Aloe Vera

    Written by:
    Kamal Patel
    Last Updated: March 11, 2024

    Aloe vera is a plant that has traditionally been used topically to alleviate burns and pain and orally against constipation. Despite its widespread use, the results of research on the benefits of Aloe vera remain conflicted.

    What is Aloe vera?

    Aloe is a genus of succulent perennial plants in the Liliaceae family characterized by fleshy green leaves arranged in a rosette formation along the stem. Aloe vera (synonym: Aloe barbadensis Mill.) is a species of the genus Aloe, alongside other species such as Aloe ferox (bitter aloe) and Aloe arborescens.[3]

    Commercially, Aloe vera is available in three main forms: Aloe vera gel, Aloe vera latex, and Aloe vera juice (or whole leaf extract). The latter of these contains both the gel and the latex and should not be confused with Aloe vera beverages sold in stores, which typically contain Aloe vera diluted in water or juice (e.g., grapefruit).[3] While it is widely recognized for its topical application to alleviate pain from burns, Aloe vera is also used in cosmetic, food, and pharmaceutical products.[3]

    What is the history of Aloe vera?

    What are Aloe vera’s main benefits?

    Aloe vera is commercially sold to treat burns and various skin conditions. While the evidence supporting its effectiveness is not robust, one meta-analysis suggested that burns treated with Aloe vera may heal more quickly than those given standard treatment.[4] Similarly, some studies indicate that Aloe vera may reduce the severity of psoriasis symptoms in individuals with mucocutaneous conditions.[5] However, Aloe vera does not seem to be effective in improving symptoms of radiation dermatitis (RD), a common side effect of radiotherapy.[6]

    Topical application of Aloe vera may also be beneficial for nipple pain and irritation in breastfeeding women,[7] although further research with stronger methodologies is needed to confirm these findings.

    Additionally, Aloe vera may have benefits for oral health. Topical oral applications of Aloe vera in mouthwash or gels have been shown to reduce plaque formation, gum inflammation, and bleeding in people with periodontal disease (gum disease) to a greater degree than commonly used preparations (e.g., fluoride‑containing triclosan, chlorhexidine).[8] Furthermore, one meta-analysis found that, for the treatment of oral ulcers, various topical preparations of Aloe vera gel had better therapeutic effect and shorter therapy duration than a control, although their effects on ulcer size and subjective pain did not differ significantly from the control.[9]

    Finally, some Aloe vera preparations can also be taken orally, and one meta-analysis found that Aloe vera may be effective in improving symptoms of irritable bowel syndrome (IBS), although the evidence is not strong.[10]

    Can aloe vera be taken with other supplements?Can Aloe vera be beneficial for diabetes or prediabetes?

    What are Aloe vera’s main drawbacks?

    Aloe vera topical gel is generally well-tolerated, but there have been reports of hypersensitive skin reactions.[5]

    Additionally, Aloe vera latex, a yellow-brownish liquid extracted from the skin of the plant's leaves and traditionally used as a laxative, and Aloe vera whole leaf extract, which contains the latex, may pose a risk of toxicity due to the latex’s high content of anthranoids.[3][1]

    Topical and oral use of Aloe vera can also theoretically cause skin irritation, urticaria, cramping, and diarrhea in people who are allergic to other plants in the same family (e.g., onion).[3]

    Regarding interactions with medications, there is evidence of a potential herb-drug interaction between Aloe vera whole leaf extract and sevoflurane, a general anesthetic.[3]

    Finally, Aloe vera has been associated with cases of acute hepatitis (liver inflammation). This side effect typically occurs within an oral dosage range of 250–500 mg per day, and while the effects appear reversible, the exact mechanism of toxicity is not fully understood.[11][12][3]

    Is Aloe vera safe during pregnancy and breastfeeding?

    How does Aloe vera work?

    Aloe vera contains more than 75 bioactive compounds, including vitamins, enzymes, minerals, anthraquinones, sugars, hormones, and fatty acids, among others.[13] Therefore, several mechanisms of action have been proposed for the effects of Aloe vera.

    In vitro studies suggest that aloesin, aloin, and emodin are the main compounds responsible for the skin-protective properties of Aloe vera, thanks to their antioxidant and anti-inflammatory mechanisms.[13] Magnesium lactate present in Aloe vera may also contribute to alleviating skin itching and irritation by reducing histamine production.[14] Additionally, the glycoprotein fraction of Aloe vera appears to inhibit thromboxanes and promote type-III collagen production, which facilitates skin healing.[15]

    Another essential constituent of Aloe vera, acemannan, is a mucopolysaccharide that exhibits anti-inflammatory and gastroprotective properties.[13] Furthermore, anthraquinones found in Aloe vera latex confer its laxative effect by increasing intestinal water content, stimulating mucus secretion, and enhancing intestinal peristalsis.[16][10]

    Regarding its hypoglycemic effect, Aloe vera may work by reducing glucose absorption in the gastrointestinal tract after food, stimulating glucose catabolism, and suppressing gluconeogenesis (glucose production). Activation of AMPK, akin to the mechanism of action of metformin (a medication for type 2 diabetes), is also proposed as a possible pathway for the hypoglycemic effects of Aloe vera.[1]

    What are other names for Aloe Vera?

    Note that Aloe Vera is also known as:

    • Aloe Barbadensis

    Dosage information

    The optimal dosage of Aloe vera has not been determined yet, with studies employing a broad spectrum of preparations containing varied extracts at different concentrations.[1][2]

    Frequently asked questions

    What is Aloe vera?

    Aloe is a genus of succulent perennial plants in the Liliaceae family characterized by fleshy green leaves arranged in a rosette formation along the stem. Aloe vera (synonym: Aloe barbadensis Mill.) is a species of the genus Aloe, alongside other species such as Aloe ferox (bitter aloe) and Aloe arborescens.[3]

    Commercially, Aloe vera is available in three main forms: Aloe vera gel, Aloe vera latex, and Aloe vera juice (or whole leaf extract). The latter of these contains both the gel and the latex and should not be confused with Aloe vera beverages sold in stores, which typically contain Aloe vera diluted in water or juice (e.g., grapefruit).[3] While it is widely recognized for its topical application to alleviate pain from burns, Aloe vera is also used in cosmetic, food, and pharmaceutical products.[3]

    What is the history of Aloe vera?

    The word “aloe” is derived from the Arabic word alloeh, which translates to “bitter and shiny substance”, while “vera” comes from the Latin word for truth.[3]

    Historical use of Aloe vera dates back to 2100 BC, as evidenced by its mention on a Mesopotamian clay tablet. Aloe vera was also documented in a papyrus discovered in a sarcophagus near Thebes (Egypt), and it was recognized for its therapeutic properties by ancient physicians such as Dioscorides, Pliny the Elder, and Galen.

    Though there isn't definitive historical evidence, it's believed that Egyptian queens Nefertiti and Cleopatra incorporated Aloe vera into their beauty regimens. Another legend says that Alexander the Great (333 BC) was encouraged by Aristotle to conquer Socotra Island, in the Indian Ocean, to obtain its abundant, medicinal aloe.[17][18]

    What are Aloe vera’s main benefits?

    Aloe vera is commercially sold to treat burns and various skin conditions. While the evidence supporting its effectiveness is not robust, one meta-analysis suggested that burns treated with Aloe vera may heal more quickly than those given standard treatment.[4] Similarly, some studies indicate that Aloe vera may reduce the severity of psoriasis symptoms in individuals with mucocutaneous conditions.[5] However, Aloe vera does not seem to be effective in improving symptoms of radiation dermatitis (RD), a common side effect of radiotherapy.[6]

    Topical application of Aloe vera may also be beneficial for nipple pain and irritation in breastfeeding women,[7] although further research with stronger methodologies is needed to confirm these findings.

    Additionally, Aloe vera may have benefits for oral health. Topical oral applications of Aloe vera in mouthwash or gels have been shown to reduce plaque formation, gum inflammation, and bleeding in people with periodontal disease (gum disease) to a greater degree than commonly used preparations (e.g., fluoride‑containing triclosan, chlorhexidine).[8] Furthermore, one meta-analysis found that, for the treatment of oral ulcers, various topical preparations of Aloe vera gel had better therapeutic effect and shorter therapy duration than a control, although their effects on ulcer size and subjective pain did not differ significantly from the control.[9]

    Finally, some Aloe vera preparations can also be taken orally, and one meta-analysis found that Aloe vera may be effective in improving symptoms of irritable bowel syndrome (IBS), although the evidence is not strong.[10]

    Can aloe vera be taken with other supplements?

    One small 2005 study found that Aloe vera gel could potentially increase the absorption and prolong the presence of both vitamin C and vitamin E in the body.[19] However, the specific dosage of Aloe vera gel used and the concentrations of vitamin C and E within the gel were not specified in the study, which could affect the outcomes. Additionally, it's noteworthy that the research was funded by the International Aloe Science Council, raising the possibility of bias in the findings.

    Can Aloe vera be beneficial for diabetes or prediabetes?

    The potential benefits of Aloe vera in preventing or improving type 2 diabetes or prediabetes remain inconclusive due to the varying methodologies and quality of studies on this topic.

    In one meta-analysis, people with prediabetes taking Aloe vera showed a significant reduction in fasting glucose (FBG) levels, compared to a control. However, the effect in people with type 2 diabetes was weak and not confirmed by sensitivity analyses. On the other hand, HbA1c (glycated hemoglobin) levels were significantly decreased by Aloe vera supplementation in people with type 2 diabetes but not in people with prediabetes.[1] It’s important to note that some studies included participants who were using antihyperglycemic medications (medication to lower blood sugar levels) and/or non-pharmacologic interventions other than aloe, making it challenging to attribute the observed effects solely to Aloe vera.

    Another meta-analysis, assessing the effect of supplementation with Aloe vera in people with prediabetes or early non-treated type 2 diabetes who also had overweight or obesity, showed a reduction in both FBG and HbA1c levels compared to a placebo, although there was no effect on insulin levels. Additionally, Aloe vera supplementation led to improvements in lipid profiles, including decreased triglycerides, total cholesterol (TC), and low-density lipoprotein (LDL) levels, as well as an increase in high-density lipoprotein (HDL) levels compared to a placebo.[2] Similar results were observed in another meta-analysis.[21]

    What are Aloe vera’s main drawbacks?

    Aloe vera topical gel is generally well-tolerated, but there have been reports of hypersensitive skin reactions.[5]

    Additionally, Aloe vera latex, a yellow-brownish liquid extracted from the skin of the plant's leaves and traditionally used as a laxative, and Aloe vera whole leaf extract, which contains the latex, may pose a risk of toxicity due to the latex’s high content of anthranoids.[3][1]

    Topical and oral use of Aloe vera can also theoretically cause skin irritation, urticaria, cramping, and diarrhea in people who are allergic to other plants in the same family (e.g., onion).[3]

    Regarding interactions with medications, there is evidence of a potential herb-drug interaction between Aloe vera whole leaf extract and sevoflurane, a general anesthetic.[3]

    Finally, Aloe vera has been associated with cases of acute hepatitis (liver inflammation). This side effect typically occurs within an oral dosage range of 250–500 mg per day, and while the effects appear reversible, the exact mechanism of toxicity is not fully understood.[11][12][3]

    Is Aloe vera safe during pregnancy and breastfeeding?

    Consumption of Aloe vera latex is not recommended during pregnancy. This is mainly due to its anthraquinone component, which, in addition to its laxative properties, may stimulate uterine contractions, potentially leading to premature labor or miscarriage.[20][3] One case study reported adverse effects in a fetus when the mother consumed Aloe vera, including intestinal peristalsis, the release of meconium in the uterus, and kidney damage.[20]

    Additionally, the anthraquinone component of Aloe vera latex and juice may be excreted into breast milk, potentially causing diarrhea in nursing infants. [20]

    How does Aloe vera work?

    Aloe vera contains more than 75 bioactive compounds, including vitamins, enzymes, minerals, anthraquinones, sugars, hormones, and fatty acids, among others.[13] Therefore, several mechanisms of action have been proposed for the effects of Aloe vera.

    In vitro studies suggest that aloesin, aloin, and emodin are the main compounds responsible for the skin-protective properties of Aloe vera, thanks to their antioxidant and anti-inflammatory mechanisms.[13] Magnesium lactate present in Aloe vera may also contribute to alleviating skin itching and irritation by reducing histamine production.[14] Additionally, the glycoprotein fraction of Aloe vera appears to inhibit thromboxanes and promote type-III collagen production, which facilitates skin healing.[15]

    Another essential constituent of Aloe vera, acemannan, is a mucopolysaccharide that exhibits anti-inflammatory and gastroprotective properties.[13] Furthermore, anthraquinones found in Aloe vera latex confer its laxative effect by increasing intestinal water content, stimulating mucus secretion, and enhancing intestinal peristalsis.[16][10]

    Regarding its hypoglycemic effect, Aloe vera may work by reducing glucose absorption in the gastrointestinal tract after food, stimulating glucose catabolism, and suppressing gluconeogenesis (glucose production). Activation of AMPK, akin to the mechanism of action of metformin (a medication for type 2 diabetes), is also proposed as a possible pathway for the hypoglycemic effects of Aloe vera.[1]

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