Peppermint Liquid and Hearing Loss
There is no evidence that peppermint liquid causes decreased hearing. The available medical literature does not document any association between peppermint exposure and hearing impairment.
Evidence Review
Lack of Ototoxicity Data
- Comprehensive safety assessments of peppermint oil, extract, and leaf preparations do not identify hearing loss as an adverse effect 1
- The primary toxicological concerns with peppermint relate to pulegone-induced cerebellar lesions and hepatotoxicity at high doses, not auditory dysfunction 1
- Peppermint's main constituents (menthol and menthone) have not been associated with ototoxic effects in animal or human studies 1, 2
Known Adverse Effects
- Documented adverse reactions to peppermint are limited to allergic responses (including rare anaphylaxis), skin irritation, and gastrointestinal effects 1, 2, 3
- When used topically in cosmetic formulations at concentrations ≤3% in rinse-off products and ≤0.2% in leave-on products, peppermint oil is considered safe 1
- Oral consumption as peppermint tea has not been associated with adverse reactions in general use, though caution is advised in patients with GI reflux, hiatal hernia, or kidney stones 2
Contrast with Known Ototoxic Agents
- Established ototoxic medications include aminoglycoside antibiotics (which should be avoided in topical ear preparations with tympanic membrane perforation) and cisplatin chemotherapy 4
- Clinical practice guidelines for ear conditions extensively discuss ototoxicity risks but do not mention peppermint as a concern 4
Clinical Context
If a patient reports hearing loss and has been using peppermint products, the hearing impairment is almost certainly unrelated to the peppermint exposure. Instead, evaluate for: