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Health Benefits of Aloe Vera: A Scientific Review

Aloe vera (Aloe barbadensis Miller) is a succulent plant species belonging to the Asphodelaceae family that has been used for medicinal purposes for thousands of years. It should not be confused with Aloe ferox (Cape aloe), Aloe arborescens (Candelabra aloe), or Agave americana (which is sometimes incorrectly called "American aloe" but belongs to a different plant family entirely).

Confirmed Health Benefits

Based on peer-reviewed scientific literature, Aloe vera has shown evidence for the following benefits:

• Wound healing and burn treatment (topical application)
• Anti-inflammatory properties for skin conditions
• Moisturizing effects for dry skin
• Mild antimicrobial activity against certain pathogens
• Potential antidiabetic effects (oral gel consumption)
• Mild laxative effects (anthraquinones in latex)

Conditions with Some Supporting Evidence

• Mild to moderate plaque psoriasis (topical application)
• Oral lichen planus (topical application)
• Radiation-induced skin reactions (topical application)
• Mild ulcerative colitis (oral gel)
• Irritable bowel syndrome (oral gel)
• Gingivitis and periodontal disease (mouthwash)
• Type 2 diabetes (oral gel for glycemic control)

Recommended Dosages and Standardization

Dosages vary significantly depending on the preparation and condition being treated:

• Topical gel/cream: Apply 2-3 times daily with products containing 0.5-97.5% Aloe vera gel
• Oral gel/juice: 15-30 ml twice daily (standardized to contain 10-20 mg/L of aloin)
• Oral capsules/tablets: 100-500 mg daily (standardized to contain 1-5% aloins)
• Mouthwash: 10-20% Aloe vera solution used 2-3 times daily

Most efficacy studies have focused on preparations standardized to contain specific amounts of active compounds, particularly acemannan (a polysaccharide) and aloin (an anthraquinone glycoside). However, standardization varies widely across commercial products, limiting precise dosage recommendations.

Active Compounds

• Acemannan (immunomodulatory and wound healing properties)
• Aloin and aloe-emodin (anthraquinones with laxative effects)
• Glycoproteins (anti-inflammatory and wound healing properties)
• Salicylic acid (analgesic properties)
• Sterols (anti-inflammatory effects)

Side Effects and Disbenefits

While generally considered safe for topical use, Aloe vera can cause adverse effects, particularly with oral consumption:

• Topical: Contact dermatitis, allergic reactions, burning sensation
• Oral: Abdominal cramps, diarrhea, electrolyte imbalances
• Long-term oral use of aloe latex: Potassium depletion, muscle weakness, cardiac disturbances
• Potential hepatotoxicity with prolonged use of aloe preparations containing anthraquinones
• Decreased absorption of certain medications

Contraindications

• Pregnancy and breastfeeding (especially oral preparations)
• Hemorrhoids or intestinal obstruction
• Known hypersensitivity to plants in the Liliaceae family
• Renal or cardiac disorders (risk of electrolyte imbalance)
• Scheduled surgery (may interfere with blood glucose control)
• Concomitant use with certain medications (digoxin, diuretics, antidiabetics)

High-Dose Studies and Knowledge Gaps

Limited studies have examined doses above the commonly recommended ranges. A few studies have investigated higher topical concentrations (up to 100% pure gel) for severe burns or wounds, suggesting potentially enhanced efficacy without increased adverse effects. For oral consumption, doses exceeding 30 ml twice daily have shown increased likelihood of adverse effects without proportional therapeutic benefits.

Significant knowledge gaps remain regarding:

• Long-term safety of oral Aloe vera preparations
• Optimal standardization of active compounds
• Mechanisms of action for many claimed benefits
• Drug interactions, particularly with chemotherapeutic agents
• Comparative efficacy between different Aloe species and preparations

Pharmaceutical Products Containing Aloe Vera

• Acemannan Hydrogel (Carrington Laboratories) - Wound healing
• A/Mannan™ (Carrington Laboratories) - Immunostimulant
• Aloeride® (PharmaCare) - IBS and digestive health
• AVGel™ (Thor Pharmaceuticals) - Topical anti-inflammatory
• Dermaide Aloe® (Dermaide Research) - Radiation dermatitis
• Oral Aloe® (Bioponic Phytoceuticals) - Oral mucositis

References

Akaberi, M., Sobhani, Z., Javadi, B., Sahebkar, A., & Emami, S. A. (2016). Therapeutic effects of Aloe spp. in traditional and modern medicine: A review. Biomedicine & Pharmacotherapy, 84, 759-772.

Bashir, A., Saeed, B., Mujahid, T. Y., & Jehan, N. (2011). Comparative study of antimicrobial activities of Aloe vera extracts and antibiotics against isolates from skin infections. African Journal of Biotechnology, 10(19), 3835-3840.

Byeon, S. W., Pelley, R. P., Ullrich, S. E., Waller, T. A., Bucana, C. D., & Strickland, F. M. (1998). Aloe barbadensis extracts reduce the production of interleukin-10 after exposure to ultraviolet radiation. Journal of investigative dermatology, 110(5), 811-817.

Devaraj, S., Yimam, M., Brownell, L. A., Jialal, I., Singh, S., & Jia, Q. (2013). Effects of Aloe vera supplementation in subjects with prediabetes/metabolic syndrome. Metabolic syndrome and related disorders, 11(1), 35-40.

Hekmatpou, D., Mehrabi, F., Rahzani, K., & Aminiyan, A. (2019). The effect of aloe vera clinical trials on prevention and healing of skin wound: a systematic review. Iranian journal of medical sciences, 44(1), 1.

Hęś, M., Dziedzic, K., Górecka, D., Jędrusek-Golińska, A., & Gujska, E. (2019). Aloe vera (L.) Webb.: natural sources of antioxidants–a review. Plant Foods for Human Nutrition, 74, 255-265.

Langmead, L., Feakins, R. M., Goldthorpe, S., Holt, H., Tsironi, E., De Silva, A., Jewell, D. P., & Rampton, D. S. (2004). Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis. Alimentary pharmacology & therapeutics, 19(7), 739–747.
https://doi.org/10.1111/j.1365-2036.2004.01902.x

Maan, A. A., Nazir, A., Khan, M. K. I., Ahmad, T., Zia, R., Murid, M., & Abrar, M. (2018). The therapeutic properties and applications of Aloe vera: A review. Journal of herbal medicine, 12, 1-10.

Rahmani, A. H., Aldebasi, Y. H., Srikar, S., Khan, A. A., & Aly, S. M. (2015). Aloe vera: Potential candidate in health management via modulation of biological activities. Pharmacognosy reviews, 9(18), 120.

Saifi, A., Sharma, A., Chaudhary, A., Siddiqui, N., Ashwlayan, V.D. and Singh, B., 2024. Unveiling the Latest Breakthroughs: A Comprehensive Review of the Therapeutic Activity and Safety Profile of Aloe vera. Current Drug Safety, 19(4), pp.407-416.
https://doi.org/10.2174/0115748863274759231221093309

Sánchez, M., González-Burgos, E., Iglesias, I. and Gómez-Serranillos, M.P., 2020. Pharmacological update properties of Aloe vera and its major active constituents. Molecules, 25(6), p.1324.

Zhang, Y., Liu, W., Liu, D., Zhao, T. and Tian, H., 2016. Efficacy of Aloe vera supplementation on prediabetes and early non-treated diabetic patients: A systematic review and meta-analysis of randomized controlled trials. Nutrients, 8(7), p.388.