Using Aloe Vera

explore the uses of this wonderful plant 

Jess says: Aloe vera is a staple in our natural medicine cabinet at home. While you may be more familiar with it in skin creams or aftersun lotions, we keep aloe juice in our fridge, and it is great for soothing an unhappy stomach, acid reflux, constipation or indigestion.

I often recommend that my patients who are suffering from an inflammatory condition drink aloe juice. Used on the skin, Aloe vera gel is wonderful for treating heat rashes, burns, fissures and wounds.

We always have an aloe plant on our windowsill for an emergency sore throat intervention and I’ve felt the fantastic results first-hand – after swallowing the fresh gel, even the most severe of throat infections seems to disappear like magic! 

Aloe barbadensis leaf (aloe vera) is a wonderful support for the digestive system, helping internally, to cool and soothe inflammation. Used externally, it can help to relieve a number of skin problems. 

aloe vera has been used by herbalists for thousands of years, to cool and soothe the digestion

In Ayurvedic medicine, aloe vera is called ‘Kumari,’ which translates to ‘young maiden,’ as it is commonly used as a cure for female health problems and for maintaining the youthfulness of the skin. Ayurvedic practitioners consider aloe vera to be cooling, good for both the circulation and digestion and as a female tonic for regulating the uterus (womb) and menstruation (particularly for heavy bleeding and blood clots). It is also seen as a good herb for treating menopausal heat and dryness. It is also used to treat skin irritations by applying the gel to the skin, or taken orally to help to calm skin irritations and inflammations. 

in traditional Chinese medicine, aloe vera is called Lu Hui

It is considered cooling and is used to treat constipation and to remove toxins, such as parasites. It is used for  any ‘heat’ condition, such as high temperatures, feeling hot, headaches or for red and sore eyes or skin.

Research shows that aloe juice and gel contained inside the leaves of the aloe plant is very safe. However, the outer leaf of the aloe plant should never be eaten. 

Studies on animals show that the inner gel of the aloe plant and aloe juice is very safe, even at high doses.1 There is also evidence that very high doses of plant chemicals called anthraquinones, which are contained in the outer rind and latex of the aloe leaf can cause an increased risk of cancer, if consumed for two years, which is why we advise against eating it. The outer of the leaves could also potentially affect fertility and sensitivity to light (phototoxicity),2 but this is at much higher levels and used for a far longer time than aloe would normally be taken. The inner gel and juice do not contain anthraquinones and so are considered safe.

Just inside the dark green outer of the aloe leaf is a yellow liquid. This is latex. While it is likely safe in small amounts, it should not be consumed in high doses or for long periods of time.

used topically, aloe vera helps to heal after burns (including radiotherapy)

Burns patients who used aloe vera had better healing and lower pain than those using standard burns dressings.3,4 Radiation mucositis is the ulceration of the mouth after radiotherapy, which is a common, and painful side effect of treatment. In patients who had radiotherapy of the head and neck, aloe mouthwash was effective and reduced the symptoms with no side effects5. In a test that mimicked sunburn in healthy subjects, aloe vera helped reduce inflammation after exposure to UVB rays6.

aloe vera reduces gum irritation, ulcers and harmful mouth bacteria

Patients with recurring mouth ulcers had significant improvements in pain and healing, when treated with a component of aloe vera.7 A small study of subjects who drank aloe vera showed that it improved the balance of bacteria in the mouth, to make it healthier after 14 days.8 Aloe in toothpaste can improve the symptoms of gingivitis and help to control plaque.9 aloe was also shown to be effective for improving the condition, lichen planus (a lumpy itchy skin rash) in the mouth, when the gel was used on the lesions.10

when taken orally, aloe vera may improve skin health and elasticity

A component of aloe vera, called aloe sterol was shown to improve skin elasticity, hydration and the collagen score of healthy women, who took a supplement for 12 weeks.11 This shows the benefit of aloe vera in maintaining healthy skin, and possibly helping to combat the effects of ageing.

aloe vera improves wound healing

In a study of 90 patients undergoing a Cesarean section, aloe vera gel applied to the wound improved healing and reduced the risk of infection.12 It has also been shown to improve healing of long-term ulcers and sores, when combined with olive oil and applied to wounds.13 

A study of long-term anal fissures – cracking around the anus, which can be painful and difficult to heal, showed that applying aloe vera juice to the area significantly improved bleeding and sped up healing.14 In patients who were recovering from haemorrhoid operations, aloe cream applied to the wound reduced pain and accelerated healing.15

aloe can also soothe digestion during chemotherapy treatment

Aloe vera has been shown to calm painful ulceration of the mouth after chemotherapy and help it to heal.16 Its soothing and anti-inflammatory activity makes it a good choice for consideration alongside chemotherapy treatment, and it may even benefit the cancer itself (see other benefits below).

aloe vera may also calm heartburn and reflux

Aloe vera made into a syrup was shown to be a safe and effective treatment for heartburn and acid reflux.17 Aloe vera’s inner leaf is also active against H. Pylori; a bacteria that can cause ulcers and increased heartburn.18

other benefits of aloe vera

  • As a houseplant, aloe vera can remove formaldehyde and benzene from the air, improving the air quality in your home.19
  • Taking aloe vera for eight weeks has been shown to help high blood sugar and insulin levels in patients with pre-diabetes or metabolic syndrome.20 In another study, as well as the benefit to blood sugar in diabetics it also improved their cholesterol levels.21
  • When applied alongside acne treatments, aloe vera gel helps to make the treatment significantly more effective.22
  • A condition called oral submucous fibrosis, caused by autoimmune diseases, means that patients can have ulcerations or a thickening of the tissue in the mouth, making it difficult for them to open or speak. Aloe vera gel was shown to be safe and effective at improving symptoms of this condition.23 24
  • In a study of overweight early diabetics, aloe vera gel taken internally for eight weeks improved blood sugar levels and significantly improved weight loss and the loss of body fat.25
  • Aloe vera was an effective treatment for healing nappy rash, in a study of 66 babies.26
  • Patients with HIV had a significant improvement in CD4 count and physical wellbeing, when taking 30-40ml aloe vera juice daily.27
  • A small study showed that taking aloe vera gel produced a promising improvement in symptoms and healing of the bowel of patients suffering from ulcerative colitis.28
  • A study of 240 cancer patients with metastatic cancer, given aloe vera juice (10ml, three times a day) over three years, alongside chemotherapy, had better improvements in tumours and better survival rates than those who were given chemotherapy alone.29
  • Four teaspoons of powdered inner aloe leaf was given to Alzheimer’s patients over 12 months. This created a significant improvement in brain functioning and also their immune system markers, compared to a placebo.30
  • Patients suffering from burning mouth syndrome had an improvement in pain when using aloe vera topically.31
  • Hepatic periportal fibrosis, a condition of the liver that is caused by a virus, significantly improved and their fibrosis reduced, when patients were given aloe vera for 12 weeks.32
  • Drinking aloe vera gel improves the compounds in the urine that cause kidney stones, making it a possible aid to prevent their formation.33
  • Vulval lichen planus is a skin condition, affecting the female genitalia. Aloe was shown to be an effective treatment, when applied topically for eight weeks.34
  • Aloe vera used in a cream for five days a week, for four weeks, slowed a significant improvement in psoriasis.35
  • A skin condition in pregnancy that causes a darkening of the skin on the face, called melasma, was improved by the application of aloe vera gel for five weeks.36

how to safely use aloe vera:

grow your own aloe vera plant: They are readily available from garden centres and even the plant section in some supermarkets. Aloe vera makes a fantastic house plant, requiring little water or care to thrive. You can harvest the leaves to use them as a gel or juice, just ensure that you don’t consume the outer rind (dark green) or yellow latex (the yellow juice just inside the rind).

eat the gel for sore throats. For stubborn sore throats, cut off a leaf from your aloe plant (make sure you have checked it is the correct plant and check with your medical herbalist or healthcare provider that aloe vera is suitable for you). Remove the dark green rind and yellow latex with a sharp knife and scoop out the clear inner gel. This can be eaten directly (it has no taste). Anecdotally, many people report that this soothes and takes away any pain and inflammation. If your sore throat persists, or you have any difficulty swallowing or breathing, or have a child with persistent symptoms and a fever, be sure to consult your doctor.

use the gel on wounds or burns. Prepare the inner gel as above, and use it on wounds, burns or ulcers. If you are buying aloe vera gel, try and buy 100% gel and organic, if possible. It is available in most health food shops in gel form. Use on sunburn or hot itchy rashes/allergic rashes to soothe them. Keep your aloe vera gel in the fridge, to maximise it’s cooling properties. (Seek medical advice for treating burns, ulcers, wounds and allergic rashes, before use).

take aloe vera liquid for digestive issues.  (Seek medical advice before proceeding, or speak to your herbalist or natural health practitioner). Choose an organic aloe vera inner leaf juice – Cytoplan is one we recommend – and take one dessert spoon daily, increasing up to one dessert spoon, three times a day, to help soothe and calm digestion, including ulcers and inflammation.

use aloe as a mouthwash. For oral health, and to soothe mouth ulcers (or during chemotherapy to help stomatitis), rinse your mouth with inner leaf juice for 2 minutes.

references

1:Yimam M, Brownell L, Jia Q. In vivo safety evaluation of UP780, a standardized composition of aloe chromone aloesin formulated with an Aloe vera inner leaf fillet  Regul Toxicol Pharmacol. 2014 Aug;69(3):390-7. doi: 10.1016/j.yrtph.2014.05.001. Epub 2014 May 14. PMID: 24830776.

2: Cosmetic Ingredient Review Expert Panel Final report on the safety assessment of AloeAndongensis Extract, Aloe Andongensis Leaf Juice,aloe Arborescens Leaf Extract, Aloe Arborescens Leaf Juice, Aloe Arborescens Leaf Protoplasts, Aloe Barbadensis Flower Extract, Aloe Barbadensis Leaf, Aloe Barbadensis Leaf Extract, Aloe Barbadensis Leaf Juice,aloe Barbadensis Leaf Polysaccharides, Aloe Barbadensis Leaf Water, Aloe Ferox Leaf Extract, Aloe Ferox Leaf Juice, and Aloe Ferox Leaf Juice Extract 

3: Effectiveness of Aloe Vera gel compared with 1% silver sulphadiazine cream as burn wound dressing in second degree burns Int J Toxicol. 2007;26 Suppl 2:1-50. doi: 10.1080/10915810701351186. PMID: 17613130.

4: Khorasani G, Hosseinimehr SJ, Azadbakht M, Zamani A, Mahdavi MR. Aloe versus silver sulfadiazine creams for second-degree burns: a randomized controlled study lSurg Today. 2009;39(7):587-91. doi: 10.1007/s00595-008-3944-y. Epub 2009 Jun 28. PMID: 19562446.

5: Sahebjamee M, Mansourian A, Hajimirzamohammad M, Zadeh MT, Bekhradi R, Kazemian A, Manifar S, Ashnagar S, Doroudgar K. Comparative Efficacy of Aloe vera and Benzydamine Mouthwashes on Radiation-induced Oral Mucositis: A Triple-blind, Randomised, Controlled Clinical Trial Oral Health Prev Dent. 2015;13(4):309-15. doi: 10.3290/j.ohpd.a33091. Erratum in: Oral Health Prev Dent. 2016;14(3):274. Mohammad, Haji Mirza Mohammad [corrected to Hajimizamohammad, Mohammad]. PMID: 25431805

6: 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. doi: 10.1159/000114871. Epub 2008 Feb 5. PMID: 18253066.

7: Bhalang K, Thunyakitpisal P, Rungsirisatean N. Acemannan, a polysaccharide extracted from Aloe vera, is effective in the treatment of oral aphthous ulceration J Altern Complement Med. 2013 May;19(5):429-34. doi: 10.1089/acm.2012.0164. Epub 2012 Dec 16. PMID: 23240939.

8: Prueksrisakul T, Chantarangsu S, Thunyakitpisal P .Effect of daily drinking of Aloe vera gel extract on plasma total antioxidant capacity and oral pathogenic bacteria in healthy volunteer: a short-term study J Complement Integr Med. 2015 Jun;12(2):159-64. doi: 10.1515/jcim-2014-0060. PMID: 25803090

9: Pradeep AR, Agarwal E, Naik SB. Clinical and microbiologic effects of commercially available dentifrice containing aloe vera: a randomized controlled clinical trial J Periodontol. 2012 Jun;83(6):797-804. doi: 10.1902/jop.2011.110371. Epub 2011 Nov 16. PMID: 22087805.

10: Reddy RL, Reddy RS, Ramesh T, Singh TR, Swapna LA, Laxmi NV. Randomized trial of aloe vera gel vs triamcinolone acetonide ointment in the treatment of oral lichen planus. Quintessence Int. 2012 Oct;43(9):793-800. PMID: 23041995.

11: Tanaka M, Yamamoto Y, Misawa E, Nabeshima K, Saito M, Yamauchi K, Abe F, Furukawa F. Effects of Aloe Sterol Supplementation on Skin Elasticity, Hydration, and Collagen Score: A 12-Week Double-Blind, Randomized, Controlled Trial. Skin Pharmacol Physiol. 2016;29(6):309-317. doi: 10.1159/000454718. Epub 2017 Jan 14. PMID: 28088806.

12: Molazem Z, Mohseni F, Younesi M, Keshavarzi S. Aloe vera gel and cesarean wound healing; a randomized controlled clinical trial Glob J Health Sci. 2014 Aug 31;7(1):203-9. doi: 10.5539/gjhs.v7n1p203. PMID: 25560349; PMCID: PMC4796446.

13: Panahi Y, Izadi M, Sayyadi N, Rezaee R, Jonaidi-Jafari N, Beiraghdar F, Zamani A, Sahebkar A. Comparative trial of Aloe vera/olive oil combination cream versus phenytoin cream in the treatment of chronic wounds  J Wound Care. 2015 Oct;24(10):459-60, 462-5. doi: 10.12968/jowc.2015.24.10.459. PMID: 26488737.

14: Rahmani N, Khademloo M, Vosoughi K, Assadpour S. Effects of Aloe vera cream on chronic anal fissure pain, wound healing and hemorrhaging upon defection: a prospective double blind clinical trial Eur Rev Med Pharmacol Sci. 2014;18(7):1078-84. PMID: 24763890.

15: Eshghi F, Hosseinimehr SJ, Rahmani N, Khademloo M, Norozi MS, Hojati O. Effects of Aloe vera cream on posthemorrhoidectomy pain and wound healing: results of a randomized, blind, placebo-control study J Altern Complement Med. 2010 Jun;16(6):647-50. doi: 10.1089/acm.2009.0428. PMID: 20569031.

16: Mansouri P, Haghighi M, Beheshtipour N, Ramzi M. The Effect of Aloe Vera Solution on Chemotherapy-Induced Stomatitis in Clients with Lymphoma and Leukemia: A Randomized Controlled Clinical Trial Int J Community Based Nurs Midwifery. 2016 Apr;4(2):119-26. PMID: 27218109; PMCID: PMC4876780.

17:Panahi Y, Khedmat H, Valizadegan G, Mohtashami R, Sahebkar A. Efficacy and safety of Aloe vera syrup for the treatment of gastroesophageal reflux disease: a pilot randomized positive-controlled trial  J Tradit Chin Med. 2015 Dec;35(6):632-6. doi: 10.1016/s0254-6272(15)30151-5. PMID: 26742306. 

18: 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 Jul;59(1):43-8. doi: 10.1111/lam.12241. Epub 2014 Mar 25. PMID: 24597562

19: Xu Z, Wang L, Hou H. Formaldehyde removal by potted plant-soil systems J Hazard Mater. 2011 Aug 15;192(1):314-8. doi: 10.1016/j.jhazmat.2011.05.020. Epub 2011 May 17. PMID: 21641719.

20: 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 Feb;11(1):35-40. doi: 10.1089/met.2012.0066. Epub 2012 Oct 4. PMID: 23035844. 

21: Huseini HF, Kianbakht S, Hajiaghaee R, Dabaghian FH. Anti-hyperglycemic and anti-hypercholesterolemic effects of Aloe vera leaf gel in hyperlipidemic type 2 diabetic patients: a randomized double-blind placebo-controlled clinical trial Planta Med. 2012 Mar;78(4):311-6. doi: 10.1055/s-0031-1280474. Epub 2011 Dec 23. PMID: 22198821.

22: 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 vulgaris: a randomized, double-blind, prospective trial J Dermatolog Treat. 2014 Apr;25(2):123-9. doi: 10.3109/09546634.2013.768328. Epub 2013 May 6. PMID: 23336746

23: Alam S, Ali I, Giri KY, Gokkulakrishnan S, Natu SS, Faisal M, Agarwal A, Sharma H. Efficacy of aloe vera gel as an adjuvant treatment of oral submucous fibrosis Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Dec;116(6):717-24. doi: 10.1016/j.oooo.2013.08.003. PMID: 24237724.

24: Singh N, Hebbale M, Mhapuskar A, Ul Nisa S, Thopte S, Singh S. Effectiveness of Aloe Vera and Antioxidant along with Physiotherapy in the Management of Oral Submucous Fibrosis J Contemp Dent Pract. 2016 Jan 1;17(1):78-84. doi: 10.5005/jp-journals-10024-1806. PMID: 27084867.

25: Choi HC, Kim SJ, Son KY, Oh BJ, Cho BL. Metabolic effects of aloe vera gel complex in obese prediabetes and early non-treated diabetic patients: randomized controlled trial Nutrition. 2013 Sep;29(9):1110-4. doi: 10.1016/j.nut.2013.02.015. Epub 2013 Jun 2. PMID: 23735317.

26: Panahi Y, Sharif MR, Sharif A, Beiraghdar F, Zahiri Z, Amirchoopani G, Marzony ET, Sahebkar A. A randomized comparative trial on the therapeutic efficacy of topical aloe vera and Calendula officinalis on diaper dermatitis in children ScientificWorldJournal. 2012;2012:810234. doi: 10.1100/2012/810234. Epub 2012 Apr 19. PMID: 22606064; PMCID: PMC3346674.

27: Olatunya OS, Olatunya AM, Anyabolu HC, Adejuyigbe EA, Oyelami OA. Preliminary trial of aloe vera gruel on HIV infection J Altern Complement Med. 2012 Sep;18(9):850-3. doi: 10.1089/acm.2010.0735. Epub 2012 Aug 8. PMID: 22873342

28: Langmead L, Feakins RM, Goldthorpe S, Holt H, Tsironi E, De Silva A, Jewell DP, Rampton DS. Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis Aliment Pharmacol Ther. 2004 Apr 1;19(7):739-47. doi: 10.1111/j.1365-2036.2004.01902.x. PMID: 15043514.

29: Lissoni P, Rovelli F, Brivio F, Zago R, Colciago M, Messina G, Mora A, Porro G. A randomized study of chemotherapy versus biochemotherapy with chemotherapy plus Aloe arborescens in patients with metastatic cancer In Vivo. 2009 Jan-Feb;23(1):171-5. PMID: 19368145

30: Lewis JE, McDaniel HR, Agronin ME, Loewenstein DA, Riveros J, Mestre R, Martinez M, Colina N, Abreu D, Konefal J, Woolger JM, Ali KH. The effect of an aloe polymannose multinutrient complex on cognitive and immune functioning in Alzheimer’s disease J Alzheimers Dis. 2013;33(2):393-406. doi: 10.3233/JAD-2012-121381. PMID: 22976077.

31: López-Jornet P, Camacho-Alonso F, Molino-Pagan D. Prospective, randomized, double-blind, clinical evaluation of Aloe vera Barbadensis, applied in combination with a tongue protector to treat burning mouth syndrome J Oral Pathol Med. 2013 Apr;42(4):295-301. doi: 10.1111/jop.12002. Epub 2012 Sep 7. PMID: 22957483.

32:  Hegazy SK, El-Bedewy M, Yagi A. Antifibrotic effect of aloe vera in viral infection-induced hepatic periportal fibrosis World J Gastroenterol. 2012 May 7;18(17):2026-34. doi: 10.3748/wjg.v18.i17.2026. PMID: 22563189; PMCID: PMC3342600.

33: Kirdpon S, Kirdpon W, Airarat W, Trevanich A, Nanakorn S. Effect of aloe (Aloe vera Linn.) on healthy adult volunteers: changes in urinary composition J Med Assoc Thai. 2006 Aug;89 Suppl 2:S9-14. PMID: 17044448.

34: Rajar UD, Majeed R, Parveen N, Sheikh I, Sushel C. Efficacy of aloe vera gel in the treatment of vulval lichen planus Surg Pak. 2008 Oct;18(10):612-4. doi: 10.2008/JCPSP.612614. PMID: 18940117.

35: Syed TA, Ahmad SA, Holt AH, Ahmad SA, Ahmad SH, Afzal M. Management of psoriasis with Aloe vera extract in a hydrophilic cream: a placebo-controlled, double-blind study Trop Med Int Health. 1996 Aug;1(4):505-9. doi: 10.1046/j.1365-3156.1996.d01-91.x. PMID: 8765459.

36: Ghafarzadeh M, Eatemadi A. Clinical efficacy of liposome-encapsulated Aloe vera on melasma treatment during pregnancy J Cosmet Laser Ther. 2017 Jun;19(3):181-187. doi: 10.1080/14764172.2017.1279329. Epub 2017 Jan 31. PMID: 28139161.

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