Aloe Vera, a Primer

Background

• 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.
• 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.
• Overuse of aloe latex may increase the risk of adverse effects from the drug digoxin, used for some heart problems.
• Aloe—both in gel and latex form—when taken by mouth may be unsafe during pregnancy and while breastfeeding.

Keep in Mind

• Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.