Bioactives → Aloe Vera

What is Aloe Vera?

Aloe vera (Aloe barbadensis Miller), a perennial succulent plant, has long been revered for its therapeutic properties, particularly in wound healing and skin regeneration. Recent scientific studies have provided further evidence of its medicinal potential, demonstrating that Aloe vera exhibits a broad spectrum of beneficial effects, including anti-inflammatory, antioxidant, antimicrobial, and immunomodulatory actions [1,5].

The therapeutic efficacy of Aloe vera is attributed to the biochemical composition of its leaves, which are structured into three distinct layers [3]. The outer rind synthesises carbohydrates and proteins, while the middle latex layer contains anthraquinones and glycosides. The inner gel, comprising approximately 99% water and 1% solid matter [3], has been the focus of extensive research due to its rich content of over 75 bioactive compounds, including polysaccharides, phenolic compounds, vitamins (vitamin A, C, E, and B12), amino acids, enzymes, and minerals (e.g., zinc, magnesium, selenium, and calcium) [4,6]. These compounds promote growth factor release, mitigate oxidative stress, and facilitate tissue repair and regeneration through diverse biochemical pathways [4,7].

Wound Healing Enhancement

Aloe polysaccharides are the cornerstone of Aloe vera's wound healing properties, particularly due to their anti-inflammatory, immunomodulatory, and regenerative effects [8]. Prominent polysaccharides such as acemannan and acetylated polymannan have been shown to modulate the expression of inflammatory cytokines, notably suppressing IL-5, IL-10, and matrix metalloproteinase-9 (MMP-9) [9]. Through these mechanisms, Aloe vera mitigates excessive inflammation, an essential step in early wound repair.

Furthermore, acemannan upregulates cyclin D1 expression, thereby promoting the proliferation of skin fibroblast and facilitating the progression of the cell cycle from the G1 to the S phase [5,10–11]. This effect accelerates the formation of granulation tissue and stimulates neovascularisation, both of which are crucial for effective wound repair [8]. Additionally, acemannan enhances the synthesis of vascular endothelial growth factor and type I collagen [11], which are critical in endothelial cell proliferation, migration, and the formation of extracellular matrix (ECM) during the healing process [8].

Another key polysaccharide, mannose-6-phosphate, binds to fibroblast receptors to stimulate cell proliferation, collagen deposition, and epithelialisation [8]. This process not only promotes tissue regeneration but also reduces fibrotic scarring by inhibiting the activation of transforming growth factor-beta (TGF-β1 and TGF-β2), thereby modulating the balance between tissue repair and fibrosis [5,8]. Collectively, these polysaccharides enhance the structural integrity of the newly formed tissue while minimising the occurrence of excessive scarring, further optimising wound healing outcomes.

Antioxidant and Photoprotective Properties

Phenolic compounds in Aloe vera are well-documented for their antioxidant properties, with studies indicating a significant correlation between their presence and enhanced free radical scavenging activity [7]. These compounds, including flavonoids, tannins, aloin, and aloesin, actively neutralise oxidative stress, which contributes to cellular protection [12]. In addition, aloin and aloesin have been shown to provide further dermatological benefits, including photoprotection against UV-induced cellular damage [13–15], reduction in pigmentation [15], and anti-inflammatory effects that help alleviate sunburn-related irritation [7,16].

The Regenerative Effects

Aloe vera gel contains a range of vitamins that further enhance wound healing by promoting antioxidant defence, collagen synthesis, and immunomodulation. Vitamin E functions as an antioxidant, protecting tissues from oxidative damage by neutralising reactive oxygen species, which can interfere with cellular repair mechanisms and delay wound healing [8,17]. It also modulates the expression of connective tissue growth factor, a regulator of ECM remodelling, and has been associated with protection against pathogenic infections, including those caused by methicillin-resistant Staphylococcus aureus [8].

Vitamin C contributes to collagen biosynthesis by serving as a cofactor in the hydroxylation of proline and lysine during procollagen maturation [8,18]. This process supports the structural stability and tensile strength of regenerated tissue.

Applications of Aloe Vera

Aloe vera is extensively acknowledged for its therapeutic properties in wound care. A meta-analysis by Sharma (2022) indicates that topical administration of Aloe vera significantly accelerates the healing of second-degree burn wounds, promoting faster recovery compared to conventional treatment options [19]. Furthermore, Aloe vera has been shown to enhance wound epithelialisation and provide superior analgesic effects when compared to 1% silver sulfadiazine cream, a standard intervention for partial-thickness burns [20].

Randomised controlled trials have examined the effects of Aloe vera on post-surgical wound healing. One study reported improved wound healing following cesarean section when Aloe vera was applied post-operatively [21], while another demonstrated accelerated recovery at split-thickness skin graft donor sites [22]. Beyond acute wound management, Aloe vera has also been investigated for its potential benefits in chronic wounds, including psoriatic lesions [23,24]. By inhibiting pro-inflammatory cytokines, including TNF-α and IL-8, and enhancing keratinocyte repair, Aloe vera polysaccharides have been shown to play a role in mitigating psoriasis-associated inflammation [4].

In the management of radiodermatitis, Aloe vera has been examined as both a protective and therapeutic agent. While some studies have reported a reduction in dermatitis when Aloe vera is applied prophylactically or after radiotherapy [14,25–26], other studies have found no significant benefit in reducing the prevalence or severity of radiotherapy-induced dermatitis [27–29]. These mixed findings underscore the need for further clinical trials to establish the role of Aloe vera in preventing and treating radiodermatitis.

Conclusion

The therapeutic efficacy of Aloe vera in wound healing is a result of its bioactive components, including polysaccharides, phenolic compounds, and essential vitamins. Through its anti-inflammatory, immunomodulatory, and antioxidant mechanisms, Aloe vera accelerates fibroblast proliferation, enhances collagen deposition, and promotes epithelialisation while reducing excessive fibrosis. Given its established therapeutic potential, cost-effectiveness, accessibility, and favourable safety profile, Aloe vera represents an effective alternative to conventional wound healing treatments.

References

1. Das S, Mishra B, Gill K, Ashraf MS, Singh AK, Sinha M, et al. Isolation and characterization of novel protein with anti-fungal and anti-inflammatory properties from Aloe vera leaf gel. Int J Biol Macromol. 2011 Jan 1;48(1):38–43.

2. Sahu PK, Giri DD, Singh R, Pandey P, Gupta S, Shrivastava AK, et al. Therapeutic and medicinal uses of Aloe vera: a review. Pharmacology & Pharmacy. 2013;4(08):599.

3. Maan A, Nazir A, Khan M, Ahmad T, Zia R, Murid M, et al. The therapeutic properties and applications of Aloe vera: A review. J Herb Med. 2018;12.

4. Sánchez M, González-Burgos E, Iglesias I, Gómez-Serranillos MP. Pharmacological Update Properties of Aloe Vera and its Major Active Constituents. Molecules. 2020 Mar 13;25(6):1324.

5. Lee ZM, Goh BH, Khaw KY. Aloe vera and the Proliferative Phase of Cutaneous Wound Healing: Status Quo Report on Active Principles, Mechanisms, and Applications. Planta Med. 2025 Jan;91(1–02):4–18.

6. Hamman JH. Composition and applications of Aloe vera leaf gel. Molecules. 2008;13(8):1599–1616.

7. Iosageanu A, Mihai E, Seciu-Grama AM, Utoiu E, Gaspar-Pintiliescu A, Gatea F, et al. In Vitro Wound-Healing Potential of Phenolic and Polysaccharide Extracts of Aloe vera Gel. J Funct Biomater. 2024 Sep 13;15(9):266.

8. Liang J, Cui L, Li J, Guan S, Zhang K, Li J. Aloe vera: A Medicinal Plant Used in Skin Wound Healing. Tissue Eng Part B Rev. 2021 Oct;27(5):455–474.

9. Oryan A, Mohammadalipour A, Moshiri A, Tabandeh MR. Topical Application of Aloe vera Accelerated Wound Healing, Modeling, and Remodeling: An Experimental Study. Ann Plast Surg. 2016 Jan;77(1):37–46.

10. Xing W, Guo W, Zou CH, et al. Acemannan accelerates cell proliferation and skin wound healing through AKT/mTOR signaling pathway. J Dermatol Sci. 2015 Aug;79(2):101–109.

11. Liu C, Cui Y, Pi F, Cheng Y, Guo Y, Qian H. Extraction, Purification, Structural Characteristics, Biological Activities and Pharmacological Applications of Acemannan, a Polysaccharide from Aloe vera: A Review. Molecules. 2019 Apr 19;24(8):1554.

12. Radha MH, Laxmipriya NP. Evaluation of biological properties and clinical effectiveness of Aloe vera: A systematic review. J Tradit Complement Med. 2014 Dec 23;5(1):21–26.

13. Saini DK, Saini MR. Evaluation of radioprotective efficacy and possible mechanism of action of Aloe gel. Environ Toxicol Pharmacol. 2011 May;31(3):427–435.

14. Haddad P, Amouzgar-Hashemi F, Samsami S, Chinichian S, Oghabian MA. Aloe vera for prevention of radiation-induced dermatitis: a self-controlled clinical trial. Curr Oncol. 2013 Aug;20(4):e345–348.

15. Rodrigues D, Viotto AC, Checchia R, et al. Mechanism of Aloe Vera extract protection against UVA: shelter of lysosomal membrane avoids photodamage. Photochem Photobiol Sci. 2016 Mar;15(3):334–350.

16. Park MY, Kwon HJ, Sung MK. Evaluation of aloin and aloe-emodin as anti-inflammatory agents in aloe by using murine macrophages. Biosci Biotechnol Biochem. 2009 Apr 23;73(4):828–832.

17. Hobson R. Vitamin E and wound healing: an evidence-based review. Int Wound J. 2016 Jun;13(3):331–335.

18. Sinno S, Lee DS, Khachemoune A. Vitamins and cutaneous wound healing. J Wound Care. 2011 Jun;20(6):287–293.

19. Sharma S, Alfonso AR, Gordon AJ, et al. Second-Degree Burns and Aloe Vera: A Meta-analysis and Systematic Review. Adv Skin Wound Care. 2022 Nov 1;35(11):1–9.

20. Shahzad MN, Ahmed N. Effectiveness of Aloe Vera Gel compared with 1% silver sulphadiazine cream as burn wound dressing in second degree burns. J Pak Med Assoc. 2013;63:225–230.

21. Molazem Z, Mohseni F, Younesi M, Keshavarzi S. Aloe vera gel and cesarean wound healing; a randomized controlled clinical trial. Glob J Health Sci. 2014 Aug 31;7(1):203–209.

22. Burusapat C, Supawan M, Pruksapong C, et al. Topical Aloe Vera Gel for Accelerated Wound Healing of Split-Thickness Skin Graft Donor Sites: A Double-Blind, Randomized, Controlled Trial and Systematic Review. Plast Reconstr Surg. 2018 Jul;142(1):217–226.

23. Armstrong AW, Read C. Pathophysiology, Clinical Presentation, and Treatment of Psoriasis: A Review. JAMA. 2020 May 19;323(19):1945–1960.

24. Jales STL, Barbosa RDM, de Albuquerque AC, et al. Development and Characterization of Aloe vera Mucilaginous-Based Hydrogels for Psoriasis Treatment. J Compos Sci. 2022;6:231.

25. Tungkasamit T, Chakrabandhu S, Samakgarn V, et al. Reduction in severity of radiation-induced dermatitis in head and neck cancer patients treated with topical aloe vera gel: A randomized multicenter double-blind placebo-controlled trial. Eur J Oncol Nurs. 2022 Aug;59:102164.

26. Rao S, Hegde SK, Baliga-Rao MP, et al. An Aloe Vera-Based Cosmeceutical Cream Delays and Mitigates Ionizing Radiation-Induced Dermatitis in Head and Neck Cancer Patients Undergoing Curative Radiotherapy: A Clinical Study. Medicines (Basel). 2017 Jun 24;4(3):44.

27. Hoopfer D, Holloway C, Gabos Z, et al. Three-Arm Randomized Phase III Trial: Quality Aloe and Placebo Cream Versus Powder as Skin Treatment During Breast Cancer Radiation Therapy. Clin Breast Cancer. 2015 Jun;15(3):181–190.e1–4.

28. Ahmadloo N, Kadkhodaei B, Omidvari Sh, et al. Lack of Prophylactic Effects of Aloe Vera Gel on Radiation Induced Dermatitis in Breast Cancer Patients. Asian Pac J Cancer Prev. 2017 Apr 1;18(4):1139–1143.

29. Farrugia CE, Burke ES, Haley ME, et al. The use of aloe vera in cancer radiation: An updated comprehensive review. Complement Ther Clin Pract. 2019 May;35:126–130.