Background: Steam inhalation with Eucalyptus leaves represents a traditional therapeutic practice that has recently gained scientific validation for respiratory symptom management. Objective: This comprehensive review evaluates the biochemical mechanisms, clinical efficacy, and safety profile of eucalyptus-based steam inhalation therapy, integrating ethnomedical perspectives with contemporary biomedical evidence. Methods: A systematic review of mechanistic and clinical studies was conducted across databases including PubMed, Scopus, Web of Science, and Google Scholar (1995–2026). Keywords: “Eucalyptus globulus,” “eucalyptol,” “1,8-cineole,” “steam inhalation,” “bronchodilation,” “mucolytic,” “COPD,” “asthma,” and “sinusitis.” Results: The primary bioactive compound, 1,8-cineole (eucalyptol), constitutes 70–84% of eucalyptus essential oil and exhibits anti-inflammatory, bronchodilatory, mucolytic, and antimicrobial activities. Mechanistic studies demonstrate that eucalyptol modulates key inflammatory pathways by inhibiting nuclear factor kappa-B (NF-κB), reducing pro-inflammatory cytokines (TNF-α, IL-1β, IL-6), and suppressing reactive oxygen species (ROS). Thermal inhalation enhances mucociliary clearance and facilitates direct delivery of volatile phytochemicals to the upper and lower respiratory tract. Clinical trials report: Cough reduction: Decrease in cough frequency by up to 68% in patients with upper respiratory infections. Pediatric outcomes: Significant decreases in respiratory rate and nasal congestion scores. Chronic respiratory disease improvement: Enhanced pulmonary function (FEV₁ and FVC) in patients with COPD and asthma. Adjunctive benefits: Reduced need for bronchodilator medications and faster recovery from acute respiratory exacerbations. Safety Profile: Adverse effects are rare when properly administered. Reported contraindications include children under two years of age, patients with severe asthma exacerbation, and individuals with hypersensitivity to eucalyptol. Excessive use or undiluted oil exposure may cause airway irritation or allergic response. Conclusions: Eucalyptus-based steam inhalation therapy integrates traditional practices with modern pharmacological understanding. By combining thermal and biochemical mechanisms, it provides evidence-based symptomatic relief for respiratory conditions such as acute infections, sinusitis, COPD, and asthma. However, it should be regarded as a complementary rather than replacement therapy for standard medical care. Further controlled clinical trials are warranted to define optimal dosing parameters, exposure duration, and long-term safety in diverse populations.
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