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Effectiveness of aloe vera



Clinical bottom line: There is some evidence from randomised, double blind trials to show that aloe vera is effective for psoriasis and genital herpes, though the results were based on few patients. There is no high quality evidence of effectiveness of aloe vera for wound healing, radiation-induced skin injury, hyperlipidaemia or diabetes mellitus. Most of the included studies were small.



Systematic review:

Vogler BK, Ernst E. Aloe vera: a systematic review of its clinical effectiveness. British Journal of General Practice 1999;49:823-828.



Date review completed: May 1998

Number of trials included: 10

Number of patients: (See below)

Control groups: none, standard treatment or placebo.

Main outcomes: wound healing, severity index for psoriasis or dermatitis, number of cured patients, blood lipid levels, blood glucose.

Inclusion criteria were clinical trial of aloe vera (for any indication).

Medline, Embase, Biosis and the Cochrane Library were searched (to May 1998) for published reports. Bibliographies of retrieved reports were checked for additional citations and no language restrictions were made. Manufacturers of aloe vera products and experts were contacted for published and unpublished trials. Data were extracted in a standardised, predefined manner by the two reviewers. Methodological quality was rated using a validated 5-point scale. A descriptive analysis was conducted.


Findings:

Wound healing:

One nonrandomised, unblinded study assessed wound healing with polyethylene oxide wound gel or polyethylene oxide wound gel saturated with aloe vera in 17 patients with acne vulgaris. Half-face treatments were carried out so that each patient received both treatments. By day 5, 90% of wounds were healed (complete re-epithelialisation) with aloe vera compared with 40-50% without aloe vera. Wound healing was 72 hours faster with aloe vera.

One randomised, unblinded trial assessed wound healing with standard wound care with or without aloe vera dermal gel every 8-12 hours in 40 women after gynaecologic surgery. All women had complications of wound healing after surgery. Details of the standard treatment were not provided and 50% of women did not complete the trial. Mean healing time (to completely epithelialised wound) was significantly longer with aloe vera (83 days) than with standard treatment (53 days).

Psoriasis:

One randomised, double blind trial assessed topical 0.5% hydrophilic aloe vera cream compared with placebo cream in 60 patients with mild to moderate chronic plaque-type psoriasis over four weeks. Patients were followed-up for 12 months. The rate of cure was significantly better with aloe vera (83% ) than with placebo (7%) with no relapses.

Radiation-induced skin injury:

Two randomised trials assessed the effects of aloe vera in women with radiation-induced skin injury associated with treatment for breast cancer. One trial was double blind (194 patients) and found no significant difference in severity score between topical aloe vera gel and placebo.

The other trial (108 patients) assessed usual care with or without topical aloe vera gel; there was no significant difference between study treatments.

Genital herpes:

Two randomised, double blind trials compared topical aloe vera cream (0.5% hydrophilic) or placebo three times daily for two weeks in 180 men with a first episode of genital herpes; one also assessed topical aloe vera gel. Response rates in the two trials were almost identical. The proportions of patients cured in the two trials were 70% and 67% with aloe vera cream, 45% with aloe vera gel, and 7.5% and 7.0% with placebo. Times to healing were 4.8 and 4.9 days with aloe vera cream, 7.0 days with aloe vera gel, and 14 and 12 days with placebo.

Hyperlipidaemia:

A nonrandomised, unblinded trial compared oral aloe vera (10 ml or 20 ml) with placebo daily for 12 weeks in 60 patients with hyperlipidaemia. All patients had had a negative response to diet control. A decrease in blood cholesterol (15%), LDL (18%), and triglycerides (25% and 31%) was reported in with aloe vera. The response rates with placebo were not reported.

Diabetes mellitus:

One nonrandomised, single blind trial oral aloe vera gel (1 tablespoon) compared with placebo over 42 days in 72 diabetic women. With aloe vera reductions in blood glucose levels (250 mg to 141 mg percentage) and triglycerides (220 mg to 123 mg percentage). No significant difference was shown for cholesterol, weight change or appetite with aloe vera, or any outcome with placebo.

One nonrandomised, single blind trial assessed aloe vera or placebo in 72 men and women with diabetes mellitus who were taking oral glibenclamide (10 mg daily) for 42 days. Patients continued their diabetic medication. A statement was made that the results were similar to those reported above. No further details were provided.


Adverse effects

Tolerability was good and all reported adverse effects were reversible. No patients withdrew from the trials because of adverse effects associated with aloe vera. Topical application led to burning sensation, contact dermatitis and mild itching in some patients.

 

Comment

To date there is no convincing evidence to show that aloe vera is effective for treating any of the conditions mentioned in this review, with the exception of psoriasis and genital herpes. The included studies were of poor methodological quality and validity, and were small which implies that their results were not robust. The use of randomisation and blinding was uncommon, so bias is a possibility. Another problem was that the trials which assessed aloe vera in different conditions were generally conducted by the same research group. This means that there was no independent verification of results. Better quality randomised, double blind trials are needed to assess whether aloe vera is effective and safe.

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Identifier

AT125 - 5903 EFFECTIVENSS OF ALOE VERA: Sep-2000