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Aloe vera is a succulent plant that has been used for medicine since as far back as ancient Egypt. Both the juice (the odorless, clear liquid from the innermost part of the leaf) and gel (which is yellowish in color and bitter in taste) are believed to have medicinal properties.
Aloe vera juice is typically taken by mouth, while aloe vera gel is usually applied to the skin. The gel, also known as latex, contains a compound called aloin which has strong laxative effects. In fact, up until 2002, aloe latex was used in over-the-counter laxatives until the U.S. Food and Drug Administration (FDA) discontinued its use due to concerns that it may cause cancer.
Aloe vera is commonly used in traditional medicine to treat skin disorders. In Ayurvedic medicine, it is said to have a cooling effect that balances aggravations of the pitta (heat) dosha. In traditional Chinese medicine, the gel's bitter taste and cooling properties are said to benefit disorders of the liver and intestines.
When applied topically, aloe vera gel has a moisturizing, emollient effect. Cosmetics manufacturers will often exploit this property by infusing derivatives of aloe vera in makeup, moisturizers, soaps, sunscreens, shaving creams, and shampoos. There are even aloe vera facial tissues that are designed to reduce nasal chafing.
Also Known As
- • Aloe
- • Burn plant
- • Elephant’s gall
- • Kathalai (in Ayurveda)
- • Lily of the Desert
- • Lu Hui (in traditional Chinese medicine)
Health Benefits
Aloe vera gel is often applied to the skin to treat sunburn, burns, and eczema. It has a soothing effect that may aid in the treatment of genital herpes, poison oak, poison ivy, and radiation-induced skin reactions. Proponents claim that aloe vera can even speed the healing of wounds and reduce the severity of psoriasis.
When taken orally as a juice or dietary supplement, aloe vera's laxative effects can help ease constipation. It is also believed by some to aid in the treatment of peptic ulcers, Crohn's disease, and ulcerative colitis. There have even been suggestions that aloe vera can help normalize blood sugar in people with diabetes.
For the most part, the evidence supporting these claims is mixed.
Burns and Wounds
One of the most popular uses of aloe vera gel is to aid in the healing of sunburns, burns, contact dermatitis, and minor cuts and abrasions. The freshly extracted gel has a cooling effect that may provide short-term relief of pain and itchiness. Whether it can actually speed healing is another issue.
A 2012 review of studies from Australia evaluated seven clinical trials investigating the use of aloe in treating burns, skin biopsies, and hemorrhoidectomies and could find no evidence that it aids in the healing of acute or chronic wounds.
The same results were seen in studies investigating the use of aloe vera in people with plaque psoriasis. A small study from Denmark involving 41 adults with stable plaque psoriasis concluded that aloe vera gel, applied twice daily for a month, was less effective than a placebo in relieving psoriasis symptoms.
Radiation Skin Reactions
Radiation-induced dermatitis (RID) is a common side effect of cancer radiation therapy, characterized by red, flaking skin as well as frequent blisters and dermal atrophy (thinning of the skin). Studies exploring the use of aloe vera in treating RID have been mixed.
A 2013 study from Iran evaluated the effects of aloe lotion in 60 people undergoing radiation therapy. Following radiation, a thin layer of lotion was applied to half of the irradiated area of skin. After four weeks of treatment, the authors found that the areas treated with aloe had a lower grade of dermatitis than areas left untreated. The conclusions were limited somewhat by the wide variety of cancers treated.
Other studies have not reached similar conclusions.
A Phase III trial from Australia evaluated the use of aloe cream in 225 women undergoing breast cancer radiation therapy. According to the report, the non-aloe cream helped reduce pain and skin peeling, while the aloe cream had little, if any, effect.
Further research may be needed to determine whether topical aloe is more useful in treating certain areas of skin or at certain radiation doses. There is no evidence that taking aloe vera by mouth has any effect on people with RID.
Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a complex of digestive disorders comprised of ulcerative colitis and Crohn's disease. Of the two, ulcerative colitis is considered the more serious with symptoms ranging from abdominal cramps and pain to rectal bleeding and bloody diarrhea.
An early study from England involving 44 people with mild to moderate ulcerative colitis concluded that a 2-to-1 dilution of aloe vera gel taken twice daily improved symptoms in most people after four weeks.
According to the investigators, nine people achieved complete remission, 11 experienced an improvement of symptoms, while 14 reported a "response" to treatment.
Diabetes
Alternative practitioners have long endorsed the use of oral aloe vera to provide better control of blood sugar (glucose) in people with prediabetes and type 2 diabetes.
A 2016 review of studies from India evaluating eight clinical trials concluded that oral aloe vera significantly improved fasting blood glucose in people with prediabetes but was only marginally effective in people with type 2 diabetes.
A 2016 review from China reached similar conclusions, suggesting that aloe vera is most beneficial to people with prediabetes. With that being said, the authors cited the generally poor quality of the research and the absence of safety testing.
Further research would be needed to determine if aloe vera is safe and effective in preventing the development of type 2 diabetes.
Possible Side Effects
Topical aloe vera is generally considered safe for use. Side effects, if any, tend to be mild and may include skin irritation and redness. Allergies can sometimes occur, especially in people who are allergic to garlic, onions, or tulips.
Aloe vera gel should not be used to treat severe burns or wounds. Seek immediate medical attention if you have a deep cut or a large or severe burn.
Oral Aloe Vera
There remain significant concerns about the long-term safety of aloe vera when taken by mouth. Aloe vera extracts can have a potent laxative effect, causing diarrhea, abdominal cramps, and the potential severe loss of potassium.
A severe loss of potassium can lead to fatigue, muscle weakness, and irregular heartbeats (arrhythmia). The long-term consumption of aloe vera—especially undiluted aloe gel—can result in permanent kidney damage.
Cancer Warning
Several animal studies have shown that whole-leaf aloe extracts can cause cancer of the large intestine. It is believed that aloin, which provides aloe latex its yellowish color, is responsible for this carcinogenic effect.
Decolorized aloe vera (in which aloin is filtered from the gel) is believed to be of low cancer risk, although further research is needed to confirm this.
The safety of aloe in people with liver and kidney disease has not been established. To be safe, do not take oral aloe vera if you have liver disease, kidney disease, diabetes, intestinal problems, heart disease, hemorrhoids, or electrolyte imbalances.
Due to the lack of safety research, oral aloe should not be used in children, pregnant women, or nursing mothers.
Drug Interactions
Aloe vera may cause certain drug interactions if taken internally. In some cases, it can block the action of the co-administered drug. In others, it can enhance the action of the drug, triggering the appearance or worsening side effects. Others still may promote the depletion of potassium.
Speak with your doctor if you intend to use oral aloe and take any of the following drugs or supplements:
- • Diabetes medications, including insulin
- • Diuretics ("water pills") like Lasix (furosemide)
- • Heart rhythm medications like digoxin
- • Laxatives and stool softeners
- • Licorice root
- • Oral or injectable steroids
- • Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, Advil (ibuprofen), or Celebrex (celecoxib)
Oftentimes, separating drug doses by two to four hours in all that is needed to avoid an interaction. At others, a dose adjustment or drug substitution may be required.
Topical aloe vera can also enhance the absorption of topical steroid creams, increasing the risk of dermal atrophy and damage.
Dosage and Preparation
Topical aloe preparations range in concentrations from as little as 0.5 percent to as high as 99 percent. There is no data to suggest that lower doses are less effective than higher doses.
Oral aloe preparation comes in a variety of forms, including capsules, soft gel caps, powders, and juices. Supplements doses range from 100 milligrams to 10,000 milligrams. Larger doses confer to a higher risk of side effects. For safety reasons, keep to the lowest possible dose. Few clinical studies have used anything more than 500 milligrams daily.
Although aloe vera gels are intended for topical use, some manufacturers will sell cold-pressed "gels" for oral use. These products (often marketed as "full strength," "whole leaf," "pure filtered") are thicker and more viscous than aloe vera juice and are commonly sold by the gallon for digestive health.
If you decide to use an oral gel preparation, do so for no more than 10 days and stop immediately if you experience any side effects.
What to Look For
Aloe vera products are approved for cosmetic or dietary supplement use. They are not intended to treat any medical condition and are not tested for quality or safety.
Since few aloe vera supplements are certified by the U.S. Pharmacopeia (USP) or similar certifying bodies, stick with well-known brands with an established market presence. You should also opt for supplements that have been certified organic under the regulations of the U.S. Department of Agriculture (USDA).
If you choose to use an oral aloe preparation for medical reasons, speak with your doctor first to determine if you have any condition or take any drugs that may contraindicate treatment. If purchasing a cold-pressed oral gel, only choose those that have been decolorized and have had most of their aloins removed.
Other Questions
Is drinking aloe vera juice safe for constipation?
Aloe vera juice is found in many health food stores and a growing number of grocery stores. Some are flavored and sweetened to make them more palatable.
As opposed to aloe gel, aloe juice contains less aloin. It has a gentler laxative effect and may help relieve mild constipation. It often helps to drink a half to a full cup of aloe juice right before bedtime for morning relief. Alternately, you can take a 100- to 200-milligram capsule.
The overconsumption of aloe juice can lead to diarrhea. Aloe gel, while sometimes used in folk medicine to treat constipation, should be avoided.
Can I use aloe if I have a latex allergy?
Aloe gel contains natural latex, which may cause a reaction in people with a latex allergy. Reactions range from mild skin rashes and hives to stuffy noses and difficulty breathing. On rare occasion, aloe latex can trigger a potentially deadly, whole-body reaction known as anaphylaxis.
Call 911 or seek emergency care if you experience rash, hives, shortness of breath, wheezing, rapid heart rate, lightheadedness, or the swelling of the face, throat, or tongue after taking an aloe preparation.
People with a latex allergy also tend to be allergic to apple, avocado, banana, carrot, celery, chestnut, kiwi, melon, papaya, raw potato, and tomato. Birch pollen is also a common co-reactive allergen.
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Aloe has been associated with acute hepatitis (liver inflammation) either in isolation or when consumed as a multinutrient supplement. These effects appear to be reversible and occur in the dosage range of 250-500 mg a day, with the exact mechanism of the toxicity is not understood.
Aloe seems to cause wide-ranging side-effects at a doses 100mg/kg or greater bodyweight in animals. These side effects are observed in all subjects. *
Topical aloe vera is generally considered safe for use. Side effects, if any, tend to be mild and may include skin irritation and redness. Allergies can sometimes occur, especially in people who are allergic to garlic, onions, or tulips.
Aloe vera gel should not be used to treat severe burns or wounds. Seek immediate medical attention if you have a deep cut or a large or severe burn.
Oral Aloe Vera
There remain significant concerns about the long-term safety of aloe vera when taken by mouth. Aloe vera extracts can have a potent laxative effect, causing diarrhea, abdominal cramps, and the potential severe loss of potassium.
A severe loss of potassium can lead to fatigue, muscle weakness, and irregular heartbeats (arrhythmia). The long-term consumption of aloe vera—especially undiluted aloe gel—can result in permanent kidney damage.
Cancer Warning
Several animal studies have shown that whole-leaf aloe extracts can cause cancer of the large intestine. It is believed that aloin, which provides aloe latex its yellowish color, is responsible for this carcinogenic effect.
Decolorized aloe vera (in which aloin is filtered from the gel) is believed to be of low cancer risk, although further research is needed to confirm this.
The safety of aloe in people with liver and kidney disease has not been established. To be safe, do not take oral aloe vera if you have liver disease, kidney disease, diabetes, intestinal problems, heart disease, hemorrhoids, or electrolyte imbalances.
Due to the lack of safety research, oral aloe should not be used in children, pregnant women, or nursing mothers.
Drug Interactions
Aloe vera may cause certain drug interactions if taken internally. In some cases, it can block the action of the co-administered drug. In others, it can enhance the action of the drug, triggering the appearance or worsening side effects. Others still may promote the depletion of potassium.
Speak with your doctor if you intend to use oral aloe and take any of the following drugs or supplements:
- • Diabetes medications, including insulin
- • Diuretics ("water pills") like Lasix (furosemide)
- • Heart rhythm medications like digoxin
- • Laxatives and stool softeners
- • Licorice root
- • Oral or injectable steroids
- • Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, Advil (ibuprofen), or Celebrex (celecoxib)
Oftentimes, separating drug doses by two to four hours in all that is needed to avoid an interaction. At others, a dose adjustment or drug substitution may be required.
Topical aloe vera can also enhance the absorption of topical steroid creams, increasing the risk of dermal atrophy and damage. *
Note 2: Toxicology and carcinogenesis studies of a nondecolorized [corrected] whole leaf extract of Aloe barbadensis Miller (Aloe vera) in F344/N rats and B6C3F1 mice (drinking water study)
Note 3: Study of the aqueous extract of Aloe vera and its two active components on the Wnt/β-catenin and Notch signaling pathways in colorectal cancer cells
Note 8: The dark side of miracle plant-Aloe vera: a review