What is Aloe Vera?
Aloe vera (Aloe barbadensis miller) is a succulent plant species that has been used for thousands of years for medicinal, cosmetic, and therapeutic purposes. While widely marketed for various health benefits, aloe vera is not an essential nutrient - there is no biological requirement for it, no deficiency disease, and no established RDA. It's a plant-based remedy with both topical and internal applications, though evidence quality varies significantly by use.
Important Note: Unlike vitamins and essential nutrients, aloe vera is a plant extract/supplement with some evidence for specific uses (especially topical) but lacking rigorous clinical proof for many marketed claims. Internal use requires particular caution due to safety concerns.
Botanical Information:
Scientific name: Aloe barbadensis miller (most common medicinal species)
Family: Asphodelaceae (formerly Liliaceae)
Origin: Arabian Peninsula, now cultivated worldwide
Plant type: Succulent with thick, fleshy leaves
Growth: Thrives in tropical/arid climates
Cultivation: Easy to grow as houseplant
Plant Structure:
Leaf Anatomy (Three Layers):
Outer Rind (Skin):
Green outer layer
Protective barrier
Contains vascular bundles
Usually removed for internal use
Latex/Sap (Yellow Layer):
Just under the rind
Yellow, bitter substance
Contains aloin and other anthraquinones
LAXATIVE EFFECT - can cause cramping, diarrhea
POTENTIAL SAFETY CONCERNS - see toxicity section
Should be removed for internal use
Inner Gel (Clear):
Clear, mucilaginous substance
Center of the leaf
Contains polysaccharides (acemannan)
Water content: 99%+
Used for topical and internal applications
Considered safest part
Forms Available:
Fresh Aloe Vera Gel:
Directly from plant: cut leaf, extract gel
Most natural: no processing
Short shelf life: use immediately
Best for: topical use
Variable potency: depends on plant age, growing conditions
Risk: may contain latex if not properly filleted
Topical Aloe Vera Gel (Bottled):
Commercial products: drugstores, cosmetics
Concentrations: 10% to 100% (check labels)
Additives: preservatives, fragrances, thickeners
Uses: burns, wounds, skin irritation, cosmetics
Quality varies: many products diluted or with minimal aloe
International Aloe Science Council (IASC) certification: indicates quality
Aloe Vera Juice/Liquid:
For internal consumption
Should be: decolorized (aloin removed) for safety
Concentrations: vary widely (10% to 99%)
Added ingredients: water, citric acid, preservatives
Check labels: "inner leaf only" or "aloin-free"
Typical dose: 1-8 oz daily (varies by product)
Aloe Vera Capsules/Supplements:
Dried aloe extract: in capsule form
Standardized extracts: often to polysaccharide content
Typical dose: 100-500 mg daily
Quality varies: third-party testing important
Uses: digestive health, immune support (claimed)
Aloe Latex (Whole Leaf Extract):
Contains aloin: powerful laxative
NOT RECOMMENDED: for regular use
Safety concerns: potential carcinogen, severe GI effects
FDA warning: removed from OTC laxative products in 2002
Should be avoided: except under medical supervision
Aloe Vera Powder:
Freeze-dried or spray-dried
Reconstitute: with water for juice
Long shelf life
Quality varies
Check: processing method and purity
Key Characteristics:
NOT essential: no biological requirement
Two distinct parts: gel (generally safe) vs. latex (concerns)
Traditional remedy: used for thousands of years
Evidence varies: strong for burns/wounds, weak for many other claims
Safety concerns: particularly with internal use of whole leaf
Processing matters: quality and safety depend on how it's prepared
Active Compounds & Proposed Mechanisms
Polysaccharides:
Acemannan (Primary Active):
Large polysaccharide: beta-(1,4)-linked acetylated mannan
Immune modulation: claimed (limited human evidence)
Wound healing: may stimulate fibroblast activity
Anti-inflammatory: some in vitro evidence
Most studied: aloe component
Other Polysaccharides:
Various glucomannans
Cell signaling: proposed mechanisms
Moisture retention: topical hydration
Anthraquinones (In Latex/Sap):
Aloin (Barbaloin):
Primary anthraquinone: 20-40% of latex
Powerful laxative: stimulates colon contractions
Potential carcinogen: animal studies show concern
Should be removed: for safe internal use
FDA concern: removed from OTC laxatives
Other Anthraquinones:
Aloe-emodin, emodin, chrysophanol
Laxative effects
Potential toxicity
Anti-inflammatory (test tube)
Vitamins & Minerals (Minimal):
Vitamin A, C, E: present in small amounts
B vitamins: trace amounts
Minerals: calcium, magnesium, potassium (minimal)
Not significant source: compared to foods or supplements
Marketing exaggeration: often overstated
Enzymes:
Bradykinase: anti-inflammatory (claimed)
Proteases, lipases, amylases
Most likely: inactivated by processing
Clinical significance: unclear
Other Compounds:
Amino acids: 18-20 present (small amounts)
Salicylic acid: anti-inflammatory
Lignins: penetration enhancers for topical use
Saponins: cleansing, antimicrobial properties
Proposed Mechanisms:
Wound healing: stimulates collagen synthesis, fibroblast proliferation
Anti-inflammatory: various pathways (not well-established in humans)
Immune modulation: polysaccharide effects (mostly theoretical)
Hydration: water content and polysaccharides
Antimicrobial: various compounds (mixed evidence)
Purported Uses & Evidence Quality
Critical Note: Evidence quality for aloe vera varies dramatically by application. Topical use for burns has moderate support; most internal uses lack strong evidence.
TOPICAL USES:
Burns (Minor/First-Degree) - MODERATE EVIDENCE:
Sunburn: may reduce healing time by 1-2 days
First-degree burns: speeds healing, reduces pain
Evidence: several small RCTs, systematic reviews show modest benefit
Effect size: small to moderate
Better than: leaving untreated
Not superior to: some other treatments (aloe vs. silver sulfadiazine inconclusive)
Practical benefit: soothing, cooling effect
Recommendation: Reasonable to try for minor burns
Wound Healing - MIXED EVIDENCE:
Minor wounds: may accelerate healing
Surgical wounds: some benefit in studies
Chronic wounds: limited evidence
Mechanism: stimulates collagen synthesis, fibroblast proliferation
Quality: small studies, mixed results
Not for deep wounds: risk of prolonging healing in some cases
Recommendation: May help minor wounds, avoid on deep/surgical wounds without medical advice
Psoriasis - WEAK POSITIVE EVIDENCE:
Some studies: 0.5% aloe cream improved psoriasis
Effect: modest reduction in scaling, redness
Quality: small studies, mixed results
Not as effective: as standard psoriasis treatments
Recommendation: May try as adjunct, not primary treatment
Acne - MINIMAL EVIDENCE:
Some claims: antibacterial effects
Limited research: mostly with aloe + other treatments
No strong evidence: as standalone treatment
Recommendation: Unlikely to significantly help, better treatments available
Anti-Aging/Wrinkles - WEAK EVIDENCE:
Some studies: improved skin elasticity
Mechanism: collagen stimulation (theoretical)
Quality: small, poorly designed studies
Marketing exceeds: actual evidence
Recommendation: Moisturizer properties, not proven anti-aging miracle
Moisturizer/Skin Health - REASONABLE:
Hydration: gel is 99% water + polysaccharides
Non-greasy: good for some skin types
Soothing: subjective reports
Recommendation: Reasonable as moisturizer, many alternatives
INTERNAL/ORAL USES:
Digestive Health - MINIMAL EVIDENCE:
IBS (irritable bowel syndrome): one study showed benefit, needs replication
Inflammatory bowel disease: NO EVIDENCE
Acid reflux: NO EVIDENCE
General digestive health: mostly anecdotal
Safety concerns: laxative effects, potential for GI distress
Recommendation: Not recommended, better options available
Blood Sugar Control - WEAK EVIDENCE:
Some studies: modest reduction in fasting glucose (prediabetes/diabetes)
Effect size: small, inconsistent
Quality: small studies, heterogeneous
Not proven: as diabetes treatment
Drug interaction concern: may enhance glucose-lowering medications
Recommendation: Not recommended without medical supervision
Cholesterol - WEAK EVIDENCE:
Some studies: modest reduction in cholesterol
Inconsistent results
Small effect size
Better options: proven supplements exist (omega-3s, plant sterols)
Recommendation: Not recommended
Immune Support - NO EVIDENCE:
Theoretical: polysaccharide immune effects
Human studies: lacking
Test tube/animal: doesn't translate
Recommendation: No reason to use for immune support
Weight Loss - NO EVIDENCE:
Marketing claims: common but false
No mechanism: for fat burning
Laxative effect: water weight loss only (dangerous)
Recommendation: Avoid, does not cause fat loss
Detox/Cleanse - NO EVIDENCE:
Marketing term: no scientific meaning
Laxative products: dangerous misuse
Body detoxes: itself (liver, kidneys)
Recommendation: Avoid, potentially harmful
DENTAL USES:
Oral Health - WEAK EVIDENCE:
Mouthwash: some studies show reduced plaque, gingivitis
Tooth gel: one study showed benefit vs. toothpaste
Quality: small studies, needs replication
Recommendation: May try but not proven superior to standard products
Summary of Evidence:
Strong: None
Moderate: Minor burns (topical)
Weak: Psoriasis (topical), blood sugar (internal), cholesterol (internal)
Insufficient: Most other claims
Marketing hype: Far exceeds scientific support
Recommended Amounts & Usage
No Official RDA or Guidelines:
NOT an essential nutrient
No established recommended intake
Traditional use and manufacturer recommendations only
TOPICAL USE:
Burns/Sunburn:
Apply: pure aloe gel liberally to affected area
Frequency: 3-4 times daily or as needed
Duration: until healed
Amount: enough to cover area
Form: 100% pure gel or 98%+ aloe product
Wounds:
Clean wound: before application
Apply: thin layer of pure gel
Frequency: 2-3 times daily
Cover: with bandage if needed
Duration: until healed
Avoid: deep, infected, or surgical wounds without medical advice
Skin Conditions (Psoriasis, Eczema):
Apply: 0.5% aloe cream or pure gel
Frequency: 2-3 times daily
Duration: several weeks to assess benefit
Not replacement: for prescribed treatments
Moisturizer:
Apply: as needed
Face/body: after cleansing
Can use: daily
Amount: enough for light coverage
INTERNAL/ORAL USE (CAUTION):
Aloe Vera Juice:
Only use: decolorized, aloin-free, inner leaf only
Typical dose: 1-8 oz (30-240 mL) daily
Start low: 1-2 oz to assess tolerance
Dilute: with water or juice if desired
Timing: before meals or as directed
Duration: short-term use only (weeks, not months)
NOT recommended: for regular long-term use
Capsules/Supplements:
Typical dose: 100-500 mg daily
Follow: manufacturer recommendations
Start low: assess tolerance
Short-term: not for chronic use
Verify: aloin-free, quality product
IMPORTANT SAFETY LIMITS:
What to AVOID:
Whole leaf extract: contains aloin (laxative, potential carcinogen)
Non-decolorized products: latex/aloin present
Long-term daily use: internal consumption (>4 weeks concerning)
High doses: internal use (increased side effect risk)
DIY internal use: from home plants (can't ensure latex removal)
Quality Selection:
For Topical:
98-100% pure aloe vera gel
Minimal additives
Clear/slightly yellow gel (not brown - oxidized)
IASC certification: quality indicator
Refrigerate: after opening
For Internal:
Must be: decolorized, aloin-free
Inner leaf: fillet only
Third-party tested
Reputable brand
Check label: aloin content should be <10 ppm (parts per million)
Or avoid entirely: due to safety concerns
Safety, Side Effects & Toxicity
TOPICAL USE - Generally Safe:
Common Side Effects (Rare):
Allergic reaction: redness, itching, rash (1-2% of people)
Contact dermatitis: in sensitive individuals
Burning/stinging: if applied to open wounds
Test first: small area before widespread use
Allergic Reactions:
Cross-reactivity: with garlic, onions, tulips (Liliaceae family)
Symptoms: rash, hives, itching, swelling
Stop immediately: if allergic reaction
Anaphylaxis: extremely rare
Safety Concerns:
Delay wound healing: reported in some deep/surgical wounds
Avoid: on deep or infected wounds without medical guidance
Clean wounds: before application to reduce infection risk
INTERNAL USE - SIGNIFICANT SAFETY CONCERNS:
Common Side Effects:
Diarrhea/loose stools: even from decolorized products
Abdominal cramping: laxative effect
Electrolyte imbalance: from diarrhea
Nausea: reported by some users
Serious Concerns - Whole Leaf/Non-Decolorized:
Aloin (Anthraquinone) Toxicity:
Powerful laxative: severe diarrhea, cramping
Electrolyte depletion: potassium loss (dangerous)
Kidney damage: reported cases with chronic use
Liver toxicity: rare hepatitis cases
Potential carcinogen: animal studies show colorectal cancer risk
FDA action: removed from OTC laxatives in 2002
Contraindicated: in pregnancy (may cause uterine contractions)
Long-Term Use Risks:
Dependency: for bowel movements (laxative abuse)
Melanosis coli: dark pigmentation of colon (reversible)
Electrolyte imbalances: hypokalemia (low potassium) dangerous
Kidney dysfunction: chronic use associated with problems
Hepatitis: rare cases reported
DRUG INTERACTIONS:
Diabetes Medications:
Aloe may: lower blood sugar
Combined with meds: risk of hypoglycemia
Monitor glucose: closely
Dose adjustment: may be needed
Medical supervision: essential
Diuretics (Water Pills):
Laxative effect: increases potassium loss
Diuretics: also deplete potassium
Combined: dangerous hypokalemia
Avoid combination
Digoxin (Heart Medication):
Potassium depletion: from laxative effect
Low potassium: increases digoxin toxicity risk
Serious cardiac: effects possible
Avoid combination
Sevoflurane (Anesthetic):
May increase: bleeding risk during surgery
Stop aloe: 2 weeks before surgery
Warfarin (Blood Thinner):
May enhance: anticoagulant effect
Increased bleeding: risk
Avoid or monitor: INR closely
Other Laxatives:
Additive effect: with stimulant laxatives
Excessive: diarrhea and dehydration
Avoid combination
PREGNANCY & BREASTFEEDING:
Topical Use:
Likely safe: for minor burns, skin issues
No known risks: from external application
Reasonable: to use as needed
Internal Use:
AVOID: aloe latex/whole leaf (uterine contractions)
Caution: even decolorized products
No safety data: in pregnancy
Laxative effects: potentially harmful
Not recommended: during pregnancy
Breastfeeding:
Avoid internal: may pass to breast milk
Topical: likely safe
Laxative effects: could affect infant
Not recommended: internal use while nursing
CHILDREN:
Topical:
Generally safe: for minor burns, wounds
Test first: for sensitivity
Supervise use: ensure proper application
Internal:
NOT RECOMMENDED: for children
Safety not established: in pediatrics
Laxative effects: more dangerous in children
Better options: exist for any claimed benefits
CONTRAINDICATIONS:
Do NOT use aloe internally if:
Pregnant or breastfeeding
Children under 12
Kidney disease
Heart disease or taking heart medications
Diabetes (unless closely monitored)
Intestinal obstruction
Crohn's disease or ulcerative colitis
Hemorrhoids or rectal bleeding
Appendicitis
Abdominal pain of unknown cause
TOXICITY:
Topical:
No known toxicity: from external use
Allergic reactions: only concern
Internal:
Dose-dependent: toxicity from aloin
Acute toxicity: severe diarrhea, electrolyte imbalance, kidney damage
Chronic toxicity: cumulative damage from long-term use
Deaths reported: from misuse of aloe laxative products
Cancer Concern:
Whole leaf extract: containing aloin
Animal studies: increased colorectal tumors
Human relevance: unclear but concerning
Recommendation: avoid non-decolorized products
FDA & Regulatory Status:
FDA: removed aloe from OTC laxative products (2002) due to lack of safety data
Not approved: for any medical use
Dietary supplement: minimal regulation
IASC: voluntary industry standards
Bottom Line - Realistic Assessment
WHAT ALOE VERA IS GOOD FOR:
Topical Uses (Moderate Evidence):
Minor burns: sunburn, first-degree burns - provides relief, modestly speeds healing
Minor wounds: may help superficial cuts, abrasions
Skin irritation: soothing, moisturizing properties
Dry skin: acts as lightweight moisturizer
Practical Uses:
Keep plant or gel: for kitchen burns, sunburn
Cosmetic ingredient: in lotions, creams (moisturizer)
Soothing agent: cooling, non-greasy feel
WHAT ALOE VERA IS NOT:
NOT essential: no biological requirement
NOT a miracle cure: despite marketing
NOT proven: for most internal uses
NOT safe: for regular long-term internal use (especially whole leaf)
NOT for weight loss: dangerous laxative abuse
NOT superior: to proven treatments for most conditions
MARKETING VS. REALITY:
Exaggerated/False Claims:
"Detox" or "cleanse": meaningless marketing
Weight loss: NO EVIDENCE, dangerous laxative abuse
Cure diseases: false and dangerous
Anti-aging miracle: minimal evidence
Immune booster: NO EVIDENCE in humans
"Heals everything": completely false
Reality:
Modest topical benefits: for minor burns, wounds
Uncertain internal benefits: weak evidence, safety concerns
Mostly safe topically: generally well-tolerated
Risky internally: especially long-term or whole leaf
Better alternatives: exist for most claimed uses
RECOMMENDATIONS:
REASONABLE USES:
Topical for minor burns: Keep aloe gel for sunburn, kitchen burns
Moisturizer: If you like the texture and it works for your skin
Minor wounds: Superficial cuts, abrasions (not deep wounds)
Skin irritation: Soothing for mild irritation
NOT RECOMMENDED:
Internal use: Too many safety concerns, minimal proven benefits
Whole leaf products: Potential carcinogen, serious GI effects
Long-term daily internal use: Risk of cumulative toxicity
As primary treatment: For any medical condition
During pregnancy/breastfeeding: Internal use
For children: Internal use
IF CONSIDERING INTERNAL USE:
Only decolorized, aloin-free, inner leaf only products
Short-term only: weeks, not months
Low doses: start with smallest amount
Medical supervision: especially if on medications or have health conditions
Consider alternatives: better options for most uses
Or skip entirely: topical use safer and more proven
COST-BENEFIT ANALYSIS:
Better Alternatives:
For burns: Aloe is reasonable, but cool water, burn cream, or hydrocortisone also effective and proven
For digestive health: Probiotics, fiber, proven GI medications have better evidence
For blood sugar: Cinnamon, berberine, chromium have more evidence; lifestyle changes most important
For immune support: Vitamin D, zinc, vitamin C, elderberry have more evidence
For skin health: Many proven moisturizers, retinoids (anti-aging), niacinamide (acne)
Growing Your Own:
Easy houseplant: low maintenance
Fresh gel: for burns, wounds
Cost-effective: one plant provides years of use
Do NOT consume: latex removal impossible without proper processing
Summary & Key Takeaways
Aloe vera is a plant remedy with modest evidence for topical use on minor burns and wounds, but weak or lacking evidence for most other claims. Internal use has safety concerns that outweigh unclear benefits. It's NOT an essential nutrient and NOT necessary for health. Marketing dramatically exceeds science.
Critical Points:
NOT essential: no biological requirement, no deficiency disease
Topical use: reasonable for minor burns, wounds (moderate evidence)
Internal use: safety concerns outweigh minimal benefits
Two parts: gel (safer) vs. latex/aloin (dangerous)
Marketing hype: far exceeds actual evidence
FDA removed: aloe from OTC laxatives due to safety concerns (2002)
Potential carcinogen: whole leaf extract in animal studies
Evidence Quality:
Moderate: Topical for minor burns
Weak: Topical for psoriasis; internal for blood sugar/cholesterol
Insufficient: Most other claims
No evidence: Weight loss, detox, immune support, anti-aging miracle
Safety Summary:
Topical: Generally safe, rare allergic reactions
Internal (decolorized): Concerning even when aloin-removed
Internal (whole leaf): DANGEROUS - potential carcinogen, serious GI effects, kidney/liver damage
Long-term use: NOT recommended
Pregnancy: Avoid internal use
Practical Recommendations:
DO:
Use topically: for minor burns, sunburn
Keep plant/gel: for first aid
Choose pure products: 98-100% aloe for topical
Test for allergies: small area first
Use as moisturizer: if you like it
DON'T:
Use internally: unless medically supervised and short-term only
Use whole leaf: or non-decolorized products internally
Expect miracles: modest benefits at best
Use for weight loss: dangerous laxative abuse
Give to children: internally
Use during pregnancy: internally
Rely on for diseases: not a medical treatment
Bottom Line: Aloe vera is a reasonable topical treatment for minor burns and skin irritation with modest supporting evidence. Internal use is questionable - safety concerns (especially long-term) likely outweigh the weak and unproven benefits. Despite thousands of years of traditional use and massive marketing, high-quality clinical evidence is lacking for most applications. The FDA's removal of aloe from OTC laxative products due to safety concerns should give pause about internal use. For topical use on minor burns, aloe is fine and may help modestly. For anything else, better-proven alternatives exist. Don't prioritize aloe over essential nutrients (vitamins, minerals, omega-3s) that have clear evidence. If you have an aloe plant, great for occasional topical use on burns - but don't drink the gel, and don't expect it to cure diseases or transform your health.