What is it?
Aloe (often called aloe vera) produces two substances, gel and latex, which are used for medicines. Aloe gel is the clear, jelly-like substance found in the inner part of the aloe plant leaf. Aloe latex comes from just under the plant's skin and is yellow in color. Some aloe products are made from the whole crushed leaf, so they contain both gel and latex. The aloe that is mentioned in the Bible is an unrelated fragrant wood used as incense.
Aloe medications can be taken by mouth or applied to the skin. Aloe gel is taken by mouth for osteoarthritis, bowel diseases including ulcerative colitis, fever, itching and inflammation, and as a general tonic. It is also used for stomach ulcers, diabetes, asthma, and for treating some side effects of radiation treatment.
But most people use aloe gel topically, as a remedy for skin conditions including burns, sunburn, frostbite, psoriasis, and cold sores. Some people also use aloe gel to help surgical wounds and bedsores heal faster. There is some science supporting these uses. Some chemicals in aloe gel seem to be able to increase circulation in the tiny blood vessels in the skin, as well as kill bacteria. Together, these effects suggest that aloe gel might be effective in speeding wound healing. But it’s too early to come to that conclusion. Evidence is contradictory. One study suggests that aloe gel may actually delay wound healing.
Some people take aloe latex by mouth, usually for constipation. Less often, aloe latex is used orally for epilepsy, asthma, colds, bleeding, absence of menstrual periods, colitis, depression, diabetes, multiple sclerosis, hemorrhoids, varicose veins, bursitis, osteoarthritis, and glaucoma and other vision problems.
But taking aloe latex by mouth is likely unsafe, especially at high doses. There is some concern that some of the chemicals found in aloe latex might cause cancer. Additionally, aloe latex is hard on the kidneys and could lead to serious kidney disease and even death.
A number of years ago, the FDA became concerned about the safety of aloe latex, which was an ingredient in many laxatives. The FDA’s concern was heightened by the fact that people develop a kind of “tolerance” to aloe latex. They have to take more and more of it to get a laxative effect. That means they are likely to increase their dose -- and their risk. The FDA requested safety data from the makers of laxatives that contained aloe latex, but they didn’t comply, possibly because of the expense involved in doing safety studies. In the absence of safety data, the FDA required manufacturers to remove or reformulate all over-the-counter (OTC) laxative products in the U.S. market that contained aloe. The deadline for compliance was November 5, 2002.
How effective is it?
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
The effectiveness ratings for ALOE are as follows:
Possibly effective for...
- Psoriasis. Applying a cream containing 0.5% aloe for four weeks seems to reduce the skin “plaques” associated with psoriasis.
- Constipation. Taking aloe latex by mouth can reduce constipation and cause diarrhea. It takes about 10 hours for aloe latex to cause a bowel movement. With continued use, increasing doses are needed for the same laxative effect. That’s because aloe latex causes a loss of potassium from cells lining the intestine. This results in a kind of paralysis of the walls of the intestine, literally making a bowel movement difficult. Taking large doses of aloe latex or using for a long time can be dangerous. That’s why the FDA took laxatives that contained aloe latex off the market in 2002.
Insufficient evidence to rate effectiveness for...
- Burns. Applying aloe gel to the skin might improve healing of certain types of burns called “partial thickness burns.”
- Diabetes. There is conflicting information about whether aloe can reduce blood sugar in people with diabetes. Two studies indicate that taking aloe gel by mouth can reduce blood sugar in women with type 2 diabetes. But another study did not show the same benefit.
- Frostbite. When applied to the skin, aloe gel seems to help skin survive frostbite injury.
- Cold sores. There is some evidence that applying aloe extract 0.5% cream 3 times daily increases healing rates compared to aloe gel or a cream without active ingredients.
- High cholesterol and other blood fats (hyperlipidemia). Preliminary evidence suggests that taking 10 mL or 20 mL of aloe orally daily for 12 weeks can reduce total cholesterol by about 15%, low-density lipoprotein (LDL) cholesterol by about 18%, and triglycerides by about 25% to 30% in people with hyperlipidemia.
- Bedsores. Preliminary evidence suggests that applying aloe gel does not improve the healing rate of bedsores compared to management with gauze moistened with salt water.
- Skin damage caused by radiation treatment for cancer. So far, applying aloe gel to skin during and after radiation treatment doesn’t seem to reduce skin damaged caused by the radiation. However, there is some evidence that aloe gel might delay the appearance of skin damage.
- Ulcerative colitis. Preliminary evidence suggests that some people with mild to moderate ulcerative colitis who take aloe gel 25-50 mL twice daily have significantly reduced symptoms.
- Wound healing. There is conflicting information about whether aloe works to improve wound healing. Some research shows that applying an aloe gel product (Carrington Dermal Wound Gel) to surgical wounds might actually delay wound healing. But other research using a different form of aloe cream applied to hemorrhoid-related wounds shows that aloe might improve wound healing and provide some pain relief.
- Other conditions.
More evidence is needed to rate aloe for these uses.
The useful parts of aloe are the gel and latex. The gel is obtained from the cells in the center of the leaf; and the latex is obtained from the cells just beneath the leaf skin.
Aloe gel might cause changes in the skin that might help diseases like psoriasis.
Aloe seems to be able to speed wound healing by improving blood circulation through the area and preventing cell death around a wound.
It also appears that aloe gel has properties that are harmful to certain types of bacteria and fungi.
Aloe latex contains chemicals that work as a laxative.
Aloe gel is LIKELY SAFE when applied to the skin and POSSIBLY SAFE when taken by mouth in adults. Once in a while aloe gel might cause burning and itching of the skin.
Taking aloe latex is POSSIBLY UNSAFE at any dose, but LIKELY UNSAFE when taken in high doses. Aloe latex can cause some side effects such as stomach pain and cramps. Long-term use of large amounts of aloe latex might cause diarrhea, kidney problems, blood in the urine, low potassium, muscle weakness, weight loss, and heart disturbances. Taking aloe latex 1 gram per day for several days can be fatal.
There have been a few reports of liver problems in some people who have taken an aloe leaf extract; however, this is uncommon. It is thought to only occur in people who are extra sensitive (hypersensitive) to aloe.
Special precautions & warnings:
Pregnancy or breast-feeding: Aloe -- either gel or latex -- is POSSIBLY UNSAFE when taken by mouth. There is a report that aloe was associated with miscarriage. It could also be a risk for birth defects. Do not take aloe by mouth if you are pregnant or breast-feeding.
Children: Aloe is POSSIBLY UNSAFE for children when taken by mouth. Children younger than 12 years old may experience abdominal pain, cramps, and diarrhea.
Diabetes: Some research suggests aloe might lower blood sugar. If you take aloe by mouth and you have diabetes, monitor your blood sugar levels closely.
Intestinal conditions such as Crohn's disease, ulcerative colitis, or obstruction: Do not take aloe latex if you have any of these conditions. Aloe latex is a bowel irritant. Remember, products made from whole aloe leaves will contain some aloe latex.
Hemorrhoids: Do not take aloe latex if you have hemorrhoids. It could make the condition worse. Remember, products made from whole aloe leaves will contain some aloe latex.
Kidney problems: High doses of aloe latex have been linked to kidney failure and other serious conditions.
Surgery: Aloe might affect blood sugar levels and could interfere with blood sugar control during and after surgery. Stop taking aloe at least 2 weeks before a scheduled surgery.
Do not take this combination.
When taken by mouth, aloe latex is a type of laxative called a stimulant laxative. Stimulant laxatives can decrease potassium levels in the body. Low potassium levels can increase the risk of side effects of digoxin (Lanoxin).
Be cautious with this combination.
Medications for diabetes (Antidiabetes drugs)
Aloe gel might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking aloe gel along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, metformin (Glucophage), pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
Medications taken by mouth (Oral drugs)
When taken by mouth, aloe latex is a laxative. Laxatives can decrease how much medicine your body absorbs. Taking aloe latex along with medications you take by mouth might decrease the effectiveness of your medication.
Aloe might decrease clotting of the blood. Sevoflurane is used as anesthesia during surgery. Sevoflurane also decreases clotting of the blood. Taking aloe before surgery might cause increased bleeding during the surgical procedure. Do not take aloe by mouth if you are having surgery within 2 weeks.
When taken orally, aloe latex is a type of laxative called a stimulant laxative. Stimulant laxatives speed up the bowels. Taking aloe latex along with other stimulant laxatives could speed up the bowels too much and cause dehydration and low minerals in the body.
Some stimulant laxatives include bisacodyl (Correctol, Dulcolax), cascara, castor oil (Purge), senna (Senokot), and others.
When taken orally, aloe latex is a type of laxative called a stimulant laxative. Stimulant laxatives speed up the bowels and can cause diarrhea in some people. Diarrhea can increase the effects of warfarin and increase the risk of bleeding. If you take warfarin, do not take excessive amounts of aloe latex.
Water pills (Diuretic drugs)
When taken by mouth, aloe latex is a laxative. Some laxatives can decrease potassium in the body. "Water pills" can also decrease potassium in the body. Taking aloe latex along with "water pills" might decrease potassium in the body too much.
Some "water pills" that can decrease potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDIURIL, Microzide), and others.
Herbs and supplements that can lower blood sugar
Aloe might lower blood sugar. If it is taken along with other herbs and supplements that might lower blood sugar, blood sugar might get too low in some people. Some herbs and supplements that might lower blood sugar include alpha-lipoic acid, bitter melon, chromium, devil's claw, fenugreek, garlic, guar gum, horse chestnut, Panax ginseng, psyllium, Siberian ginseng, and others.
Herbs containing cardiac glycosides
Aloe can decrease the amount of potassium in the body. This can be a special problem for the heart if aloe is taken along with other herbs that contain chemicals (cardiac glycosides) that affect the electrical system of the heart. Herbs that contain cardiac glycosides include black hellebore, Canadian hemp roots, digitalis leaf, hedge mustard, figwort, lily of the valley roots, motherwort, oleander leaf, pheasant's eye plant, pleurisy root, squill bulb leaf scales, and strophanthus seeds.
Using aloe along with horsetail increases the risk of lowering potassium levels too much.
Using aloe along with licorice rhizome increases the risk of lowering potassium levels too much.
Stimulant laxative herbs
Using aloe along with other stimulant laxative herbs may increase the risk of lowering potassium levels too much. Stimulant laxative herbs include blue flag rhizome, alder buckthorn, European buckthorn, butternut bark, cascara bark, castor oil, colocynth fruit pulp, gamboge bark exudate, jalap root, black root, manna bark exudate, podophyllum root, rhubarb root, senna leaves and pods, and yellow dock root.
There are no known interactions with foods.
The following doses have been studied in scientific research:
APPLIED TO THE SKIN:
- For constipation: 100-200 mg aloe or 50 mg aloe latex taken in the evening; however, it might not be safe to take aloe latex for this use.
- For psoriasis: Aloe extract 0.5% cream applied 3 times daily.
Aloe africana, Aloe arborescens, Aloe barbadensis, Aloe Capensis, Aloe ferox, Aloe frutescens, Aloe Gel, Aloe indica, Aloe Latex, Aloe Leaf Gel, Aloe natalenis, Aloe Perfoliata, Aloe perryi, Aloe spicata, Aloe supralaevis, Aloe ucriae, Aloe Vera Barbenoids, Aloe Vera Gel, Aloe vera, Aloes, Aloès, Aloès de Curaçao, Aloès des Barbades, Aloès du Cap, Aloès Vrai, Aloès Vulgaire, Arborescens natalenis, Barbados Aloe, Burn Plant, Cape Aloe, Chritkumari, Curacao Aloe, Elephant's Gall, Gel de la Feuille d’Aloès, Ghee-Kunwar, Ghi-Kuvar, Ghrita-Kumari, Gvar Patha, Hsiang-Dan, Indian Aloe, Jafarabad Aloe, Kanya, Kumari, Latex d’Aloès, Lily of the Desert, Lu-Hui, Miracle Plant, Plant of Immortality, Plante de l’Immortalité, Plante de la Peau, Plante de Premiers Secours, Plante Miracle, Plantes des Brûlures, Sábila.
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).
To see all references for the Aloe page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/607.html.
- 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;3:245-8.
- Yongchaiyudha S, Rungpitarangsi V, Bunyapraphatsara N, Chokechaijaroenporn O. Antidiabetic activity of Aloe vera L juice. I. Clinical trial in new cases of diabetes mellitus. Phytomedicine 1996;3:241-3.
- Chalaprawat M. The hypoglycemic effects of aloe vera in Thai diabetic patients. J Clin Epidemiol 1997;50(Suppl 1):3S.
- Yang HN, Kim DJ, Kim YM, et al. Aloe-induced toxic hepatitis. J Korean Med Sci 2010;25:492-5.
- Eshghi F, Hosseinimehr SJ, Rahmani N, et al. Effects of Aloe vera cream on posthemorrhoidectomy pain and wound healing: results of a randomized, blind, placebo-control study. J Altern Complement Med 2010;16:647-50.
- Schorkhuber M, Richter M, Dutter A, et al. Effect of anthraquinone laxatives on the proliferation and urokinase secretion of normal, premalignant and malignant colonic epithelial cells. Eur J Cancer 1998;34:1091-8.
- Mueller SO, Stopper H. Characterization of the genotoxicity of anthraquinones in mammalian cells. Biochim Biophys Acta 1999;1428:406-14.
- Kanat O, Ozet A, Ataergin S. Aloe vera-induced acute toxic hepatitis in a healthy young man. Eur J Int Med 2006;17:589.
- Rabe C, Musch A, Schirmacher P, et al. Acute hepatitis induced by an Aloe vera preparation: a case report. World J Gastroenterol 2005;11:303-4.
- Bottenberg MM, Wall GC, Harvey RL, Habib S. Oral aloe vera-induced hepatitis. Ann Pharmacother 2007;41:1740-3.
Lee A, Chui PT, Aun CST, et al. Possible interaction between sevoflurane and Aloe vera. Ann Pharmacother 2004;38:1651-4.
- Vogler BK, Ernst E. Aloe vera: a systematic review of its clinical effectiveness. Br J Gen Pract 1999;49:823-8.
- Williams MS, Burk M, Loprinzi CL, et al. Phase III double-blind evaluation of an aloe vera gel as a prophylactic agent for radiation-induced skin toxicity. Int J Radiat Oncol Biol Phys 1996;36:345-9.
- Miller MB, Koltai PJ. Treatment of experimental frostbite with pentoxifylline and aloe vera cream. Arch Otolaryngol Head Neck Surg 1995;121:678-80.
- Kaufman T, Kalderon N, Ullmann Y, Berger J. Aloe vera gel hindered wound healing of experimental second-degree burns: a quantitative controlled study. J Burn Care Rehabil 1988;9:156-9.
- Gallagher J, Gray M. Is aloe vera effective for healing chronic wounds? J Wound Ostomy Continence Nurs 2003;30:68-71.
- Olsen DL, Raub W, Bradley C, et al. The effect of aloe gel/mild soap versus mild soap alone in preventing skin reactions in patients undergoing radiation therapy. Oncol Nurs Forum 2001;28:543-7.
- Langmead L, Makins RJ, Rampton DS. Anti-inflammatory effects of aloe vera gel in human colorectal mucosa in vitro. Aliment Pharmacol Ther 2004;19:521-7.
- Heggie S, Bryant GP, Tripcony L, et al. A phase III study on the efficacy of topical aloe vera gel on irradiated breast tissue. Cancer Nurs 2002;25:442-51.
- Muller MJ, Hollyoak MA, Moaveni Z, et al. Retardation of wound healing by silver sulfadiazine is reversed by Aloe vera and nystatin. Burns 2003;28:834-6.
- 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;1:505–9.
- Langmead L, Feakins RM, Goldthorpe S, et al. Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis. Aliment Pharmacol Ther 2004;19:739-47.
- Rajasekaran S, Sivagnanam K, Ravi K, Subramanian S. Hypoglycemic effect of Aloe vera gel on streptozotocin-induced diabetes in experimental rats. J Med Food 2004;7:61-6.
- Schmidt JM, Greenspoon JS. Aloe vera dermal wound gel is associated with a delay in wound healing. Obstet Gynecol 1991;78:115-7.
- Luyckx VA, Ballantine R, Claeys M, et al. Herbal remedy-associated acute renal failure secondary to Cape aloes. Am J Kidney Dis 2002;39:E13.
- Cascara sagrada, aloe laxatives, O-9 contraceptives are category II-FDA. The Tan Sheet May 13, 2002.
- Food and Drug Administration, HHS. Status of certain additional over-the counter drug category II and III active ingredients. Final rule. Fed Regist 2002;67:31125-7.
- Reynolds T, Dweck AC. Aloe vera leaf gel: a review update. J Ethnopharmacol 1999;68:3-37.
- Hutter JA, Salman M, Stavinoha WB, et al. Antiinflammatory C-glucosyl chromone from Aloe barbadensis. J Nat Prod 1996;59:541-3.
- Nusko G, Schneider B, Schneider I, et al. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut 2000;46:651-5.
- Klein AD, Penneys NS. Aloe vera. J Am Acad Dermatol 1988;18:714-20.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Gennaro A. Remington: The Science and Practice of Pharmacy. 19th ed. Lippincott: Williams & Wilkins, 1996.
- Wichtl MW. Herbal Drugs and Phytopharmaceuticals. Ed. N.M. Bisset. Stuttgart: Medpharm GmbH Scientific Publishers, 1994.
- Foster S, Tyler VE. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 3rd ed., Binghamton, NY: Haworth Herbal Press, 1993.
- Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
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Last reviewed - 06/06/2013
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