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Aloe

Aloe vera

The Aloe vera plant has been used for thousands of years to heal a variety of conditions, most notably burns, wounds, skin irritations, and constipation. It is grown in subtropical and tropical locations, including South Africa, Latin America, and the Caribbean. Aloe was one of the most frequently prescribed medicines throughout most of the 18th and 19th centuries and it remains one of the most commonly used herbs in the United States today. However, oral use of aloe for constipation is no longer recommended, as it can have severe side effects.

Burns

Aloe gel, made from the central part of the aloe leaf, is a common household remedy for minor cuts and burns, as well as sunburns. It can be found in many commercial skin lotions and cosmetics. Aloe contains active compounds that may reduce pain and inflammation and stimulate skin growth and repair. It is also an effective moisturizing agent. For this reason, aloe vera gel has gained tremendous popularity for relief of burns. In one study, burn sites treated with aloe healed completely in less than 16 days compared to 19 days for sites treated with silver sulfadiazine. In a review of the scientific literature, researchers found that patients who were treated with aloe vera healed an average of almost 9 days sooner than those who were not treated with the medicinal plant. However, other studies show mixed results. At least one study found that aloe actually delayed healing. Aloe is best used for minor burns and skin irritations and should never be applied to an open wound.

Herpes and skin conditions

Preliminary evidence suggests that aloe gel may improve symptoms of genital herpes and certain skin conditions such as psoriasis. One study found that aloe vera gel displayed anti-inflammatory effects superior to 1% hydrocortisone cream or a placebo gel. Another study found that aloe vera gel combined with tretinoin was more effective than tretinoin alone for treating acne. As such, researchers claim that aloe vera gel may be useful in the treatment of inflammatory skin conditions, such as ultraviolet-induced erythema.

Constipation

Aloe juice or aloe latex, a yellow, bitter liquid derived from the skin of the aloe leaf, is a powerful laxative. However, it can cause painful cramping and is not safe to use in this way.

Dental Cavities

Studies show that aloe vera gel inhibits the activity of several types of bacteria that may lead to cavities and gum disease. More research is needed.

Diabetes

Preliminary studies suggest that aloe juice may help lower blood sugar levels in people with type 2 (adult onset) diabetes. More research is needed to determine whether aloe is helpful for diabetes.

Alcohol-induced Liver Disease

Preliminary studies suggest that aloe vera extract may help mitigate the effects of alcohol-induced liver damage.

 

Plant Description

Aloe vera is a perennial, succulent plant (meaning its leaves hold large quantities of water). The plant can grow up to 4 feet tall, and its tough, fleshy, spearlike leaves can grow up to 36 inches long. The clear, thick gel found in the inner part of the leaf is most commonly used for minor cuts and burns.

What is it Made Of?

Although aloe is 99 percent water, aloe gel also contains substances known as glycoproteins and polysaccharides. Glycoproteins speed the healing process by stopping pain and inflammation while polysaccharides stimulate skin growth and repair. These substances may also stimulate the immune system.

Available Forms

You can get aloe by simply breaking off leaves of the plant (which can be grown as a houseplant), but it is also available commercially in ointments, creams, and lotions. Aloe gel is often included in cosmetic and over-the-counter skin care products as well. You can purchase aloe in the form of capsules, tablets, juice, gel, ointment, cream, and lotion.

How to Take It

Pediatric

Pure aloe gel may be applied to the surface of the skin for minor skin irritations. Children should never take oral aloe preparations.

Adult

Slit the leaf of an aloe plant lengthwise and remove the gel from the inside, or use a commercial preparation. Carefully clean affected area, and then apply aloe gel liberally to the skin. DO NOT apply to open wounds.

Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care provider.

Aloe gel is considered safe when applied to the surface of the skin, but should not be applied to open or deep wounds. In rare cases, it may cause an allergic reaction, mainly a skin rash. If you develop a rash, stop using the gel.

Taking aloe latex orally may cause severe intestinal cramps or diarrhea and is not recommended. Pregnant women should never take aloe latex because it may cause uterine contractions and trigger miscarriage. Nursing mothers should not take aloe latex either because the effects and safety for infants and children are not known. High doses of aloe can cause kidney damage.

Possible Interactions

If you are being treated with any of the following medications, you should not use aloe vera without talking to your doctor. DO NOT take aloe for 2 weeks prior to any surgical procedure as it may increase bleeding during surgery.

Medications for diabetes: The combination of aloe vera and glyburide, a medication used to treat type 2 diabetes, may help control blood sugar and triglyceride (fat) levels in the blood. People with diabetes who use aloe either alone or in combination with other medications must be monitored closely by their doctor to make sure blood sugar levels don't fall too low (a condition called hypoglycemia).

Digoxin and diuretics: Because taking oral aloe can decrease levels of potassium in the body, aloe latex should not be used by people taking diuretics (water pills) or digoxin (a medication used to treat irregular heart rhythms and congestive heart failure). These drugs also lower potassium levels in the body, so a combination of aloe and digoxin or diuretics could cause potassium levels to fall too low.

Due to aloe's effects on the bowels, it can potentially interfere with the absorption of any medication. Talk to your doctor if you plan to take oral aloe.

Supporting Research

Auerbach: Wilderness Medicine. 6th ed. Philadelphia, PA: Elsevier Mosby; 2011.

Beppu H, Shimpo K, Chihara T, et al. Antidiabetic effects of dietary administration of Aloe arborescens Miller components on multiple low-dose streptozotocin-induced diabetes in mice: investigation on hypoglycemic action and systemic absorption dynamics of aloe components. J Ethnopharmacol. 2006 Feb 20;103(3):468-77.

Blumenthal M, Busse WR, Goldberg A, et al. The Complete German Commission E Monographs. Boston, MA: Integrative Medicine Communications; 1998.

Boudreau MD, Beland FA. An evaluation of the biological and toxicological properties of Aloe barbadensis (miller), Aloe vera. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev. 2006 Apr;24(1):103-54.

Bunyapraphatsara N, Yongchaiyudha S, Rungpitarangsi V, et al. Antidiabetic activity of aloe vera L. juice II. Clinical trial in diabetes mellitus patients in combination with glibenclamide. Phytomedicine. 1996;3:245-248.

Capasso F, Borrelli F, Capasso R, et al. Aloe and its therapeutic use. Phytother Res. 1998;12:S124-S127.

Cellini L, Di bartolomeo S, Di Campli E, Genovese S, Locatelli M, Di Giulio M. In vitro activity of Aloe vera inner gel against Helicobacter pylori strains. Lett Appl Microbiol. 2014;59(1):43-8.

Cowan D. Oral Aloe vera as a treatment for osteoarthritis: a summary. Br J Community Nurs. 2010;15(6):280-2.

Dat AD, Poon F, Pham KB, Doust J. Aloe vera for treating acute and chronic wounds. Cochrane Database Syst Rev. 2012(2).

Davis RH, Parker WL, Murdoch DP. Aloe vera as a biologically active vehicle for hydrocortisone acetate. J Am Podiatr Med Assoc. 1991;81:1-9.

Devaraj S, Yimam M, Brownell LA, Jialal I, Singh S, Jia Q. Effects of Aloe vera supplementation in subjects with prediabetes/metabolic syndrome. Metab Syndr Relat Disord. 2013;11(1):35-40.

du Plessis LH, Hamman JH. In vitro evaluation of the cytotoxic and apoptogenic properties of aloe whole leaf and gel materials. Drug Chem Toxicol. 2014;37(2):169-77.

Duke J. The Green Pharmacy. Emmaus, PA: Rodale Press; 1997.

Ernst E. Adverse effects of herbal drugs in dermatology. Br J Derm. 2000;143:923-929.

Fani M, Kohanteb J. Inhibitory activity of Aloe vera gel on some clinically isolated cariogenic and periodontopathic bacteria. J Oral Sci. 2012;54(1):15-21.

Fulton JE Jr. The stimulation of postdermabrasion wound healing with stabilized aloe vera gel-polyethylene oxide dressing. J Dermatol Surg Onco. 1990;16:460.

Gruenwald J, Brendler T, Jaenicke C, et al, eds. PDR for Herbal Medicines. 2nd ed. Montvale, NJ: Medical Economics Company. 2000.

Hajheydari Z, Saeedi M, Morteza-Semnani K, Soltani A. Effect of Aloe vera topical gel combined with tretinoin in treatment of mild and moderate acne vulagaris: a randomized, double-blind, prospective trial. J Dermatolog Treat. 2014;25(2):123-9.

Heggers J, et al. Beneficial effects of aloe in wound healing. Phytother Res. 1993;7:S48-S52.

Jia Y, Zhao G, Jia J. Preliminary evaluation: the effects of Aloe ferox Miller and Aloe arborescens Miller on wound healing. J Ethnopharmacol. 2008;120(2):181-9.

Karch SB. The Consumer's Guide to Herbal Medicine. Hauppauge, NY: Advanced Research Press; 1999:28-30.

Khorasani G, Hosseinimehr SJ, Azadbakht M, Zamani A, Mahdavi MR. Aloe versus silver sulfadiazine creams for second-degree burns: a randomized controlled study. Surg Today. 2009;39(7):587-91.

Maddocks-Jennings W, Wilkinson JM, Shillington D. Novel approaches to radiotherapy-induced skin reactions: a literature review. Complement Ther Clin Pract. 2005 Nov;11(4):224-31.

Maenthaisong R, Chaiyakunapruk N, Niruntraporn S, Kongkaew C. The efficacy of aloe vera used for burn wound healing: a systematic review. Burns. 2007;33(6):713-8.

Mantle D, Gok MA, Lennard TW. Adverse and beneficial effects of plant extracts on skin and skin disorders. Adverse Drug React Toxicol Rev. 2001;20(2):89-103.

Matsuda Y et al. One-year chronic toxicity study of Aloe arborescens Miller var. natalensis Berger in Wistar Hannover rats. A pilot study. Food Chem Toxicol. 2008;46(2):733-9.

Odes HS, Madar Z. A double-blind trial of a celandin, aloevera and psyllium laxative preparation in adult patients with constipation. Digestion. 1991;49(2):65-71.

Park MY, Kwon HJ, Sung MK. Evaluation of aloin and aloe-emodin as anti-inflammatory agents in aloe by using murine macrophages. Biosci Biotechnol Biochem. 2009;73(4):828-32.

Paulsen E, Korsholm L, Brandrup F. A double-blind, placebo-controlled study of a commercial Aloe vera gel in the treatment of slight to moderate psoriasis vulgaris. J Eur Acad Dermatol Venereol. 2005 May;19(3):326-31.

Reuter J, Jocher A, Stump J, Grossjohann B, Franke G, Schempp CM. Investigation of the anti-inflammatory potential of Aloe vera gel (97.5%) in the ultraviolet erythema test. Skin Pharmacol Physiol. 2008;21(2):106-10.

Saka WA, Akhhigbe RE, Ishola OS, Ashamu EA, Olayemi OT, Adeleke GE. Hepatotherapeutic effect of Aloe vera in alcohol-induced hepatic damage. Pak J Biol Sci. 2011;14(14):742-6.

Shahzad MN, Ahmed N. Effectiveness of Aloe Vera gel compared with 1% silver sulphadiazine cream as burn wound dressing in second degree burns. J Pak Med Assoc. 2013;63(2):225-30.

Singh RP, Dhanalakshmi S, Rao AR. Chemomodulatory action of Aloe vera on the profiles of enzymes associated with carcinogen metabolism and antioxidant status regulation in mice. Phytomed. 2000;7(3):209-219.

Somboonwong J, Jariyapongskul A, Thanamittramanee S, et al. Therapeutic effects of aloe vera on cutaneous microcirculation and wound healing in second degree burn model in rats. J Med Assoc Thai. 2000;83:417-425.

Syed TA, Ahmad SA, Holt AH, et al. Management of psoriasis with Aloe vera extract in a hydrophilic cream: a placebo-controlled, double-blind study. Trop Med Int Health. 1996;1:505-509.

Vazquez B, et al. Anti-inflammatory activity of extracts from aloe vera gel. J Ethnopharmacol. 1996;55:69-75.

Visuthikosol V, Sukwanarat Y, Chowchuen B, et al. Effect of aloe vera gel to healing of burn wound a clinical and histologic study. J Med Assoc Thai. 1995:78(8):402-408.

Volgler BK, Ernst E. Aloe vera: a systematic review of its clinical effectiveness. Br J Gen Pract. 1999;49:823-828.

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        Review Date: 3/24/2015  

        Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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