Herbs > Aloe
Aloe
Botanical Name:  Aloe vera/Aloe barbadensis/Aloe ferox 
Common Names:  Aloe vera, aloe gel, aloe juice, aloe latex, aloe sap
 
Overview
Plant Description
What's It Made Of?
Available Forms
How to Take It
Precautions
Possible Interactions
Supporting Research

Overview

The Aloe vera plant has been used for thousands of years to heal a variety of conditions ranging from skin lesions to constipation. It is grown in most 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.

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 stop pain and inflammation and stimulate skin growth and repair. For this reason, aloe vera gel has gained tremendous popularity for relief of burns, with individual success in helping minor burns. In fact, preliminary research, in both animals and people, suggests that this folkloric use has some scientific validity. These results seem encouraging, but studies comparing aloe gel with standard medication may help determine whether the herb is as effective for the treatment of burns as more customary therapies.

Herpes and Skin Conditions
Preliminary evidence also suggests that aloe gel may improve symptoms of genital herpes and certain skin conditions such as psoriasis. Additional studies would be helpful to confirm these findings.

Constipation
Aloe gel is often confused with another part of the aloe plant known as aloe juice, but the two substances are quite different. Aloe juice (also known as aloe latex or aloe sap) is a yellow, bitter liquid derived from the outer layer of the aloe leaf. It contains substances that, when taken by mouth, have very strong laxative effects. For example, in a study of 35 men and women with constipation, those who received capsules containing aloe latex, and other laxatives including psyllium (a natural substance high in fiber) experienced softer and more frequent stools compared to those who received placebo.

Although aloe latex is a powerful laxative, it is not used frequently because it can cause painful cramping. Other gentler, herbal laxatives from the same plant family as aloe (such as cascara and senna) are generally recommended first.

Diabetes
Preliminary studies suggest that aloe juice may help lower blood sugar levels in people with type 2 (adult onset) diabetes. Although further studies are need to fully assess the safety and effectiveness of aloe in the treatment of diabetes, it seems possible that the herb may prove to be a useful addition to the diet, exercise, and medication program for type 2 diabetics.

Other
Studies in test tubes and animals suggest that active substances in aloe leaf extracts (which contain both aloe gel and aloe latex) may have immunostimulant and anti-cancer effects. This information has inspired the production of a substance for people with cancer combining aloe leaf, honey, and gin. However, studies of the use of this substance in people are lacking and, therefore, the safety and effectiveness of this substance is not known.

Use of aloe may enhance the effectiveness of some medications used to treat the human immunodeficiency virus (HIV), but well-designed research trials are needed to confirm these findings.

Aloe is also being evaluated for use in treating asthma.


Plant Description

Aloe vera is a perennial plant with yellow flowers. The plant can grow up to 4 feet in height and its tough, fleshy, spearlike leaves can grow up to 20 inches long. Only the leaves are used for medicine, but different parts of the leaves can be used for different purposes. For example, the clear, thick gel found in the inner part of the leaf is most commonly used for minor cuts and burns. The bitter yellow juice found between the gel and the outer skin of the leaf is dried and commonly used for laxative purposes.


What's It Made Of?

Aloe gel contains active substances known as glycoproteins and polysaccharides. Glycoproteins are protein-carbohydrate compounds that speed the healing process by stopping pain and inflammation. Polysaccharides are a type of carbohydrate that stimulates skin growth and repair. These substances are also thought to stimulate the immune system.

Aloe latex contains compounds known as anthraquinones that stimulate the activity of the gastrointestinal tract.


Available Forms

Aloe gel is most effective when obtained fresh from an aloe plant, but it is also available commercially in a stabilized gel form, incorporated into ointments, creams, and lotions. Aloe gel is often included in cosmetic and over the counter skin care products as well.

Aloe latex is made by heating aloe juice until all of the liquid evaporates. This process produces large, translucent blocks that contain active ingredients known as anthraquinones. Aloe latex is available in a powdered form or in 500 mg capsules for use as a laxative.


How to Take It

Pediatric

There are no known scientific reports on the pediatric use of aloe latex. Therefore, the use of oral aloe latex is not currently recommended for children.

Pure aloe gel may be applied to the surface of the skin for minor skin irritations.

Adult

Slit the leaf of an aloe plant lengthwise and remove the gel from the inside. Carefully clean affected area and then apply aloe gel liberally to the skin.

For use as a laxative, take 50 to 200 mg of dry or up to 1 tablespoon liquid aloe latex one time by mouth. Once the laxative effect is achieved, you can consider using 1 to 2 teaspoons of liquid aloe latex 2 to 3 times per week to maintain regular bowel habits; however, this should only be done under the supervision of an appropriately trained healthcare practitioner (see Precautions for a discussion of the risks with aloe latex). If taking dry aloe latex, you must drink a lot of water at room temperature.


Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain active substances that can trigger side effects and that can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a practitioner knowledgeable in the field of botanical medicine.

Aloe gel is considered safe when applied to the surface of the skin. In rare cases, it may cause an allergic reaction, mainly a skin rash called dermatitis. People who develop these reactions should discontinue use of aloe gel.

Aloe gel is not useful for treatment of deep wounds.

Pregnant women should not 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.

Aloe latex may cause severe intestinal cramps or diarrhea. Aloe latex is not recommended for people with gastrointestinal illness, intestinal obstruction, appendicitis, or stomach pain. It may worsen ulcers, hemorrhoids, diverticulosis (small protruding sacs of the inner lining of the colon), colitis, or irritable bowel syndrome. Aloe latex may also cause nephritis (an inflammatory process in the kidneys).

Many experts advise against long-term use of oral aloe latex as it can turn urine brown or red and may even become addictive.

Chronic use of any laxative can deplete levels of potassium in the body, which can lead to abnormal heart rhythms. It is best to use this laxative no more than once or twice at a time.


Possible Interactions

If you are currently being treated with any of the following medications, you should not use aloe vera without first talking to your healthcare provider.

Antidiabetic Medications
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 latex either alone or in combination with other medications must be monitored closely by health care providers to avoid potential complications from low blood sugar levels.

Hydrocortisone
Aloe gel may enhance the ability of hydrocortisone to reduce swelling.

Digoxin and Diuretics
Because oral aloe can decrease levels of potassium, aloe latex should not be used by individuals taking diuretics or digoxin (a medication used to treat irregular heart rhythms and congestive heart failure). These medications lower potassium levels in the body, so a combination of aloe and digoxin or diuretics can result in dangerously low levels of this important mineral.


Supporting Research

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

Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, Ore: Eclectic Medical; 1998:28-30..

Bunyapraphatsara N, Yongchaiyudha S, Rungpitarangsi V, Chokechaijaroenporn O. 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.

Danhof I. Potential benefits from orally-injested internal aloe vera gel. International Aloe Science Council Tenth Annual Aloe Scientific Seminar; 1991; Irving, Texas.

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.

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

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

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.

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

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

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

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.

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, Patumraj S. 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, Sriurairatana S, Boonpucknavig V. 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.

Yongchaiyudha S, Rungpitarangsi V, Bunyapraphatsara N, Chokechaijaroenporn O. Antidiabetic acitivy of Aloe vera L. juice I. Clinical trial in new cases of diabetes mellitus. Phytomedicine. 1996;3:241-243.


Review Date: April 2002
Reviewed By: Participants in the review process include: Constance Grauds, RPh (April 1999), President, Association of Natural Medicine Pharmacists, San Rafael, CA; Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University and Senior Medical Editor Integrative Medicine, Boston, MA; Gary Kracoff, RPh (Pediatric Dosing section February 2001), Johnson Drugs, Natick, MA; Steven Ottariono, RPh (Pediatric Dosing section February 2001), Veteran's Administrative Hospital, Londonderry, NH; R. Lynn Shumake, PD, Director, Alternative Medicine Apothecary, Blue Mountain Apothecary & Healing Arts, University of Maryland Medical Center, Glenwood, MD; Tom Wolfe, P.AHG (April 1999), Smile Herb Shop, College Park, MD. All interaction sections have also been reviewed by a team of experts including Joseph Lamb, MD (July 2000), The Integrative Medicine Works, Alexandria, VA; Enrico Liva, ND, RPh (August 2000), Vital Nutrients, Middletown, CT; Brian T Sanderoff, PD, BS in Pharmacy (March 2000), Clinical Assistant Professor, University of Maryland School of Pharmacy; President, Your Prescription for Health, Owings Mills, MD; Ira Zunin, MD, MPH, MBA (July 2000), President and Chairman, Hawaii State Consortium for Integrative Medicine, Honolulu, HI.

 

 

RELATED INFORMATION
  Uses of this Herb
Asthma
Burns
Constipation
Diabetes Mellitus
Herpes Simplex Virus
HIV and AIDS
Photodermatitis
Psoriasis
Wounds
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  Drugs that Interact
Summary
Digoxin
Diuretics
Glyburide
Hydrocortisone-containing Medications
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