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Aloe


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...

  • Constipation. Taking aloe latex by mouth can reduce constipation and also cause diarrhea.
  • Cold sores (herpes simplex virus). Some evidence shows that applying an aloe extract 0.5% cream 3 times daily increases healing rates in men with cold sores.
  • Itchy rash on the skin or mouth (Lichen planus). Research shows that using a mouthwash containing aloe 3 times daily for 12 weeks or applying a gel containing aloe twice daily for 8 weeks can reduce pain associated with itchy rashes in the mouth. Other research shows that using a mouthwash containing aloe 4 times daily for one month reduces pain and increases healing similarly to standard treatment in people with itchy rashes in the mouth.
  • Psoriasis. Applying a cream containing 0.5% aloe for 4-8 weeks seems to reduce the skin plaques and decrease the severity of psoriasis. However, using an aloe gel does not seem to improve other symptoms associated with psoriasis, including skin redness.

Possibly ineffective for...

  • HIV. Early research suggests that taking 400 mg of a supplement that comes from aloe 4 times daily does not improve immune function in people with human immunodeficiency virus (HIV).
  • Skin damage caused by radiation treatment for cancer. Applying aloe gel to the skin during and after radiation treatment does not seem to reduce skin damage caused by the radiation. However, there is some evidence that aloe gel might delay the appearance of skin damage.
  • Sunburn. Research suggests that applying aloe gel to the skin does not prevent sunburn or reduce skin redness when applied before or after sunlight exposure.

Insufficient evidence to rate effectiveness for...

  • Dry socket (alveolar osteitis). Research shows that applying acemannan, a chemical that comes from aloe, to the tooth socket of people with dry sockets after standard treatment, reduces pain and improves symptoms more than standard treatment alone.
  • Burns. Applying aloe gel to the skin might improve healing of certain types of burns called “partial thickness burns.” Some research shows that applying aloe cream twice daily decreases the size of first or second degree burn wounds and reduces the amount of time needed to heal. However, other research suggests that applying aloe daily is no more effective than standard treatment for reducing healing time.
  • Cancer. Early research suggests that when given with standard chemotherapy, three daily doses of a mixture containing fresh aloe leaves and honey dissolved in alcohol increases the number of patients with lung cancer who are able to heal completely, partially, or maintain control of their disease when compared to just chemotherapy alone. However, other research shows that taking aloe has not benefit in people with lung cancer.
  • Canker sores. Early research suggests that taking acemannan, a chemical that comes from aloe, shortens the amount of time needed for canker sores to heal. However, other research suggests that a gel containing aloe does not consistently shorten the length of time between canker sores.
  • Dental plaque. Some research suggests that using a toothpaste containing aloe daily for 24 weeks reduces plaque. However, other research evaluating another substance containing aloe found it to be comparable to a toothpaste that contains fluoride.
  • 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.
  • Diaper rash. Early research suggests that applying a cream containing aloe gel and olive oil 3 times daily for 10 days reduces the severity of diaper rash in children younger than 3 years-old.
  • Dry skin. Early research suggests that applying a cream containing aloe to the skin for 2 weeks increases the amount of water in the outermost later of the skin, but not on the inner layers. Other research suggests that wearing gloves coated in aloe improves symptoms of dry skin in women. However, it is not clear if the benefits were from the aloe or the gloves.
  • Frostbite. When applied to the skin, aloe gel seems to help skin survive frostbite injury.
  • Gingivitis. Some research suggests that using a toothpaste containing aloe daily for 24 weeks reduces gingivitis. However, other research evaluating another substance containing aloe found it to be comparable to a toothpaste that contains fluoride.
  • Hepatitis. Early evidence suggests that taking aloe 3 times daily for 12 weeks reduces symptoms of hepatitis in people with liver fibrosis mainly caused by hepatitis B or C.
  • High cholesterol and other blood fats (hyperlipidemia). Preliminary evidence suggests that taking 10 mL or 20 mL of aloe by mouth 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.
  • Insect repellent. Applying a product containing coconut oil, jojoba oil and aloe to the feet twice daily for one week intervals seems to reduce the number of sandfleas in people with flea infestations.
  • Inflammation in the mouth (oral mucositis). Some evidence suggests that using an aloe solution 3 times daily during radiation therapy lowers the risk of developing painful inflammations in the mouth.
  • Bedsores. Some preliminary evidence suggests that applying aloe gel does not improve the healing rate of bedsores compared to management with gauze moistened with salt water. However, other research suggests that a spray containing aloe does reduce the severity of sores compared to a standard treatment spray.
  • Dandruff (seborrheic dermatitis). Early research suggests that applying aloe twice daily for 4-6 weeks improves dandruff.
  • 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.

How does it work?

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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.

Are there safety concerns?

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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.

Are there interactions with medications?

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Major

Do not take this combination.

Digoxin (Lanoxin)
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).

Moderate

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.

Sevoflurane (Ultane)
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.

Stimulant laxatives
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.

Warfarin (Coumadin)
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.

Are there interactions with herbs and supplements?

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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.

Horsetail
Using aloe along with horsetail increases the risk of lowering potassium levels too much.

Licorice
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.

Are there interactions with foods?

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There are no known interactions with foods.

What dose is used?

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The following doses have been studied in scientific research:

BY MOUTH:
  • 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.
APPLIED TO THE SKIN:
  • For psoriasis: Aloe extract 0.5% cream applied 3 times daily.

Other names

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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.

Methodology

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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).

References

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To see all references for the Aloe page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/607.html.

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Last reviewed - 04/09/2014




Page last updated: 27 October 2014