Aloe Vera

Aloe is a cactus-like plant that grows in hot, dry climates. It is cultivated in subtropical regions around the world, including the southern border areas of Texas, New Mexico, Arizona, and California.

A cut Aloe Vera Leaf. Photo: Rae Allen/Wikipedia

Common Names: aloe

Latin Names: Aloe vera, Aloe africana, Aloe arborescens, Aloe barbadensis

Historically, aloe has been used for skin conditions and was thought to improve baldness and promote wound healing.

Aloe is used topically (applied to the skin) and orally. Topical use of aloe is promoted for acne, lichen planus (a very itchy rash on the skin or in the mouth), oral submucous fibrosis, burning mouth syndrome, burns, and radiation-induced skin toxicity.

Oral use of aloe is promoted for weight loss, diabetes, hepatitis, and inflammatory bowel disease (a group of conditions caused by gut inflammation that includes Crohn’s disease and ulcerative colitis).

In 2002, the U.S. Food and Drug Administration issued a ruling that required manufacturers to remove aloe from over-the-counter laxative products because of a lack of safety data.

How Much Do We Know?

A number of studies have investigated the usefulness of aloe as a dietary supplement or a topical product for health purposes in people.

What Have We Learned?

Clinical research suggests that topical application of an aloe-based gel twice daily (along with medical soap and tretinoin gel) may improve acne.

Clinical research suggests topical application of aloe gel may speed burn healing. There also is evidence that treatment with aloe vera may reduce pain from burns.

Research suggests topical use of aloe also may help people with herpes simplex, lichen planus, or psoriasis.

Three trials (with a total of 236 adult participants) have evaluated the use of oral doses of aloe vera for symptoms of irritable bowel syndrome. Results from one trial showed a benefit; the other two trials showed no benefit of aloe vera over placebo.

In a small European study, 44 adults with ulcerative colitis were randomly assigned to receive aloe vera gel or a placebo twice daily for a month. Almost half of the people treated with aloe vera responded to the treatment whereas 14 percent of those treated with placebo responded.

Aloe vera has been studied in clinical (human) trials for diabetic foot ulcers and dental plaque, but there’s not enough scientific evidence to show whether aloe vera is helpful for these conditions. A 2009 review article examined data from a mix of laboratory, animal, and clinical trials and concluded that more research is necessary to explore aloe’s clinical effectiveness for a number of different skin conditions.

What Do We Know About Safety?

Topical use of aloe gel is generally well tolerated. However, there have been occasional reports of burning, itching, and eczema with topical use of aloe gel. Oral use of aloe latex can cause abdominal pain and cramps. Oral consumption of aloe leaf extracts (for as little as 3 weeks and as long as 5 years) has been related to cases of acute hepatitis.

Animal studies have noted an association between aloe vera leaf extract taken orally and gastrointestinal cancer in rats and mice; however, concerns were expressed about the differences in the product used in that study and those commonly used by consumers. Thus, more research is needed to assess the relevance to human health.

Aloe—both in gel and latex form—when taken by mouth may be unsafe during pregnancy and while breastfeeding.

Topical medication and potential side effects

Aloe vera may be prepared as a lotion, gel, soap or cosmetics product for use on skin as a topical medication. For people with allergies to Aloe vera, skin reactions may include contact dermatitis with mild redness and itching, difficulty with breathing, or swelling of the face, lips, tongue, or throat.

Dietary supplement

Aloin, a compound found in the semi-liquid latex of some Aloe species, was the common ingredient in over-the-counter (OTC) laxative products in the United States until 2002 when the Food and Drug Administration banned it because manufacturers failed to provide the necessary safety data. Aloe vera has potential toxicity, with side effects occurring at some dose levels both when ingested and when applied topically.

Although toxicity may be less when aloin is removed by processing, Aloe vera ingested in high amounts may induce side effects, such as abdominal pain, diarrhea or hepatitis. Chronic ingestion of aloe (dose of 1 gram per day) may cause adverse effects, including hematuria, weight loss, and cardiac or kidney disorders.

Aloe vera juice is marketed to support the health of the digestive system, but there is neither scientific evidence nor regulatory approval for this claim. The extracts and quantities typically used for such purposes are associated with toxicity in a dose-dependent way.

Traditional medicine

Aloe vera is used in traditional medicine as a skin treatment. Early records of its use appear from the fourth millennium BCE. It is also written of in the Juliana Anicia Codex of 512 CE.

Commodities

Aloe vera is used on facial tissues where it is promoted as a moisturizer and anti-irritant to reduce chafing of the nose. Cosmetic companies commonly add sap or other derivatives from Aloe vera to products such as makeup, tissues, moisturizers, soaps, sunscreens, incense, shaving cream, or shampoos.

A review of academic literature notes that its inclusion in many hygiene products is due to its "moisturizing emollient effect".

Toxicity

Orally ingested non-decolorized aloe vera leaf extract was listed by the California Office of Environmental Health Hazard Assessment among "chemicals known to the state to cause cancer or reproductive toxicity", possibly resulting from the anthraquinones.

Since 2016, aloe vera whole leaf extract is classified as a possible human carcinogen (group 2B) by the International Agency for Research on Cancer.

Use of aloe vera on the skin is generally not associated with significant side effects. Oral ingestion of aloe vera is potentially toxic, and may cause abdominal cramps and diarrhea which in turn can decrease the absorption of drugs.

Interactions with prescribed drugs

Ingested aloe products may have adverse interactions with prescription drugs, such as those used to treat blood clots, diabetes, heart disease and potassium-lowering agents (such as Digoxin), and diuretics, among others. (National Institutes of Health/Wikipedia)

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