Aloe vera is a medicinal plant with various uses, depending on whether you use its dried sap (latex) or the translucent gel present in the heart of its leaves. Dried, the sap is a powerful laxative. The gel is used in the treatment of wounds, minor burns, as well as to fight against certain skin infections.
A little history :
Originally from North Africa, aloe vera was introduced to America where it spread to the West Indies and Venezuela to then be widely cultivated in the subtropics of the United States.
Despite the current consensus that revives the image of aloe vera, it should be noted that the medicinal use of this medicinal plant is very old, 6000 years at the very least. The oldest written record of it dates back to the time of the Sumerians. On a clay tablet, we can already talk about its laxative properties. It is also found among the Assyrians and the Egyptians, through old documents listing the plants used in the pharmacopoeias of the time. The Ebers papyrus is one of these.
Testimonies in hieroglyphic form highlight the anti-aging properties of aloe vera. Very present on the Mediterranean rim during Antiquity, we discover aloe in a tinctorial recipe on the Leyden papyrus (Thebes, 3rd century AD), the oldest known “alchemical” document. It was also said to be able to heal wounds and heal them quickly. It would also have been made a preventive against poisons.
What are the uses of aloe vera “juice” ?
The use of aloe juice is “well established” to treat occasional constipation according to the EMA¹. It is a short-term treatment for occasional constipation according to the WHO and the German Commission E. WHO confirms these uses and cites its use in traditional medicine for seborrheic dermatitis, gastrointestinal ulcers, tuberculosis and infections caused by fungi. This organization also recognizes the traditional use of the gel as a healing agent, especially on burns.
Powerful colon laxative: Like the other anthracenoside drugs contained in senna or buckthorn, aloe vera acts in the same way as the sennosides of the first or the anthraquinones of the second. This laxative effect, becoming purgative at high doses, is linked in particular to the interaction of aloin and its derivatives with the synthesis of prostaglandins. In the colon, the enzymatic degradation of aloin consequently leads to the formation of anthrones which stimulate intestinal peristalsis, increase secretions, inhibit the reabsorption of water and electrolytes (Na +, Cl-) and promote potassium losses.
The effectiveness is such that the use of aloe juice responds to the same rules of caution and short duration of treatment as with other anthraquinone laxatives, ideally on medical prescription in specific indications such as preparation for a colonoscopy or anorectal surgery.
What are the properties of aloe vera “gel” ?
Action on the metabolism:
An antidiabetic action has in particular been shown in a model of diabetes induced by streptozotocin. Aloe gel exerts an anti-inflammatory action in the context of non-insulin-dependent diabetes.
By acting on the arachidonic acid pathway by inhibiting cyclo-oxygenase³, this activity has been demonstrated in several models of inflammation and exposure to irritants.
Aloe vera increases the humoral immune response and decreases cell-mediated immunity.
In relation to its richness in water giving the gel hydrating, insulating and protective properties, and because of its content of immunostimulating polysaccharides and the anti-inflammatory activity of the plant, aloe gel is widely used in external use. in cosmetic products and as an adjunct, soothing and antipruritic treatment in dermatological conditions, or as a topical substance with a protective aim in the treatment of burns and small skin lesions.
On burns :
Aloe gel slightly reduces the healing time of 2nd degree burns, compared to a cream containing silver sulfadiazine.
In radiation protection⁵ :
Aloe vera may be effective on the skin, but only when cumulative radiation doses are greater than 2700 cGy and for acute proctitis..
On genital herpes⁶ :
Aloe gel promotes healing of lesions.
On the lichen planus⁷ :
Although corticosteroids are still the gold standard, aloe vera gives promising results, especially without side effects compared to various side effects of corticosteroids.
About psoriasis⁸ :
A cream containing 70% aloe vera is a little more effective in reducing the severity of lesions and in fact improving the quality of life of people than the conventional topical topical containing 0.1% triamcinolone acetonide.
On other skin conditions and external mucous membranes :
Seborrheic dermatitis, aphthosis, gingivitis, scabies, skin lesions, pain and post-hemorrhoidectomy scarring.
Main therapeutic indications of aloe vera “juice” :
Acute constipation :
Aloe juice helps in preparation for resto-colonoscopy or lower digestive surgery. Use for a short period, never exceeding 8 to 10 days.
Main therapeutic indications of aloe vera “gel” :
Oral aloe vera :
- Non-insulin-dependent diabetes, by course of 10 to 15 days per month or 5 days out of 7
- Symptomatic treatment of inflammatory bowel disease
Aloe vera in local use :
- Scars, burns, solar and post-radiation erythema, skin ulcers, chapped skin, cracks, frostbite, skin irritation and redness, pruritus, wounds, mouth ulcers, gingivitis
- Search for a mild analgesic effect in joint, muscle and neuralgic pain
What are the contraindications ?
- Aloe juice is contraindicated in children under 12 years of age, as well as in intestinal obstruction and stenosis, intestinal atony, appendicitis, inflammatory bowel disease, pain abdominal of unknown origin, severe state of dehydration with depletion of water and electrolytes.
- Aloe juice is not recommended for people suffering from irritable bowel syndrome, hemorrhoids, digestive ulcers, heart problems (bradycardia) or kidneys, hypothermia, malaise.
- Dried aloe latex should be avoided during pregnancy. Breast-feeding women should also refrain from taking them, as the active substances in aloe pass into the milk in small amounts. Topical application of aloe gel during pregnancy or breastfeeding is possible, if application to the nipple is avoided.
- Given the risk associated with their food consumption, the fresh leaves of this plant, sometimes offered for sale to be cooked, present as a precautionary principle, the same contraindications as for aloe juice, especially in pregnant women. or breastfeeding, children and frail people.
- The intake of dried aloe latex is contraindicated in people with intestinal obstruction or narrowing, Crohn’s disease, ulcerative or bleeding colitis, abdominal pain or severe dehydration.
Are there any side effects ?
Taking dried aloe latex can cause abdominal pain or diarrhea. With regular use, it can cause, like all so-called irritant laxatives, a loss of mineral salts, especially potassium. The drop in the level of potassium in the blood exposes you to potentially serious heart problems.
A chronic overdose of dried aloe latex can have dramatic consequences: constipation resistant to other treatments (phenomenon of dependence), decalcification, heart problems, edema, fatigue, etc. Finally, taking aloe will change the color of the urine, which turns reddish brown.
Repeated intake of aloe juice can, however, lead to laxative disease: nausea, vomiting, inflammatory bowel disorders with diarrhea, recto-colic melanosis, electrolyte imbalance with hypokalaemia, renal dysfunction, congestion and irritation of the pelvic organs.
The EMA recalls that the long-term use of stimulant laxatives should be avoided, because if its use exceeds a short period of treatment, it can lead to impaired bowel function and dependence on laxatives. If laxatives are needed daily, then the cause of the constipation should be investigated. Aloe juice preparations, however, should only be used if therapeutic efficacy on transit cannot be obtained by a change in diet. Aloe vera gel in local use can also cause contact dermatitis, erythema or even phototoxicity.
Are there any risks of drug interactions ?
Dried aloe latex interacts with many medicines used to treat heart problems, diabetes and kidney failure, among other things. Anyone taking medication for the heart, kidneys or against diabetes should consult their doctor before taking aloe.
Taking aloe may interfere with urine tests that measure estrogen and urobilinogen (a substance measured when anemia or liver problems are suspected).
The prolonged use of aloe juice (more than 10 days) also exposes the risk of interaction with various drugs such as digitalis cardiotonics or hypokalaemic diuretics, etc.
The gel is an inhibitor of CYP3A4 and CYP2D6. It indeed presents risks of drug interactions with anticancer drugs (bortezomib, gefitinib, imatinib) and tamoxifen.
- EUROPEAN MEDICINES AGENCY, European Union herbal monograph on Aloe barbadensis Mill. And on Aloe (various species, mainly Aloe ferox Mill. and its hybrids), folii succus siccatus, 22 November 2016.
- DE WITTE P., The metabolism of anthranoid laxatives, Hepatogastroenterology, 1990 Dec.
- VAZQUEZ B. et al., Antiinflammatory activity of extracts from Aloe vera gel, J Ethnopharmacol., 1996 Dec.
- DAVIS R.H. et al., The isolation of an active inhibitory system from an extract of aloe vera. J Am Podiatr Med Assoc. 1991 May.
- FARRUGIA C.E. et al., The use of aloe vera in cancer radiation. An updated comprehensive review, Complement Ther Clin Pract., 2019 May.
- SYED T.A. et al. Aloe vera extract 0,5 % in ahydrophilic 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.
- CHOONHAKARN C. et al., The efficacy of aloe vera gel in the treatment of oral lichen planus. Arandomizedcontrolled trial, Br J Dermatol. 2008 Mar.
- CHOONHAKARN C. 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 Feb.