This site is intended for health professionals only

Aloe vera - myth or medicine?

Peter Atherton
MB ChB DObstRCOG MRCGP
Director of the Tyringham Naturopathic Clinic

Aloe vera is one of the most widely used herbal agents. Modern physicians, knowing little about it, are generally reluctant to recommend its use, but its healing properties have been known for thousands of years. Evidence supporting the use of aloe was discovered on a Mesopotamian clay tablet dated 2100 BC. The plant was known not only to the Egyptians but also to Roman, Greek, Arab and Indian cultures and many famous physicians of earlier times.
Aloe's many nicknames, such as "the burn plant" and "the medicine plant", suggest that within its leaves resides a potent medicine. The aloe leaf has an outer rind, green and waxy, below which are tubules containing the sap. Next comes a mucilaginous polysaccharide layer that contains the inner gel. The 1-1.5% of solid matter contains 75 known ingredients, which synergistically produce some remarkable effects.
There is confusion about the properties of the sap of the aloe leaf, commonly known as "bitter aloes", and those of the inner gel. Bitter aloes contains anthraquinones (aloin), which are responsible both for its taste and its stunning laxative effect (anthraquinones also occur in senna and cascara). Aloin was used medicinally by ancient physicians as an efficient vermifuge, killing gut parasites, and also by my grandmother, who painted it on my nails in an attempt to stop me biting them! Pregnant women are often advised to avoid ingesting aloe vera, because of aloin's reputed abortifacient effect; this is mistaken advice, because modern aloe vera products contain either no aloin or just minute traces and are quite safe.

Beneficial effects of aloe
Aloe vera works in two main areas, on epithelial tissue and the immune system, and it is used in oral and topical formulations.(1) It is widely accepted that the reduced nutrient content of today's foods can lead to deficiencies in trace elements and other micronutrients that adversely affect many enzyme systems. By drinking aloe vera gel, this imbalance can be redressed and the absorption of food improved.(2)
The polysaccharide glucomannan, present in the mucilage layer of aloe vera leaves, has been shown in vitro to have an immunomodulatory effect on the cytokine system. It is for this action, together with its natural anti-inflammatory and analgesic effects, that aloe vera is used in complementary therapy to help sufferers with immune-mediated disorders such as rheumatoid arthritis, lupus, ulcerative colitis and psoriasis. Its use may result in the need for less medication, and a recent British clinical trial showed the beneficial effect of aloe vera gel over placebo in ulcerative colitis.(3)
Topical aloe vera products, provided they are formulated with enough active ingredient, have a natural moisturising effect, easily penetrating the skin and mucous membranes. By virtue of their anti-inflammatory and broad antimicrobial activity and stimulatory effect on cell growth, especially fibroblasts, they speed up the healing of damaged epithelial tissue by up to 30%.(4,5) Topical aloe vera preparations are therefore a safe and effective alternative to moisturisers and steroids in the treatment of common skin conditions such as dermatitis, eczema and psoriasis, but can also be used effectively to manage fungal conditions, urticaria and even acne rosacea.
I will leave it to Christopher Colombus to sum up. He said: "Four vegetables are indispensable for the wellbeing of man: wheat, the grape, the olive and the aloe. The first nourishes him, the second raises his spirit, the third brings him harmony and the fourth cures him."

References

  1. Atherton PG. The essential aloe vera: the actions and the evidence. Bucks: Mill Enterprises; 1997.
  2. Bland J. Prevent Med 1985;14:152-4.
  3. Langmead L, Makins RJ, Rampton DS. Aliment Pharmacol Ther 2004;19:739-47.
  4. Choi SW, Son BW, Son YS, et al.Br J Dermatol 2001;145:535-45.
  5. Danhof IE, McAnalley BH. Drug Cosmetic Ind 1983;133:54-196.