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Aloe: Health Benefits, Side Effects, Uses, Dose & Precautions

Aloe

Other Name(s):

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, Kidachi Aloe, 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.

Overview

Aloe is a cactus-like plant that grows in hot, dry climates. In the United States, aloe is grown in Florida, Texas, and Arizona. Aloe 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. People take aloe gel by mouth for weight loss, diabetes, hepatitis, inflammatory bowel diseases, osteoarthritis, stomach ulcers, asthma, radiation-related skin sores, fever, itching and inflammation, and as a general tonic. A chemical in aloe called acemannan is taken by mouth for HIV/AIDS. Aloe extract is used for high cholesterol.

Aloe latex is taken by mouth mainly as a laxative for constipation. It is also used for seizures, asthma, colds, bleeding, lack of a menstrual period, swelling of the colon (colitis), depression, diabetes, eye conditions that cause blindness (glaucoma), multiple sclerosis, hemorrhoids, varicose veins, joint inflammation, osteoarthritis, and vision problems. Fresh aloe leaves are taken by mouth for cancer.

People apply aloe gel to the skin for acne, an inflammatory skin condition called lichen planus, inflammation in the mouth, burning mouth, radiation-induced skin damage, dental plaque, diaper rash, frostbite, gum disease, bedsores, scabies, dandruff, wound healing, hemorrhoids and pain after surgery to remove internal hemorrhoids, osteoarthritis, inflammation, and as an antiseptic. Aloe extract and aloe gel are also applied to the skin for genital herpes, scaly and itchy skin, burns, sunburns, and dry skin. Aloe extract is applied to the skin as an insect repellant. Aloe leaf juice is applied to the skin for anal fissures. A chemical in aloe called acemannan is applied to the skin for dry sockets in the mouth and canker sores.

How does work?

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.

SLIDESHOW

Types of Psoriasis: Medical Pictures and Treatments See Slideshow

Uses

Possibly Effective for...

  • Acne. Research suggests that applying an aloe gel in the morning and evening, in addition to a prescription anti-acne medicine, improves acne by about 35% in both children and adults.
  • Burns. Applying aloe gel to the skin seems to improve burn healing. Also applying cream that contains aloe to the skin twice daily appears to improve itching and reduce skin picking compared to applying corticosteroid medication in people with chemical burns. It is unclear if aloe reduces healing time compared to applying antibiotics. Some research shows that applying aloe cream reduces healing time and wound size compared to applying antibiotics in people with first or second degree burns. But other early research suggests that applying fresh aloe or aloe extract daily is not more effective than antibiotic treatments for reducing wounds or improving healing in people with first or second degree burns.
  • Constipation. Taking aloe latex by mouth can reduce constipation and also cause diarrhea.
  • Genital herpes. Evidence shows that applying an aloe extract 0.5% cream three times daily increases healing rates in men with genital herpes.
  • Itchy rash on the skin or mouth (Lichen planus). Research shows that using a mouthwash containing aloe gel three times daily for 12 weeks or applying a gel containing aloe gel twice daily for 8 weeks can reduce pain associated with itchy rashes in the mouth. Other research shows that using a mouthwash containing aloe four times daily for one month or applying an aloe gel three times daily for 2 months reduces pain and increases healing similarly to the corticosteroid triamcinolone acetonide in people with itchy rashes in the mouth.
  • A mouth condition called oral submucous fibrosis. Early research suggests that applying aloe gel (Sheetal lab Surat) on each side of the inner lining of the cheeks three times daily for 3 months improves burning, the ability to open the mouth, and cheek flexibility in people with a mouth condition called oral submucous fibrosis. Other research suggests that applying aloe gel twice daily for up to 6 months along with other treatments can reduce burning and improve movement of the mouth.
  • Psoriasis. Applying a cream containing 0.5% aloe extract for 4 weeks seems to reduce the skin plaques. Also applying cream containing aloe gel seems to decrease the severity of psoriasis better than the corticosteroid triamcinolone. But using an aloe gel does not seem to improve other symptoms associated with psoriasis, including skin redness.
  • Weight loss. Research suggests that taking a specific aloe product (Aloe QDM complex, Univera Inc., Seoul, South Korea) containing 147 mg of aloe gel twice daily for 8 weeks reduces body weight and fat mass in overweight or obese people with diabetes or prediabetes.

Possibly Ineffective for...

  • Burning mouth syndrome. Applying aloe gel to sore areas on the tongue three times daily before wearing a tongue protector for 12 weeks does not appear to improve pain or reduce symptoms in people with burning mouth syndrome.
  • HIV/AIDS. Early research suggests that taking 400 mg of a chemical that comes from aloe four times daily does not improve immune function in people with human immunodeficiency virus (HIV). Also, eating 30-40 mL of aloe gruel does not improve immune function in people with HIV compared to antiretroviral therapy.
  • Skin damage caused by radiation treatment for cancer. Most research shows that applying aloe gel to the skin during and after radiation treatment does not reduce skin damage caused by the radiation, although it might delay the appearance of skin damage. Some early research suggests that applying a specific cream product (Radioskin 2, Herbalab di Perazza Massimiliano Company) to the skin two to three times daily at least 3 hours before and after radiation treatment from 15 days before the start of treatment until one month after, along with another specific cream product (Radioskin 1, Herbalab di Perazza Massimiliano Company), might improve skin hydration and reduce skin damage caused by radiation therapy in people with breast cancer. But it's not clear if the effects of these creams are related to aloe or other ingredients in the creams.

Insufficient Evidence to Rate Effectiveness for...

  • Dry socket (alveolar osteitis) . Research shows that applying a specific product (SaliCept patch) containing acemannan, a chemical from aloe, to the tooth socket of people with dry sockets after standard treatment, reduces pain and improves symptoms more than standard treatment alone.
  • Anal fissures. Early research suggests that applying an aloe cream (Zarban Phyto-Pharmaceutical Co, Iran) three times daily for at least 3 weeks, along with sitz bath three times daily, using a laxative, and eating a full fiber diet, improves pain, wound healing, and bleeding in people with anal fissures.
  • 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, taking aloe does not seem to be linked with a lower risk of getting lung cancer.
  • Canker sores. Early research suggests that using a wound dressing containing acemannan, a chemical that comes from aloe, shortens the amount of time needed for canker sores to heal. Also, applying a gel containing acemannan might reduce ulcer size in some patients. But using the corticosteroid triamcinolone acetonide seems to work better. Other research suggests that applying a gel containing aloe does not seem to increase the length of time between canker sores.
  • Dental plaque. Some early research suggests that using a toothpaste containing aloe daily for 24 weeks reduces plaque. Other research evaluating a specific aloe-containing toothpaste (Forever Bright, Forever Living Products) found it to be comparable to a toothpaste that contains fluoride at reducing plaque.
  • Diabetes. There is conflicting information about whether aloe can reduce blood sugar in people with diabetes. Some studies indicate that taking aloe gel by mouth can reduce blood sugar in people with type 2 diabetes. But another study did not show the same benefit. Also, other research suggests that taking a specific aloe gel product (Aloe QDM complex, Univera Inc., Seoul, South Korea) twice daily for 8 weeks does not affect blood sugar in patients with diabetes or prediabetes.
  • Diaper rash. Early research suggests that applying a cream containing aloe gel and olive oil three 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 extract 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.
  • Gum disease. Some research shows that using a specific aloe-containing toothpaste (Forever Bright, Forever Living Products) is comparable to a toothpaste that contains fluoride at reducing gingivitis. Other research suggests that using a toothpaste containing aloe daily for 24 weeks reduces gingivitis, but not as well as a toothpaste the contains the drug triclosan.
  • Hepatitis. Early evidence suggests that taking aloe three 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). Early research suggests that taking 10 mL or 20 mL of aloe extract 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 (Zanzarin, Engelhard Arzneimittel GmbH & Co. KG, Niederdorfelden, Germany) containing coconut oil, jojoba oil, and aloe to the feet twice daily for one week intervals seems to reduce the number of sand fleas in people with flea infestations.
  • Inflammation in the mouth (oral mucositis). Some evidence suggests that using an aloe solution three times daily during radiation therapy lowers the risk of developing painful inflammations in the mouth.
  • Bedsores. Some early research suggests that applying aloe gel does not improve the healing rate of bedsores compared to using gauze moistened with salt water. However, other research suggests that using a spray containing aloe does reduce the severity of sores compared to a salt water spray.
  • Scabies. Early research suggests that aloe gel might reduce itching and wounds similar to benzyl benzoate lotion in people with scabies.
  • Dandruff (seborrheic dermatitis). Early research suggests that applying aloe twice daily for 4-6 weeks improves dandruff.
  • Inflammatory bowel disease (ulcerative colitis). Early research suggests that some people with mild to moderate ulcerative colitis who take aloe gel by mouth for 4 weeks 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. Other research shows that applying a hydrogel containing the chemical in aloe called acemannan (Carrasyn, Carrington hydrogel) doesn't affect wound healing. But other research suggests that applying an aloe cream (Zarband, Phytopharmaceutical Co., Iran) to hemorrhoid-related wounds improves wound healing and provides some pain relief. Also, applying aloe gel under a dry gauze to a caesarean wound seems to improve initial healing compared to applying dry gauze alone.
  • Epilepsy.
  • Asthma.
  • Colds.
  • Bleeding.
  • Lack of a menstrual period.
  • Depression.
  • Glaucoma.
  • Multiple sclerosis.
  • Varicose veins.
  • Vision problems.
  • Other conditions.
More evidence is needed to rate aloe for these uses.

Side Effects

Aloe gel is LIKELY SAFE when applied to the skin appropriately as a medicine or as a cosmetic.

Aloe gel is POSSIBLY SAFE when taken by mouth appropriately, short-term. Aloe gel has been used safely in a dose of 15 mL daily for up to 42 days. Also, a solution containing 50% aloe gel has been safely used twice daily for 4 weeks. A specific gel complex (Aloe QDM complex Univera Inc., Seoul, South Korea) has been used safely at a dose of about 600 mg daily for up to 8 weeks.

Taking aloe latex or aloe whole-leaf extract by mouth is POSSIBLY UNSAFE at any dose. Aloe latex is LIKELY UNSAFE when taken by mouth 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 daily for several days can be fatal. Also, there is concern that chemicals in aloe latex and/or aloe whole-leaf extract may promote the development of cancer.

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.

Precautions

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 gel is POSSIBLY SAFE when applied to the skin appropriately. Aloe latex and aloe whole leaf extracts are POSSIBLY UNSAFE when taken by mouth in children. Children younger than 12 years-old might have stomach pain, cramps, and diarrhea.

Diabetes: Some research suggests that 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.

QUESTION

Psoriasis causes the top layer of skin cells to become inflamed and grow too quickly and flake off. See Answer

Interactions


Digoxin (Lanoxin)Interaction Rating: Major 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).


Medications for diabetes (Antidiabetes drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

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)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

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)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

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 laxativesInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

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)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

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)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

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.

Dosing

The following doses have been studied in scientific research:

ADULTS

BY MOUTH:
  • For constipation: 100-200 mg of aloe or 50 mg of aloe extract taken in the evening has been used. Also, a 500 mg capsule containing aloe, starting at a dose of one capsule daily and increasing to three capsules daily as required, has been used.
  • For weight loss: A specific aloe gel product (Aloe QDM complex, Univera Inc., Seoul, South Korea) containing 147 mg of aloe twice daily for 8 weeks has been used.
APPLIED TO THE SKIN:
  • For acne: A 50% aloe gel has been applied in the morning and evening after washing the face, along with a prescription called tretinoin gel in the evening.
  • For burns: Aloe and olive oil cream, applied twice daily for 6 weeks, has been used. Also, aloe cream, applied twice daily after changing a wound dressing, or every three days until the burn heals, has been used.
  • For herpes: A cream containing 0.5% aloe extract, applied three times daily for 5 consecutive days once or twice over a 2-week period, has been used.
  • For itchy rash on the skin or mouth (Lichen planus): Aloe gel, applied two to three times daily for 8 weeks has been used. Two tablespoons of aloe mouthwash, swished for 2 minutes and then spit, four times daily for one month has been used.
  • For a mouth condition called oral submucous fibrosis: 5 mg of an aloe gel (Sheetal lab Surat) applied on each side of the cheeks three times daily for 3 months has been used.
  • For psoriasis: Aloe extract 0.5% cream applied three times daily for 4 weeks has been used. A cream containing aloe, applied twice daily for 8 weeks, has been used.

CHILDREN

APPLIED TO THE SKIN:
  • For acne: A 50% aloe gel has been applied in the morning and evening after washing the face, along with a prescription called tretinoin gel in the evening.
  • For a precancerous mouth condition called oral submucous fibrosis: 5 mg of an aloe gel (Sheetal lab Surat), applied on each side of the cheeks three times daily for 3 months, has been used.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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Morales-Bozo, I., Rojas, G., Ortega-Pinto, A., Espinoza, I., Soto, L., Plaza, A., Lozano, C., and Urzua, B. Evaluation of the efficacy of two mouthrinses formulated for the relief of xerostomia of diverse origin in adult subjects. Gerodontology. 2012;29(2):e1103-e1112. View abstract.

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Nassiff HA, Fajardo F Velez F. Efecto del aloe sobre la hyperlipidemia en pacientes refractarios a la dieta. Rev Cuba Med Gen Integr 1993;9:43-51.

No author. Aloe vera helps ulcerative colitis. Health News 2004;10(6):2. View abstract.

Pecere, T., Sarinella, F., Salata, C., Gatto, B., Bet, A., Dalla, Vecchia F., Diaspro, A., Carli, M., Palumbo, M., and Palu, G. Involvement of p53 in specific anti-neuroectodermal tumor activity of aloe-emodin. Int J Cancer 10-10-2003;106(6):836-847. View abstract.

Phillips T, Ongenae K Kanj L Slater-Freedberg J. A randomised study of an Aloe vera derivative gel dressing versus conventional treatment after shave biopsy excisions. Wounds 1995;7(5):200-202.

Plemons J, Rees TD Binnie WH Wright JM. Evaluation of acemannan in providing pain relief in patients with recurrent aphthous stomatitis. Wounds 1994;6(2):4.

Puataweepong P, Dhanachai M Dangprasert S Sithatani C Sawangsilp T Narkwong L et al. The efficacy of oral Aloe vera for radiation induced mucositis in head and neck cancer patients: a double-blind placebo controlled study. Asian Biomedicine 2009;3(4):375-382.

Puentes Sanchez J., Pardo Gonzalez, C. M., Pardo Gonzalez, M. B., Navarro Casado, F. J., Puentes, Sanchez R., Mendez Gonzalez, J. M., Gonzalez, Rojo J., Juarez, Morales A., and Lopez, Fernandez, I. [Prevention of vascular ulcers and diabetic foot. Non-randomized open clinical evaluation on the effectiveness of "Mepentol Leche"]. Rev Enferm. 2006;29(10):25-30. View abstract.

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Rieger, L. and Carson, R. E. The clinical effects of saline and aloe vera rinses on periodontal surgical sites. J Okla.Dent.Assoc 2002;92(3):40-43. View abstract.

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Rowe TD, Lovell BK, and Parks LM. Further observations on the use of Aloe vera leaf in the treatment of third degree x-ray reactions. J Amer Pharmaceut Assoc 1941;30:266-269.

Salazar-Sanchez, N., Lopez-Jornet, P., Camacho-Alonso, F., and Sanchez-Siles, M. Efficacy of topical Aloe vera in patients with oral lichen planus: a randomized double-blind study. J.Oral Pathol.Med. 2010;39(10):735-740. View abstract.

Savchak VI. Acute bullous allergic dermatitis due to local application of aloe leaves. Vestnik Dermatologii i Venerologii 1977;12:44-45. View abstract.

Schmidt JM and Greenspoon JS. Aloe vera dermal wound gel is associated with a delay in wound healing. Obstetrics & Gynecology 1991;78(1):115-117.

Shah, S. A., DiTullio, P., Azadi, M., Shapiro, R. J., Eid, T. J., and Snyder, J. A. Effects of oral Aloe vera on electrocardiographic and blood pressure measurements. Am.J.Health Syst.Pharm. 11-15-2010;67(22):1942-1946. View abstract.

Shoji, A. Contact dermatitis to Aloe arborescens. Contact Dermatitis 1982;8(3):164-167. View abstract.

Simao, D. A., Lima, E. D., Souza, R. S., Faria, T. V., and Azevedo, G. F. [Hand-foot syndrome induced by chemotherapy: a case study]. Rev.Bras.Enferm. 2012;65(2):374-378. View abstract.

Singh, R. P., Dhanalakshmi, S., and Rao, A. R. Chemomodulatory action of Aloe vera on the profiles of enzymes associated with carcinogen metabolism and antioxidant status regulation in mice. Phytomedicine 2000;7(3):209-219. View abstract.

Syed TA, Afzal M, and Ashfaq AS. Management of genital herpes in men with 0.5% Aloe vera extract in a hydrophilic cream. A placebo-controlled double-blind study. J Derm Treatment 1997;8(2):99-102.

Syed TA, Cheema KM Ashfaq A Holt AH. Aloe vera extract 0.5% in a hydrophilic cream versus Aloe vera gel for the management of genital herpes in males. A placebo-controlled, double-blind, comparative study. [Letter.]. J Eur Acad Dermatol Venereol 1996;7:294-295.

Syed TA, Cheema KM, and Ahmad SA et al. Aloe vera extract 0.5% in hydrophilic cream versus aloe vera gel for the measurement of genital herpes in males. A placebo-controlled, double-blind, comparative study. Journal of the European Academy of Dermatology & Venerology 1996;7(3):294-295.

Syed, T. A., Ahmadpour, O. A., Ahmad, S. A., and Ahmad, S. H. Human leukocyte interferon-alpha in a hydrophilic cream versus in a gel for the treatment of genital herpes in males: a placebo-controlled, double-blind, comparative study. J.Dermatol. 1997;24(9):564-568. View abstract.

Thamlikitkul V, Bunyapraphatsara N Riewpaiboon W Theerapong S Chantrakul C et al. Clinical trial of Aloe vera linn. for treatment of minor burns. Siriraj Hospital Gazette 1991;43(5):31-36.

Vardy AD, Cohen AD, and Tchetov T. A double-blind, placebo-controlled trial of Aloe vera (A. barbadensis) emulsion in the treatment of seborrheic dermatitis. J Derm Treatment 1999;10(1):7-11.

Vazquez, B., Avila, G., Segura, D., and Escalante, B. Antiinflammatory activity of extracts from Aloe vera gel. J Ethnopharmacol. 1996;55(1):69-75. View abstract.

Wang, Z. W., Huang, Z. S., Yang, A. P., Li, C. Y., Huang, H., Lin, X., Liu, Z. C., and Zhu, X. F. [Radioprotective effect of aloe polysaccharides on three non-tumor cell lines]. Ai.Zheng. 2005;24(4):438-442. View abstract.

Wang, Z., Huang, Z., Wu, Q., Zhou, J., Zhu, X., Li, Q., and Liu, Z. [The modulating of aloe polysaccharides on the cell cycle and cycle regulating protein expression in X-ray irradiated non-malignant cells]. Zhong.Yao Cai. 2005;28(6):482-485. View abstract.

Worthington, H. V., Clarkson, J. E., and Eden, O. B. Interventions for preventing oral mucositis for patients with cancer receiving treatment. Cochrane.Database.Syst.Rev. 2007;(4):CD000978. View abstract.

Worthington, H. V., Clarkson, J. E., Bryan, G., Furness, S., Glenny, A. M., Littlewood, A., McCabe, M. G., Meyer, S., and Khalid, T. Interventions for preventing oral mucositis for patients with cancer receiving treatment. Cochrane.Database.Syst.Rev. 2010;(12):CD000978. View abstract.

Wright CS. Aloe vera in the treatment of roentgen ulcers and telangiectasis. J Amer Med Assoc 1935;106(16):1363-1364.

Wu, J. H., Xu, C., Shan, C. Y., and Tan, R. X. Antioxidant properties and PC12 cell protective effects of APS-1, a polysaccharide from Aloe vera var. chinensis. Life Sci 1-2-2006;78(6):622-630. View abstract.

Yagi, A., Kabash, A., Mizuno, K., Moustafa, S. M., Khalifa, T. I., and Tsuji, H. Radical Scavenging Glycoprotein Inhibiting Cyclooxygenase-2 and Thromboxane A2 Synthase from Aloe vera Gel. Planta Med. 2003;69(3):269-271. View abstract.

Yagi, A., Kabash, A., Okamura, N., Haraguchi, H., Moustafa, S. M., and Khalifa, T. I. Antioxidant, free radical scavenging and anti-inflammatory effects of aloesin derivatives in Aloe vera. Planta Med 2002;68(11):957-960. View abstract.

Yongchaiyudha S, Rungpitarangsi V, Bunyapraphatsara N, and et al. Antidiabetic activity of aloe vera L. juice. I Clinical trial in new cases of diabetes mellitus. Phytomedicine 1996;3(3):241-243.

Yongchaiyudha, S., Rungpitarangsi, V., Bunyapraphatsara, N., and Chokechaijaroenporn, O. Antidiabetic activity of Aloe vera L. juice. I. Clinical trial in new cases of diabetes mellitus. Phytomedicine. 1996;3(3):241-243. View abstract.

Zawahry, M. E., Hegazy, M. R., and Helal, M. Use of aloe in treating leg ulcers and dermatoses. Int J Dermatol. 1973;12(1):68-73. View abstract.

Akhtar M, Hatwar S. Efficacy of Aloe vera extract cream in management of burn wound. Journal of Clinical Epidemiology 1996;49(Suppl 1):24.

Alam S, Ali I, Giri KY, Gokkulakrishnan S, Natu SS, Faisal M, Agarwal A, Sharma H. Efficacy of aloe vera gel as an adjuvant treatment of oral submucous fibrosis. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;116(6):717-24. View abstract.

Bhalang K, Thunyakitpisal P, Rungsirisatean N. Acemannan, a polysaccharide extracted from Aloe vera, is effective in the treatment of oral aphthous ulceration. J Altern Complement Med 2013;19(5):429-34. View abstract.

Bottenberg MM, Wall GC, Harvey RL, Habib S. Oral aloe vera-induced hepatitis. Ann Pharmacother 2007;41:1740-3. View abstract.

Boudreau MD, Beland FA, Nichols JA, Pogribna M. Toxicology and carcinogenesis studies of a nondecolorized [corrected] whole leaf extract of Aloe barbadensis Miller (Aloe vera) in F344/N rats and B6C3F1 mice (drinking water study). Natl Toxicol Program Tech Rep Ser. 2013;(577):1-266. View abstract.

Boudreau MD, Mellick PW, Olson GR, et al. Clear Evidence of Carcinogenic Activity by a Whole-Leaf Extract of Aloe barbadensis Miller (Aloe vera) in F344/N Rats. Toxicol Sci. 2013;131(1):26-39. View abstract.

Buckendahl J, Heukelbach J, Ariza L, et al. Control of tungiasis through intermittent application of a plant-based repellent: an intervention study in a resource-poor community in Brazil. PLoS Negl Trop Dis. 2010 Nov 9;4:e879. View abstract.

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. View abstract.

Cascara sagrada, aloe laxatives, O-9 contraceptives are category II-FDA. The Tan Sheet May 13, 2002.

Chalaprawat M. The hypoglycemic effects of aloe vera in Thai diabetic patients. J Clin Epidemiol 1997;50(Suppl 1):3S.

Cheng S, Kirtschig G, Cooper S, et al. Interventions for erosive lichen planus affecting mucosal sites. Cochrane Database Syst Rev. 2012;2:CD008092. View abstract.

Choi HC, Kim SJ, Son KY, Oh BJ, Cho BL. Metabolic effects of aloe vera gel complex in obese prediabetes and early non-treated diabetic patients: randomized controlled trial. Nutrition. 2013;29(9):1110-4. View abstract.

Choonhakarn C, Busaracome P, Sripanidkulchai B, et al. A prospective, randomized clinical trial comparing topical aloe vera with 0.1% triamcinolone acetonide in mild to moderate plaque psoriasis. J.Eur.Acad.Dermatol.Venereol. 2010;24:168-72. View abstract.

Cosmetic Ingredient Review Expert Panel. Final report on the safety assessment of AloeAndongensis Extract, Aloe Andongensis Leaf Juice,aloe Arborescens Leaf Extract, Aloe Arborescens Leaf Juice, Aloe Arborescens Leaf Protoplasts, Aloe Barbadensis Flower Extract, Aloe Barbadensis Leaf, Aloe Barbadensis Leaf Extract, Aloe Barbadensis Leaf Juice,aloe Barbadensis Leaf Polysaccharides, Aloe Barbadensis Leaf Water, Aloe Ferox Leaf Extract, Aloe Ferox Leaf Juice, and Aloe Ferox Leaf Juice Extract. Int J Toxicol 2007;26 Suppl 2:1-50. View abstract.

Crowell J, Hilsenbeck S, Penneys N. Aloe vera does not affect cutaneous erythema and blood flow following ultraviolet B exposure. Photodermatol. 1989 Oct;6:237-9. View abstract.

Dal'Belo SE, Gaspar LR, Maia Campos PM. Moisturizing effect of cosmetic formulations containing Aloe vera extract in different concentrations assessed by skin bioengineering techniques. Skin Res Technol. 2006;12:241-6. View abstract.

de Oliveira SM, Torres TC, Pereira SL, et al. Effect of a dentifrice containing Aloe vera on plaque and gingivitis control. A double-blind clinical study in humans. J Appl Oral Sci. 2008;16:293-6. View abstract.

Di Franco R, Sammarco E, Calvanese MG, De Natale F, Falivene S, Di Lecce A, Giugliano FM, Murino P, Manzo R, Cappabianca S, Muto P, Ravo V. Preventing the acute skin side effects in patients treated with radiotherapy for breast cancer: the use of corneometry in order to evaluate the protective effect of moisturizing creams. Radiat Oncol 2013;8:57. View abstract.

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. View abstract.

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. View abstract.

Gallagher J, Gray M. Is aloe vera effective for healing chronic wounds? J Wound Ostomy Continence Nurs 2003;30:68-71. View abstract.

Garnick JJ, Singh B, Winkley G. Effectiveness of a medicament containing silicon dioxide, aloe, and allantoin on aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;86:550-6. View abstract.

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Hajheydari Z, Saeedi M, Morteza-Semnani K, Soltani A. Effect of Aloe vera topical gel combined with tretinoin in treatment of mild and moderate acne vulgaris: a randomized, double-blind, prospective trial. J Dermatolog Treat 2014;25(2):123-9. View abstract.

Heck E and Head M. Aloe vera gel cream as a topical treatment for outpatient burns. Burns 1981;7(4):291-294.

Hegazy SK, El-Bedewy M, Yagi A. Antifibrotic effect of aloe vera in viral infection-induced hepatic periportal fibrosis. World J Gastroenterol. 2012;18:2026-34. View abstract.

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.. View abstract.

Huseini HF, Kianbakht S, Hajiaghaee R, et al. Anti-hyperglycemic and anti-hypercholesterolemic effects of Aloe vera leaf gel in hyperlipidemic type 2 diabetic patients: a randomized double-blind placebo-controlled clinical trial. Planta Med. 2012;78:311-6. View abstract.

Hutter JA, Salman M, Stavinoha WB, et al. Antiinflammatory C-glucosyl chromone from Aloe barbadensis. J Nat Prod 1996;59:541-3. View abstract.

International Agency for Research on Cancer (IARC). Aloe Vera. Some drugs and herbal products: IARC monographs on the evaluation of carcinogenic risks to humans, Volume 108. Lyon, France: International Agency for Research on Cancer; 2015. 37-71. NO PMID

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Jiménez-Encarnación E, Ríos G, Muñoz-Mirabal A, Vilá LM. Euforia-induced acute hepatitis in a patient with scleroderma. BMJ Case Rep 2012;2012. View abstract.

Kanat O, Ozet A, Ataergin S. Aloe vera-induced acute toxic hepatitis in a healthy young man. Eur J Int Med 2006;17:589. View abstract.

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. View abstract.

Kaya GS, Yapici G, Savas Z, et al. Comparison of alvogyl, SaliCept patch, and low-level laser therapy in the management of alveolar osteitis.J Oral Maxillofac Surg. 2011;69:1571-7. View abstract.

Khorasani G, Hosseinimehr SJ, Azadbakht M, et al. Aloe versus silver sulfadiazine creams for second-degree burns: a randomized controlled study. Surg Today. 2009;39:587-91. View abstract.

Klein AD, Penneys NS. Aloe vera. J Am Acad Dermatol 1988;18:714-20. View abstract.

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. View abstract.

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. View abstract.

Lee A, Chui PT, Aun CST, et al. Possible interaction between sevoflurane and Aloe vera. Ann Pharmacother 2004;38:1651-4. View abstract.

Lee J, Lee MS, Nam KW. Acute toxic hepatitis caused by an aloe vera preparation in a young patient: a case report with a literature review. Korean J Gastroenterol 2014;64(1):54-8. View abstract.

Lissoni P, Rovelli F, Brivio F, et al. A randomized study of chemotherapy versus biochemotherapy with chemotherapy plus Aloe arborescens in patients with metastatic cancer. In Vivo. 2009;23:171-5. View abstract.

Lodi G, Carrozzo M, Furness S, et al. Interventions for treating oral lichen planus: a systematic review. Br J Dermatol. 2012;166:938-47. View abstract.

López-Jornet P, Camacho-Alonso F, Molino-Pagan D. Prospective, randomized, double-blind, clinical evaluation of Aloe vera Barbadensis, applied in combination with a tongue protector to treat burning mouth syndrome. J Oral Pathol Med 2013;42(4):295-301. View abstract.

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. View abstract.

Mansourian A, Momen-Heravi F, Saheb-Jamee M, et al. Comparison of aloe vera mouthwash with triamcinolone acetonide 0.1% on oral lichen planus: a randomized double-blinded clinical trial. Am J Med Sci. 2011;342:447-51. View abstract.

Merchant TE, Bosley C, Smith J, et al. A phase III trial comparing an anionic phospholipid-based cream and aloe vera-based gel in the prevention of radiation dermatitis in pediatric patients. Radiat Oncol. 2007;2:45. View abstract.

Miller MB, Koltai PJ. Treatment of experimental frostbite with pentoxifylline and aloe vera cream. Arch Otolaryngol Head Neck Surg 1995;121:678-80. View abstract.

Molazem Z, Mohseni F, Younesi M, Keshavarzi S. Aloe vera gel and caesarean wound healing; a randomized controlled clinical trial. Glob J Health Sci 2014;7(1):203-9. View abstract.

Montaner JS, Gill J, Singer J, et al. Double-blind placebo-controlled pilot trial of acemannan in advanced human immunodeficiency virus disease. J Acquir Immune Defic Syndr Hum Retrovirol. 1996;12:153-7. View abstract.

Moore Z, Cowman S. A systematic review of wound cleansing for pressure ulcers. J Clin Nurs. 2008;17:1963-72. View abstract.

Mueller SO, Stopper H. Characterization of the genotoxicity of anthraquinones in mammalian cells. Biochim Biophys Acta 1999;1428:406-14. View abstract.

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.. View abstract.

Nassiff HA, Fajardo F Velez F. Efecto del aloe sobre la hyperlipidemia en pacientes refractarios a la dieta. Rev Cuba Med Gen Integr 1993;9:43-51.

Nelemans FA. Clinical and toxicological aspects of anthraquinone laxatives. Pharmacology. 1976;14 Suppl 1:73-7. View abstract.

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. View abstract.

Odes HS, Madar Z. A double-blind trial of a celandin, aloevera and psyllium laxative preparation in adult patients with constipation. Digestion. 1991;49:65-71. View abstract.

Olatunya OS, Olatunya AM, Anyabolu HC, et al. Preliminary trial of aloe vera gruel on HIV infection. J Altern Complement Med. 2012;18:850-3. View abstract.

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. View abstract.

Oyelami OA, Onayemi A, Oyedeji OA, et al. Preliminary study of effectiveness of aloe vera in scabies treatment. Phytother Res. 2009;23:1482-4. View abstract.

Panahi Y, Davoudi SM, Sahebkar A, et al. Efficacy of Aloe vera/olive oil cream versus betamethasone cream for chronic skin lesions following sulfur mustard exposure: a randomized double-blind clinical trial. Cutan Ocul Toxicol. 2012;31:95-103. View abstract.

Panahi Y, Sharif MR, Sharif A, et al. A randomized comparative trial on the therapeutic efficacy of topical aloe vera and Calendula officinalis on diaper dermatitis in children. ScientificWorldJournal. 2012;2012:810234. View abstract.

Paulsen E, Korsholm L, Brandrup F. A double-blind, placebo-controlled study of a commercial Aloe vera gel in the treatment of slight to moderate psoriasis vulgaris. J Eur Acad Dermatol Venereol. 2005;19:326-31. View abstract.

Phillips T, Ongenae K, Kanj L, et al. A randomised study of an Aloe vera derivative gel dressing versus conventional treatment after shave biopsy excisions. Wounds 1995;7(5):200-202.

Plemons J, Rees TD Binnie WH, et al. Evaluation of acemannan in providing pain relief in patients with recurrent aphthous stomatitis. Wounds 1994;6:4.

Pradeep AR, Agarwal E, Naik SB. Clinical and microbiologic effects of commercially available dentifrice containing aloe vera: a randomized controlled clinical trial. J Periodontol. 2012;83:797-804. View abstract.

Puataweepong P, Dhanachai M, Dangprasert S, et al. The efficacy of oral Aloe vera for radiation induced mucositis in head and neck cancer patients: a double-blind placebo controlled study. Asian Biomedicine 2009;3(4):375-382.

Puvabanditsin P, Vongtongsri R. Efficacy of aloe vera cream in prevention and treatment of sunburn and suntan. J Med Assoc Thai. 2005;88 Suppl 4:S173-6. View abstract.

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. View abstract.

Rahmani N, Khademloo M, Vosoughi K, Assadpour S. Effects of Aloe vera cream on chronic anal fissure pain, wound healing and hemorrhaging upon defection: a prospective double blind clinical trial. Eur Rev Med Pharmacol Sci 2014;18(7):1078-84. View abstract.

Rajar UD, Majeed R, Parveen N, et al. Efficacy of aloe vera gel in the treatment of vulval lichen planus. J Coll Physicians Surg Pak. 2008;18:612-4. View abstract.

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. View abstract.

Reddy RL, Reddy RS, Ramesh T, Singh TR, Swapna LA, Laxmi NV. Randomized trial of aloe vera gel vs triamcinolone acetonide ointment in the treatment of oral lichen planus. Quintessence Int 2012;43(9):793-800. View abstract.

Reuter J, Jocher A, Stump J, et al. Investigation of the anti-inflammatory potential of Aloe vera gel (97.5%) in the ultraviolet erythema test. Skin Pharmacol Physiol. 2008;21:106-10. View abstract.

Reynolds T, Dweck AC. Aloe vera leaf gel: a review update. J Ethnopharmacol 1999;68:3-37. View abstract.

Sakai R. Epidemiologic survey on lung cancer with respect to cigarette smoking and plant diet. Jpn J Cancer Res. 1989;80:513-20. View abstract.

Schmidt JM, Greenspoon JS. Aloe vera dermal wound gel is associated with a delay in wound healing. Obstet Gynecol 1991;78:115-7. View abstract.

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. View abstract.

Su CK, Mehta V, Ravikumar L, et al. Phase II double-blind randomized study comparing oral aloe vera versus placebo to prevent radiation-related mucositis in patients with head-and-neck neoplasms. Int J Radiat Oncol Biol Phys. 2004 Sep 1;60:171-7. View abstract.

Sudarshan R, Annigeri RG, Sree Vijayabala G. Aloe vera in the treatment for oral submucous fibrosis - a preliminary study. J Oral Pathol Med 2012;41(10):755-61. View abstract.

Syed TA, Afzal M, and Ashfaq AS. Management of genital herpes in men with 0.5% Aloe vera extract in a hydrophilic cream. A placebo-controlled double-blind study. J Derm Treatment 1997;8(2):99-102.

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.. View abstract.

Syed TA, Cheema KM, and Ahmad SA et al. Aloe vera extract 0.5% in hydrophilic cream versus aloe vera gel for the measurement of genital herpes in males. A placebo-controlled, double-blind, comparative study. Journal of the European Academy of Dermatology & Venerology 1996;7:294-95.

Thamlikitkul V, Bunyapraphatsara N Riewpaiboon W Theerapong S Chantrakul C et al. Clinical trial of Aloe vera linn. for treatment of minor burns. Siriraj Hospital Gazette 1991;43(5):31-36.

Thomas DR, Goode PS, LaMaster K, et al. Acemannan hydrogel dressing versus saline dressing for pressure ulcers. A randomized, controlled trial. Adv Wound Care. 1998;11:273-6. View abstract.

Thongprasom K, Carrozzo M, Furness S, et al. Interventions for treating oral lichen planus. Cochrane Database Syst Rev. 2011;(7):CD001168. View abstract.

Vardy AD, Cohen AD, and Tchetov T. A double-blind, placebo-controlled trial of Aloe vera (A. barbadensis) emulsion in the treatment of seborrheic dermatitis. J Derm Treatment 1999;10:7-11.

Visuthikosol V, Chowchuen B, Sukwanarat Y, et al. Effect of aloe vera gel to healing of burn wound a clinical and histologic study. J Med Assoc Thai. 1995;78:403-9. View abstract.

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