Currently the most popular use for aloe is topically for dermatological conditions, but some do still ingest aloe to relieve constipation. There has been a lot of current research on the efficacy of aloe and its potential side effects. Aloe gel seems to be harmless, but ingestion of aloe is not recommended (Haller, 1990). Two current studies by Choonhakarn, Busaracome, Sripanidkulchai and Sarakarn (2009) and Eshghi and collegues (2010) got positive results with the use of aloe vera gel topically for skin conditions.
Choonhakarn et al. (2009) studied the efficacy of aloe vera gel compared to 0.1% triamcinolone acetonide (TA) on cases of mild to moderate plaque psoriasis (an autoimmune skin cell disease). It was a randomized, double-blind, control trial with 75 adult patients with this condition with two conditions; aloe or 0.1% TA for 8 weeks. Efficacy was measured using a Psoriasis Area Severity Index (PASI) and Dermatology Life Quality Index (DLQI) at week 0 and week 8. Results showed that the aloe group had significantly better results with 1.1 points higher than the 0.1% TA group on the PASI scale. There was not a significant difference between the DLQI scores. There were 6 reported cases of itching but it was reversed with antihistamines, thus no serious adverse effects were elicited. Choonhakarn et al. concluded that aloe is more clinically effective than 0.1% TA.
The importance of this study is that psoriasis is a chronic disease and topical corticosteroids is often administered for it, but it has many adverse effects. The authors sought a more natural remedy. However, there are several points to address in this study. Firstly, the authors made reference to other studies with a placebo control group, but did not include one themselves. Therefore, the effect strength is unclear. Also, there was not a clear description of how the aloe cream was prepared. The participants were well controlled with no significant differences in baseline measures. An important point is the authors suggested from the results that the 0.1% TA and aloe equally improved the quality of life for the patients. However, the results showed that the DLQI score decreased about 6 points for both groups between week 0 and week 8. This suggests that perhaps aloe as treatment by itself is perhaps not as promising as suggested, as it significantly decreased quality of life. Lastly, only measures were taken at baseline and week 8, so long term effects were not studied.
The Eshghi et al. (2010) studied the effects of aloe on posthemorrhoidectomy pain, postdefection pain, and wound healing. It was a randomized, double-blind controlled trial with two conditions - placebo or aloe applied to 3 times daily for 4 weeks to the surgical area. There were 49 postoperative patients recruited and assessment was done in 12, 24 and 48 hours and 2, 4 weeks post surgery. The results are summarized in the table below. Pain was measured using a Visual Analog Scale (VAS), an expert surgeon assessed wound healing, and narcotics consumption was documented.
Measure | Significant Difference? | |
Overall Postoperative Pain | Yes; Aloe group had less pain at 12, 24 and 48 hours and at 2 weeks. | |
Defecation Pain | Yes; Aloe group had less pain at 24 and 48 hours. | No; there was no significant difference at 2 and 4 weeks. |
Wound Healing | Yes; Aloe group had faster wound healing at week 2. | No; there was no significant difference at week 4. |
Narcotics | Yes; Aloe group took less narcotics at 12 hours and 2 weeks. | |
Table 1: Summarized results from Eshghi et al. (2010) study on postoperative pain, defecation pain, wound healing and narcotics consumption.
No adverse effects were observed. The authors concluded that aloe was an effective treatment in reducing posthemorrhoidectomy pain and promoting wound healing.
Again, there are some strengths and weaknesses to this study. There was not a description of the aloe vera powder used, but a list of all the ingredients that went into the aloe cream was included. Measurement of pain using the VAS may be somewhat subjective, but the authors took care in standardizing the VAS scores, and a more objective measure of narcotics consumption was included. More than half the participants in this study were females, but they were equally distributed amongst the conditions. However, this may have had an effect on the results.
