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Benefits of Geranium Oil for Acne and other Skin Problems

Geranium essential oil with fresh geranium flowers, on the old wooden board

Geranium oil is one of the most popular essential oils. It comes from a perennial shrub called geranium. The shrub has small, pink flowers and pointy leaves. The geranium plant is native to South Africa and is famous for its medicinal use since the times of Hottentots and Zulus of South Africa. In 1897, a traditional healer in South Africa treated tuberculosis with a herbal decoction of the local geranium. The patient, called Steven, was English and he brought the remedy to England as ‘Stevens’ Consumption Cure’. This remedy was used to cure 800 patients of tuberculosis. Not only is the geranium plant useful in its raw form, but its oil is also popular for some amazing benefits.

Geranium oil is extracted from leaves, stems, and flowers of the geranium plant. The plant exists in many varieties, but its most popular essential oil comes from the Pelargonium graveolens species. Considered as non-irritant, nontoxic, and overall non-sensitizing, geranium oil is known to have therapeutic properties. It offers many benefits for physical, mental, and emotional health. The first use of Geranium oil is found in the early days of Egyptians, who used it for skincare and many other purposes. And so, Egypt remains the world’s largest producer of this oil with China holding a second position in terms of production. Other countries producing geranium oil include Morocco, Algeria, Spain, France, Rwanda, the UK, and the Republic of South Africa.

Geranium essential oil versus rose geranium oil

People often confuse between geranium essential oil and rose geranium. Both oils are extracted from the same plant, Pelargonium graveolens, but a different variety. The two oils have almost similar components and both are colorless to greenish-brown. Geranium essential oil and rose geranium oil share the common benefits and both are used for medicinal purposes as well as for skincare and haircare. Both oils have a sweet aroma with nuances of rose. Geranium essential oil has more pronounced tobacco note, whereas, rose geranium oil come with best rose notes, which is why people prefer it over the other variety.

The two oils have analgesic, antiviral, estrogenic, antidepressant, aphrodisiac, and relaxant properties. So, they are not much different, except for the better scent of rose geranium oil.

Physical properties of geranium oil

The geranium oil exists in liquid form and has a boiling point of 197 °C. It is slightly soluble in water and is stable under normal conditions. The oil has a sweet, minty, and rosaceous odor.

Chemical composition of geranium oil

Geranium oil contain esters, alcohols, aldehydes, and ketones. The alcohol makes 60-70 percent of the total composition. The ester content is 20-30 percent and comprises mainly geranyl and citronellyl esters. Other esters present in the geranium oil include geranyl tiglate, geranyl acetate, citronellyl formate, and citronellyl acetate. Other oil components are carotenoids and other hydrocarbons like tiglates and formats.

Geranium oil contains about 65 different phytochemicals. It also has an abundance of flavonoids including quercetin, which is the most well-known component.

Popular uses of geranium oil

Geranium oil has multiple uses. The common ones are given below.

1. Medicinal use:

Geranium oil has long been used for medicinal purposes. Even today, with the availability of modern drugs and colorful pills, the medicinal use of geranium oil is still in practice. The oil has anti-inflammatory properties and works as analgesic in fighting nerve pain. Apart from that, geranium oil also helps with aches and cramps resulting from exertion.

Some known benefits of geranium oil against respiratory infections are also documented in some researches. The oil is especially popular among women because it helps with menstrual cramps and symptoms of menopause as well. It is believed to reduce the hemorrhage episodes. Geranium oil also reduces the symptoms of anxiety and depression.

Research, albeit meager, shows some possible connection between geranium oil use and prevention of dementia and Alzheimer’s.

The rose geranium oil is used as an ingredient in supplements for weight loss, bodybuilding, and athletic performance.

2. Skincare:

Geranium oil is famous for its dermatological use, especially for the treatment of wrinkles and dry skin. It has antibacterial, anti-inflammatory, and soothing properties. These properties make it a valuable choice with regard to treatment of several skin-related issues like acne and dermatitis.

3. Insect repellent:

Geranium oil can be used as a natural insect repellent. It keeps the mosquitos and other bugs away, and proves to be as effective as off-the-shelf repellants. Also, it is much safer to use, as it does not contain chemical hazardous to human health.

The oil also relieves itching and heals insect bites.

4. Flavoring:

Rose geranium oil is used as a flavoring item in foods and alcoholic and non-alcoholic beverages. It is also added to baked goods, candies, and frozen dairy.

5. Fragrance:

Geranium oil can be used as a natural deodorant. It is a circulatory oil, which means that it leaves the body through perspiration. This way, it will release scent whenever the person sweats. The fragrance of geranium oil also makes it useful in the production of soaps, perfumes, and cosmetics.

Health benefits of geranium oil

Geranium oil offers wide-ranging health benefits. Here are a few of those:

1. Fights infection

Geranium oil has potent antifungal and antibacterial properties. According to research, it can protect against 24 different types of fungi and bacteria.

Fungi against which geranium oil shows activity Fungal strains
Alternaria citrii SP-6
Aspergillus fumigatus SP-13
A.oryzae SP-2
Candida albicans SP-14
Cryptococcus neoformans SP-16
Fusarium oxysporum SP-4
F.solani SP-8
Helminthosporium compactum SP-9
Macrophomina phaseolina SP-3
Sclerotium rolfsii SP-5
Sporothrix schenkii SP-15
Trichophyton mentagrophytes SP-12
Bacteria against which geranium oil shows activity Bacterial strains
Staphylococcus aureus SP-1
Bacillus brevis RB-3
B.circulans RB-6
Escherichia coli SP-11
Salmonella typhi VR-20
Pseudomonas aeruginosa SP-10
Vibrio cholerae VR-65, VR-75, VR-78 and VR-80
Plant pathogen (GNR) BB-212 and PB-203

2. Treats Candida

Geranium essential oil is known to help treat fungal infections resulting from Candida albicans. Candida is the most common yeast infection that usually affects the mouth, vagina, and intestinal tract, and even skin. Research shows that geranium oil is especially good for treating/preventing growth of candida in the vagina.

Another example of fungal infections treated with geranium oil is Athlete’s foot. Here’s the remedy: Put warm water and sea salt in a tub. Add five drops of geranium oil and soak feet in this water for about 25 minutes. This activity should be performed twice a day to get better results.

In case of a wound or a cut, apply two drops of geranium mixed with a carrier oil on the affected area. Doing this twice a day till the wound gets healed will keep away the infection.

3. Eliminates intestinal worms

Geranium oil is a natural vermifuge. It eliminates intestinal worms, which are a common issue among children and some of the adults as well, especially where there is poor sanitation and unhygienic conditions. Evidence supports the fact that certain essential oils, including geranium oil, can help remove the intestinal worms, such as roundworms and tapeworms.

Notably, intestinal worms are very harmful to the human body. They consume all the nutrients from the food, leaving the person undernourished; and that makes eliminating intestinal worms a necessity. Geranium oil can help with it.

4. Relieves respiratory infection

Geranium oil is believed to cure several respiratory infections. According to a scientific review, certain kinds of geranium extract (both in liquid or tablet form) are effective in relieving common cold symptoms and acute rhinosinusitis. Moreover, it can help reduce the symptoms of acute bronchitis in both adults and children.

Use a diffuser twice a day to inhale geranium oil and treat respiratory infections. Another way is to rub the oil under the nostrils and on the throat.

5. Anti-inflammatory agent

Inflammation can be found at the bottom of many major health conditions. For instance, arthritis is the inflammation of the joints. While researchers have been trying to find possible medical applications for chronic inflammation, one is lying in several household’s pantry.

Research shows that geranium essential oil can be very effective in the development of new, improved anti-inflammatory drugs. The geranium oil inculcates the inflammatory responses in the skin. It helps the human body to fight several health issues.

A study conducted in 2013 shows that geranium oil is a more effective and relatively safer ingredient for an anti-inflammatory medicine. There is supporting evidence that geranium oil reduces inflammation in the body. Moreover, the side effects of this essential oil are fewer than the anti inflammatory drugs.

6. Pain killer

Germanium oil has the ability to relieve nerve pain when applied to the affected area. According to a double-blind crossover study, applying rose geranium oil to the skin can drastically reduce the pain caused by shingles. Shingles is a viral condition that results in painful rash and is caused by herpes simplex virus.

The research shows that geranium oil can relieve pain in minutes and renders it tolerable, if not relieving it entirely. The concentration of geranium oil plays a role here, as 100 percent concentration of geranium oil is twice as effective as a 50 percent concentration.

In order to treat nerve pain with geranium oil, add three drops of geranium oil in a tablespoon of coconut oil. Massage this oil on the areas where there is tension or pain.

7. Reduces anxiety and depression

Geranium essential oil can improve the mental functioning and uplift the mood. It is believed to help with depression, anger, and anxiety, given that it supports the endocrine system.

Apart from its properties, the sweet and floral fragrance of geranium oil relaxes and calms the body and mind. A study of 100 pregnant women showed that geranium helps alleviate anxiety during labor. This study observed that the aroma of geranium essential oil is very effective in reducing anxiety during labor. It further stated that the said essential oils can be recommended as a non-invasive, anti-anxiety aid during childbirth. The study also observed that the participants also experienced a decrease in diastolic blood pressure after smelling geranium essential oil.

Another study shows that geranium oil when used in aromatherapy massage has the ability to improve depression symptoms in postmenopausal women.

8. Helps balance hormones

Geranium oil is highly recommended for hormonal health. It acts as a tonic for the endocrine glands that regulate the release of hormones. The oil is known to maintain the hormonal balance especially in cases of premenstrual phases, puberty, menopause, menstrual irregularities, and sterility. As this oil supports the adrenal system, it is quite helpful in alleviating chronic exhaustion and fatigue.

Geranium oil also improves mood and combats nervousness and weariness. It also regulates the functioning of several internal systems to keep the acid, bile, enzymes in check.

In order to reduce the symptoms of PMS, add five drops each of Geranium oil and Bergamot oil in the bath water.

9. Increases urination

Urination releases the toxins from the human body. More urination means more toxins getting out of the human body. Geranium oil is a natural and effective diuretic. Evidence shows that it promotes urination.

Urination removes toxic chemicals, sugar, heavy metals, pollutants, and sodium from the body. It also helps get rid of excess bile and acids from the stomach. This process keeps the body well and kidney functioning.

Furthermore, urination prevents the occurrence of kidney stones by removing the excess calcium from the system. It also reduces the blood pressure as the more one urinates, the more sodium is eliminated from his/her body. That causes the blood pressure to fall.

10. Relieves hemorrhages

A 2013 study conducted on 20 participants found that a mixture of sesame and rose geranium oil can improve the treatment of hemorrhages. The study found that geranium oil proved to be the compound that drastically reduces the number of hemorrhage episodes occurring in patients.

Combine rose geranium oil and sesame oil in a dropper. A few drops can help reduce the nosebleeds. In other cases of bleeding, apply a few drops of geranium oil (mixed with a carrier oil) on the affected area.

Geranium oil skin benefits

Geranium essential oils offer a number of benefits for the skin. Early Egyptians used this oil to have radiant, scarless, and beautiful skin. They also used it for fragrance. Here are a few benefits of geranium oil for the skin.

1. Treats acne

Acne has many causes among which the major one is bacteria. The bacteria gets clogged into the pores and causes pimples, whiteheads, and blackheads by mixing with sebum. Sebum is the oil produced by the skin. Nevertheless, all this can go away with geranium oil, which has antiseptic and antibacterial properties.

Notably, increased sebum production also causes acne. Geranium oil regulates the sebum production of the skin and thus, can help prevent acne breakouts. The geranium oil’s ability to regulate the sebum production makes it a wonderful choice to treat oily skin.

Another acne trigger that geranium oil tackles is the hormonal imbalance. Imbalance in hormones like estrogen, insulin, and progesterone results in acne breakouts. Whereas, geranium oil is known to regulate the adrenal cortex and stabilize hormones.

2. Treats blemishes and scars

Geranium oil can remove the red marks and dark spots left by the pimples. This oil has antiseptic and antioxidant properties. Owing to these properties, it speeds up the healing of wounds.

Geranium oil is also helpful in eliminating other marks like that of boils, surgeries, or pox. It is a strong cicatrizant and thus, helps the blemishes and scars fade off the skin.

Moreover, this essential oil accelerates blood circulation right below the surface of the skin, which helps promote a uniform distribution of melanin. In this way, it prevents the two toning of the skin.

To remove marks from the face, apply the aforementioned mixture of geranium and olive oil on the affected area with Q-tip or clean hands. Apply daily and you will see some positive effects within 2 weeks time.

Acne and blemish removal regime using BLACK PAINT

BLACK PAINT offers an array of skin care products that are made with ingredients suitable for acne and blemishes. All of these products contain natural elements that have anti-inflammatory and antiseptic properties.

Rose Water

1. Rose Water

Dab your palms with two pumps of Rose Water and apply it on the entire face. It helps tone your skin. Rose Water is produced from 100 percent Bulgarian Damask Roses and serves as a finishing lotion and toner. It revives the skin’s natural moisturizing factor (NMF) and helps tighten the skin. Rose Water has astringent properties and thus reduces and regulates oil production, which is a major cause of acne.

 

Best Water

2. Best Water

Now that you have applied Rose Water, keep Best Water with you for use when you wash your face the second time at a later part of the day. Using Rose Water at one time and then Best Water at another time of the day is an essential component of this acne and blemish removal regime, and helps enhance the overall effect.

Best Water is an odorless, pore-minimizing toning water that contains as much as 30 minerals for deeper hydration. Best Water rejuvenates your skin’s natural moisturizing factor (NMF) and prevents moisture loss. All you have to do is apply two to three pumps of Best Water directly onto your face. Press your face with the palms while you are applying the product.

Oil Water

3. Oil Water

Oil Water helps in the nourishment of your skin. Use it after you wash your face at the end of the day. It is a pore-minimizing skin regenerating facial essence. It contains damask rose water and oil, both of which have anti-inflammatory properties. This product also tightens the pores, which prevent acne to arise again.

 

 

Water Cream

4. Water Cream

Water Cream is a suitable option for moisture lock. It is a water-based moisturizing cream that keeps your skin moisturized throughout the day. Use it after the Rose Water and Best Water dries. It contains Argan Oil that promotes moisture retention and improves skin metabolism.

Water Cream has a combination of seven different types of flower oil and polymeric silicon that creates a defensive veil against potential harm from the external environment.

3. Minimizes wrinkles

Geranium oil has strong astringent properties. It tightens the skin and prevents it from sagging. Moreover, it has the ability to reduce the look of wrinkles as this oil not only tightens the skin but also slows down the aging impacts.

To prevent wrinkling and skin-aging, add a few drops of rose geranium essential oil. Gently massage it on the skin. Apply daily. Another option is to mix a few drops of geranium oil with a tablespoon of olive oil (carrier). Apply the mixture twice every day.

4. Improves skin health

The anti-bacterial and anti-inflammatory properties of the geranium boost the skin health. It is very effective in the treatment of acne, dermatitis, and other skin conditions. It also has a soothing effect on the skin and can decrease swelling. Due to its antiseptic and antioxidant properties, geranium oil is used in several skin tonics, moisturizers, lotions, and balms.

Wrinkle reduction and dryness removal regime using BLACK PAINT

Wrinkles and dryness can be reduced with the help of the following BLACK PAINT products.

White Paint Soap

1. White Paint Soap

White Paint Soap is a skin brightening facial cleanser that cleanses the pores as well. You should use this soap right after the use of Vegetable Oil. It contains significant amounts of geranium oil and this is very helpful in reducing the appearance of wrinkles and fine lines. The geranium oil present in this product protects the skin from sagging. It not only reduces the look of wrinkles, but also slows down wrinkling. Moreover, geranium oil is known to keep the skin hydrated and thus, White Paint Soap renders the skin soft and supple.

Rose Water

2. Rose Water

This product is used as a toner and a finishing lotion. Use it after cleaning your face with White Paint Soap. It prevents moisture loss by restoring the skin’s natural moisturizing factor. It also helps reduce the appearance of wrinkles and tightens the skin. Having astringent properties, Rose Water can reduce and regulate sebum production as well. Moreover, it calms and soothes irritated skin.

 

German Blue

3. Best Water & German Blue

Best Water is a pore-refining toning water that contains minerals to keep your skin hydrated, whereas, German Blue is a high-quality facial serum that nourishes your skin. Use Best Water and German Blue together in the noon time. Mix 2 drops of German Blue with 2 pumps of Best Water and apply the mixture on the face. This combination minimizes pores and prevents moisture loss by restoring the skin’s natural moisture. It is also useful in healing burns, scrapes, and blemishes.

German Blue moisturizes deeply and addresses the skin-aging concerns.This serum contains geranium oil that has anti-bacterial and anti-inflammatory properties. It can boost your skin health. It is also helpful in reducing swelling and helping with wrinkles. German Blue penetrates deep into the skin and replenishes its natural oils layer.

Ostrich Balm

4. Ostrich Balm

Ostrich Balm is a rich moisturizer that repairs the dry skin very effectively. Apply this balm on your face before going to bed. You can also use it during the day on dry skin, especially around the mouth, lips, and eyes.

The Ostrich Oil content in Ostrich Balm is rich in palmitoleic acid that reloads omega-7 component of your skin. It has positive effects on the skin that has lost its elasticity because of reasons like aging. It is very effective when used for dry wrinkles.

Benefits of geranium oil for hair

Not only for skin but geranium oil also has many benefits for hair. As the oil acts as antioxidant, antiseptic, and antibacterial, it can do wonders with respect to hair-related problems.

1. Prevents hair fall

Geranium oil is a natural astringent. It is filled with amino acids, which are the building blocks of healthy hair. Geranium essential oil nourishes the hair with amino acids and thus, prevents hair loss.

To prevent hair fall, apply a mixture of geranium oil and a carrier oil (jojoba or olive oil) onto the roots of hair. Massage for a while and leave the mixture on for 20 minutes. After that, wash with a good shampoo. Repeat this practice once a week to have healthy hair.

2. Hydrates the hair

Geranium essential oil hydrates the hair while restoring the natural pH of the scalp. That renders the strands appear softer and healthier.

Geranium oil conditioner can hydrate the hair and render it health. To make one, combine one cup of water with two-tablespoon apple cider vinegar and ten drops of geranium oil. Shake the mixture and pour it into a 240 ml glass spray bottle. Spray the conditioner onto the hair. Let it soak for five minutes and then rinse. Use this conditioner about three times a week to yield better results.

3. Repairs damaged hair

Geranium oil is high in antioxidant content. The antioxidants fight the free radicals, which are the culprits damaged hair at the first place. The antioxidants also repair damaged hair and add a shine to the strands. Therefore, geranium oil is safe to use for strengthening hair strands and follicles.

Geranium oil as a tick repellent

Geranium oil is a natural tick repellent. One variant of geranium essential oil, i.e., geranium bourbon, even made it to the US Environmental Protection Agency’s (EPA) guidelines to insect repellants. Nevertheless, other types of geranium oil can also repel insects.

Rose geranium oil prevents ticks to sense the presence of an animal or a human being. When applied on the skin, the human or animal scent gets masked by that of rose geranium. This way, ticks do not come near the person or the animal. According to a 2013 study published in the Journal of Agriculture and Food Chemistry, rose geranium oil repels ticks with 90 percent effectiveness.

A tick repellant can easily be made at home with rose geranium oil. Combine four tablespoons of almond oil, two tablespoons of aloe vera gel, and 30 drops of rose geranium essential oil. Mix these ingredients thoroughly in a small bowl. Draw off the mixture with an eyedropper. Apply a few drops and massage into the skin. It will keep the ticks away.

Adding almond oil as a carrier augments the effectiveness of this repellant.

Homemade geranium oil

Geranium oil can easily be made at home with a few simple components. Take the leaves of the geranium plant; the more, the better. Wash them thoroughly. After washing, dry the leaves with the help of a clean cloth, preferably microfiber.

Once dried, ground the leaves using a pestle and mortar. Continue until the leaves are completely mashed. Now let the mush sit for a few hours. Now, add jojoba oil or coconut to the crushed leaves. Cover the mixture and let it sit for two weeks straight. When a beautiful scent starts filling the room, drain the leaves and keep the oil in an airtight container.

Precautions while using geranium oil

• Note that the quality of essential oils varies. Before buying geranium oil, check out what production methods the oil supplier uses. You can check for organic label. It ensures that no chemicals were used in the production of the oil. Also, do some research and only buy the oils from a trusted source, i.e., big companies with more reviews and good reputation.

• Steer clear of eyes, ears, or sensitive areas of the body when administering geranium oil.

• In case of the medicinal use, always consult a healthcare professional first.

• Before applying on skin, do a patch test on a small area (better inside the elbow). If it does not suit you, dilute the essential oil with a carrier oil like coconut, hemp, almond, or jojoba.

• Using geranium oil alone for cancer or any other health condition is never advised. It is always better to combine it with other treatments.

• Do not use excessively, as it can lead to skin sensitization.

Frequently asked questions about geranium oil

1. Can I use geranium oil directly on skin?

Some people experience irritation or allergic reaction while applying geranium oil to the skin. It is better to dilute geranium oil with a carrier oil for treating skin conditions. Mix a teaspoon of coconut oil with five drops of geranium oil. Then apply the mixture on the face.

Note: Always do a patch test. Apply it to a small area on the hand and look for allergic reactions. If none occurs in the next 20-30 minutes, the oil is safe to use.

Caution: Do not apply geranium oil on babies and toddlers. They have delicate skin and the oil may not suit them leading to negative effects.

2. Does geranium oil clog pores?

No, geranium oil (or any essential oil to that effect) does not clog pores. In fact, it prevents the clogging of pores by fighting harmful bacteria, preventing extra-release of oil, and removing dirt and grime from the pores.

3. Can I take geranium oil internally? Or Is it safe to inhale geranium oil?

Geranium essential oil can be inhaled by the adults only if sprinkled on a cloth or aromatherapy diffusers. Orally, geranium oil should only be taken in small quantity. Large amount of this essential oil can have toxic effects. In any case, do not take geranium oil internally without the supervision of a healthcare professional.

Note: Be careful when babies and children are around. The oil contains toxic compounds, ingestion/inhalation of which can result in negative consequences in the case of a child.

4. How do I use geranium essential oil on my face?

Dilute geranium oil with a carrier oil and apply it using a brush or cotton swab on the face. Take note that despite the safe external use of geranium oil, pregnant and nursing women are advised to not use it without consulting their healthcare provider.

5. How do you apply geranium oil to hair?

Mix the geranium oil with some other oil, such as olive oil, and apply it on the tips and roots of hair. Massage the scalp. Leave it on for about 30 minutes and wash with a suitable shampoo afterwards.

6. What does geranium oil smell like?

Geranium oil smells like roses and their leaves. It is for this smell that geranium oil is sometimes used as an extender for rose in many scents.

7. What can I diffuse with geraniums?

Essential oils like Basil, Clary Sage, Cedarwood, Bergamot, Grapefruit, Lavender, Rosemary, and Wild Orange are good options to dilute the geranium oil.

8. What blends well with rose geranium essential oil?

Rose geranium oil blends well with oils like cedarwood, clary sage, jasmine, lime, rosemary, basil, angelica, and citronella.

9. Is geranium oil good for pain?

Yes, geranium oil can do wonders when it comes to relieving pain, especially nerve pain. Just apply geranium oil combined with olive oil on the affected area. Massage it for a while. Repeat it a few times a day, and you will see some positive results.

10. How does geranium oil work?

Inhaling the essential oil sends a message to the limbic system, which controls the emotions and affects the nervous system. This way, geranium oil can influence the heart rate, breathing, stress levels, blood pressure, and immune system.

11. What is a common method of geranium oil use?

Geranium oil can be used in several ways. A common practice is inhaling the oil by putting a few drops onto a cloth or through aromatherapy diffuser.

References
https://naturalingredient.org/wp/wp-content/uploads/DATA-SHEET-GERANIUM.pdf
https://ecommons.cornell.edu/bitstream/handle/1813/56128/geranium-oil-MRP-NYSIPM.pdf?sequence=1&isAllowed=y
https://en.wikipedia.org/wiki/Pelargonium_graveolens
https://articles.mercola.com/herbal-oils/geranium-oil.aspx
https://www.mommypotamus.com/natural-tick-repellent-recipe/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3793238/
https://www.sciencedirect.com/science/article/pii/S2221169115001033
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5435909/
https://www.ncbi.nlm.nih.gov/pubmed/8893526
https://www.ncbi.nlm.nih.gov/pubmed/25514231
https://www.sciencedirect.com/science/article/pii/S1756464609000796
https://www.webmd.com/vitamins/ai/ingredientmono-153/rose-geranium-oil
https://www.amjmed.com/article/S0002-9343(03)00434-0/fulltext
https://www.ncbi.nlm.nih.gov/pubmed/24103319

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