Common Names: aloe

Scientific Names: Aloe vera, Aloe africana, Aloe arborescens, Aloe barbadensis

Background

• Aloe is a succulent-style plant that thrives in warm, arid settings. It is cultivated in subtropical climates across the globe, including regions like southern Texas, Arizona, New Mexico, and California.

• The use of aloe can be traced back to ancient civilizations such as Greece, Rome, Babylonia, and China. Historically, it was renowned for its ability to treat skin ailments and believed to support wound repair and prevent early graying of hair.

• Aloe is available in both topical (applied on the skin) and oral forms. Its topical use is often recommended for conditions like acne, psoriasis, lichen planus (an itchy skin or oral rash), oral submucous fibrosis (a scarring oral disease), burns, and skin complications from radiation therapy. Oral formulations are marketed for managing weight, diabetes, and inflammatory bowel conditions such as Crohn’s disease and ulcerative colitis.

• Aloe-based products are derived from different segments of the leaf — the interior gel, the outer latex, and the whole leaf combined (which incorporates both latex and gel).

• As of 2002, the FDA mandated the removal of aloe latex from over-the-counter laxatives due to inadequate data proving its safety profile.

• The International Agency for Research on Cancer (IARC) has identified non-decolorized whole-leaf aloe vera extract as a potential carcinogen. This form retains anthraquinones, which have not been filtered out by activated carbon treatment.

What Do We Know?

• Several studies have explored aloe's uses both as a dietary supplement and as a topical remedy across a variety of health concerns.

What Have We Found Out?

• A couple of small-scale clinical trials indicate aloe gel applied on the skin, when used alongside other treatments, might help reduce acne.

• Evidence suggests that aloe gel used topically can enhance the healing process of burns and help lessen associated discomfort.

• Limited research supports aloe’s benefits for issues such as genital herpes, psoriasis, lichen planus, radiation-induced skin damage, oral submucous fibrosis, and mouth sores from dental devices.

• A few studies indicate that oral consumption of aloe may help lower blood sugar and HbA1c levels in diabetic patients. Another small study found modest reductions in weight and body fat from taking aloe gel orally for 8 weeks in overweight individuals with diabetes or prediabetes.

• While there's interest in using aloe for other conditions like eczema, diabetic ulcers, IBS, and ulcerative colitis, scientific evidence remains sparse at this time.

What Do We Know About Safety?

• Aloe gel used on the skin is usually well-tolerated. However, some users report itching, rash, burning sensations, or eczema.

• Short-term use of aloe gel taken orally—up to six weeks—has generally been considered safe according to current research.

• Ingesting aloe latex can lead to abdominal discomfort, cramps, and diarrhea. Extended oral use of aloe leaf extracts has been associated with certain cases of acute liver inflammation.

• Animal studies have shown a possible connection between orally consumed, non-decolorized whole-leaf aloe vera and certain gastrointestinal cancers. Additionally, even decolorized extracts may potentially cause cellular DNA damage, though this finding is mostly limited to laboratory-based studies.

• A 2023 scientific assessment concluded that commercially produced aloe drinks containing under 10 parts per million of aloin are not considered genotoxic.

• Excessive intake of aloe latex may heighten sensitivity to heart medications like digoxin, possibly amplifying side effects.

• Always consult your healthcare provider before combining aloe vera with any prescription medication, as interactions do occur.

• Women who are pregnant or breastfeeding should avoid taking aloe by mouth in any form due to potential risks. Always speak to your provider before use in these cases.

Things to Keep in Mind

• Be proactive with your health—always discuss any alternative or complementary treatments you’re considering with a healthcare professional. Together, you can make better-informed choices.

• How Herbal Remedies Are Regulated: The way herbal products are governed varies based on their ingredients, labeled uses, and how they're delivered (topically or orally). Many such items sold for ingestion are classified as dietary supplements and fall under less rigorous guidelines compared to pharmaceutical drugs.

• Unlike prescription medications, dietary supplements do not require FDA approval before entering the market. If concerns arise regarding a supplement’s safety, the FDA can intervene. Manufacturers are ultimately responsible for verifying that their products are safe and appropriately labeled before distributing them.

Further Resources

• Tips on Using Dietary Supplements Safely

• Understand How Supplements and Medication May Interact

• Learn to Understand Scientific Articles

Key References

• Al-Maweri SA, Ashraf S, Lingam AS, et al. Systematic review and meta-analysis on Aloe vera for oral submucous fibrosis. Journal of Oral Pathology & Medicine. 2019;48(2):99-107.

• Aloe entry from NatMed Pro. Accessed July 18, 2023.

• Guo X, Mei N. Overview of aloe vera's potential toxicities. Journal of Environmental Science and Health. 2016;34(2):77–96.

• IARC Monograph Volume 108: Herbal products like aloe. International Agency for Research on Cancer. 2016.

• Kim S-T, Pressman P, Clemens R, et al. Review on genotoxic risk of aloe vera beverages. Food and Chemical Toxicology. 2023;174:113628.

• Long V. Aloe vera’s dermatology applications. JAMA Dermatology. 2016;152(12):1364.

• Mahboub M, Aghazadeh Attari AM, et al. Comparing aloe vera gel and traditional burn creams. Journal of Caring Sciences. 2021;11(3):132–138.

• Pressman P, Clemens R, Hayes AW. Aloe in integrative medicine. SAGE Open Medicine. 2019;7:2050312119875921.

• Rodriguez S, Dentali S, Powell D. Aloe vera. In: Coates PM et al., eds. Encyclopedia of Dietary Supplements. 2nd ed. 2010:7–14.

• Sharma S, Alfonso AR, et al. Aloe vera's role in burn treatment: review and meta-analysis. Advances in Skin and Wound Care. 2022;35(11):1–9.

• Zhong H, Li X, Zhang W, et al. Aloe vera with ultrasound and mask therapy in acne treatment. Frontiers in Medicine. 2021;8:662640.

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The NCCIH offers this for educational use only. It should not replace professional healthcare guidance. Conversations about treatments should always occur between you and your healthcare provider. Mention of specific treatments or products is not an endorsement by the NCCIH.