g., TRPV1) implicated in neuropathic pain signaling. ScienceDirect
• Whole-oil effects in animals: Recent mouse work with P. graveolens oil nanoemulsions reports anti-nociceptive and anti-inflammatory effects; composition analyses highlight the same major terpenes above. Mechanisms may involve peripheral anti-inflammatory actions and central modulation (opioid pathway involvement suggested in that model). Nature

There’s a plausible mechanistic basis and a small clinical signal in PHN, but overall evidence is limited and condition-specific (mostly PHN), not a broad proof for all neuropathies.

Topical (most studied/most reasonable for neuropathic pain):

• Dilution range: General aromatherapy safety suggests 1–3% for routine body application; for short-term, localized analgesic blends some practitioners go higher, but authoritative profiling for geranium sets a dermal maximum ~17–17.5% (upper limit, not a starting point). Start low (1–3%) and titrate only if well tolerated. Tisserand Institute+2Aromatics International
• Carrier: Mix the essential oil into a neutral carrier (e.g., fractionated coconut, jojoba, or medium-chain triglyceride oil). Apply a pea-sized amount over the painful dermatome or focal area (avoid broken skin/mucosa), up to 3–4× per day as needed. The PHN trial observed onset within minutes with relief lasting hours, so repeat application is typically intermittent/PRN. The American Journal of Medicine
• Application method: Gently spread a thin film; do not massage aggressively if the area is allodynic (touch-sensitive).

Inhalation (adjunct for pain distress/anxiety):

• Not studied for neuropathy specifically, but a 2024 RCT in lumbar spinal stenosis found that inhaled 1% geranium oil reduced pain and improved psychological measures vs placebo. You can add 1–2 drops to a diffuser for 15–30 minutes in a ventilated room as an adjunct (especially if touch is intolerable). MDPI

What to combine/avoid:

• Combine with standard care your clinician recommends (gabapentinoids, lidocaine patch, capsaicin, etc.), because these have stronger evidence for neuropathic pain; geranium oil can be tried as a complement, not a replacement. New England Journal of Medicine

Human randomized, double-blind crossover (PHN): Temporary Relief of Postherpetic Neuralgia Pain with Topical Geranium Oil, Am J Med 2003—rapid, temporary pain relief vs placebo; well tolerated. (Short communication; small sample.) The American Journal of Medicine+1

Registered clinical studies:

• NCT01007747 (“EPT-100”): interventional study of topical geranium oil across neuropathic pain conditions (completed; summary describes aims and enrollment; results not posted in registry). ICHGCP
• NCT00611949 (“EPT-101”): comparison of synthetic geranium-oil components for neuropathic pain (listing). MedPath

Pilot/adjunctive EO work: A pilot RCT in Pain Management Nursing evaluated an essential-oil blend (including P. graveolens) for diabetic/idiopathic neuropathic pain, reporting significant pain reduction vs baseline; because it’s a multi-oil blend, it doesn’t isolate geranium oil’s effect. Pain Management Nursing

Mechanistic/preclinical:

• Geranium oil nanoemulsion: antinociceptive/anti-inflammatory effects in mice. Nature
• Terpenes (incl. geraniol) relieve chemotherapy-induced neuropathic pain in rodents via A2A receptors; additional models confirm antinociception. ScienceDirect
• TRPV1 and related channels are key in neuropathic pain; several geranium oil constituents interact with these pathways in preclinical literature (mechanistic plausibility, not clinical proof). Frontiers

Summary: One small clinical trial in PHN + supportive mechanistic/animal data. No large, confirmatory RCTs in diabetic neuropathy, chemotherapy-induced neuropathy, or radiculopathy. Consider it experimental/adjunctive.