Glucomannan, a mannose-rich polysaccharide, and gibberellin, a growth hormone, interacts with growth factor receptors on the fibroblast, thereby stimulating its activity and proliferation, which in turn significantly increases collagen synthesis after topical and oral Aloe vera. Aloe gel not only increased collagen content of the wound but also changed collagen composition (more type III) and increased the degree of collagen cross-linking. Due to this, it accelerated wound contraction and increased the breaking strength of resulting scar tissue. An increased synthesis of hyaluronic acid and dermatan sulfate in the granulation tissue of a healing wound following oral or topical treatment has been reported.




*Applications of Aloe vera based on a medical bibliography



The use of Aloe vera in hair loss began in ancient Egypt. The Aloe vera is rich in enzymes, vitamins and minerals. The activity of the enzymes removes dead skin cells from the scalp and allows the penetration of nutrients of Aloe vera in inner layers of the skin. Thus seborrheic dermatitis is combated, which is one of the causes of hair loss. Polysaccharides of Aloe vera contribute to the maximum natural hydration, providing moisture which is essential for hair. At the same time, it creates a grid, preventing moisture loss. In this way, the hair becomes soft, shiny and more resistant to atmospheric pollution and climate variations. The removal of dead cells (antifungal activity) in combination with anti-inflammatory and antimicrobial properties of Aloe vera, due largely to the action of bradykinesia (enzyme) and salicylic acid (the active ingredient of aspirin), treat itching, dandruff, eczema and psoriasis.


Aloe vera gel has been reported to have a protective effect against radiation damage to the skin. Exact role is not known, but following the administration of aloe vera gel, an antioxidant protein, metallothionein, is generated in the skin, which scavenges hydroxyl radicals and prevents suppression of superoxide dismutase and glutathione peroxidase in the skin. It reduces the production and release of skin keratinocyte-derived immunosuppressive cytokines such as interleukin-10 (IL-10) and hence prevents UV-induced suppression of delayed-type hypersensitivity


Aloe vera inhibits the cyclooxygenase pathway and reduces prostaglandin E2 production from arachidonic acid. Recently, the novel anti-inflammatory compound called C-glucosyl chromone was isolated from gel extracts.


Alprogen inhibits calcium influx into mast cells, thereby inhibiting the antigen-antibody-mediated release of histamine and leukotriene from mast cells. In a study on mice that had previously been implanted with murine sarcoma cells, acemannan stimulates the synthesis and release of interleukin-1 (IL-1) and tumor necrosis factor from macrophages in mice, which in turn initiated an immune attack that resulted in necrosis and regression of the cancerous cells. Several low-molecular-weight compounds are also capable of inhibiting the release of reactive oxygen free radicals from activated human neutrophils.


Anthraquinones present in latex are a potent laxative. It increases intestinal water content, stimulates mucus secretion and increases intestinal peristalsis.


These actions may be due to indirect or direct effects. An indirect effect is due to stimulation of the immune system and direct effect is due to anthraquinones. The anthraquinone aloin inactivates various enveloped viruses such as herpes simplex, varicella zoster and influenza. In recent studies, a polysaccharide fraction has shown to inhibit the binding of benzopyrene to primary rat hepatocytes, thereby preventing the formation of potentially cancer-initiating benzopyrene-DNA adducts. An induction of glutathione S-transferase and an inhibition of the tumor-promoting effects of phorbol myristic acetate has also been reported which suggest a possible benefit of using aloe gel in cancer chemoprevention.


Mucopolysaccharides help in binding moisture into the skin. Aloe stimulates fibroblast which produces the collagen and elastin fibres making the skin more elastic and less wrinkled. It also has cohesive effects on the superficial flaking epidermal cells by sticking them together, which softens the skin. The amino acids also soften hardened skin cells and zinc acts as an astringent to tighten pores. Its moisturizing effects have also been studied in the treatment of dry skin associated with occupational exposure where aloe vera gel gloves improved the skin integrity, decreases the appearance of fine wrinkle and decreases erythema. It also has an anti-acne effect.


Aloe vera contains 6 antiseptic agents: Lupeol, salicylic acid, urea nitrogen, cinnamonic acid, phenols and sulfur. They all have an inhibitory action on fungi, bacteria and viruses.


The antibacterial activity of the plant juice was found mainly against the Gram-positive bacteria. Reports have mainly focused on the antidiabetic, anticancer and antimicrobial properties of the whole leaf, gel, or juice of the plant. Whole-leaf components proposed to have direct antibacterial properties include anthraquinones and saponins, while polysaccharides have been attributed with indirect bactericidal activity through stimulation of phagocytic leukocytes to destroy bacteria.

Anthraquinones contain phenolic compounds which are found exclusively in the plant sap. The important ones, aloin, aloe-emodin and barbaloin, act as painkillers. They also function as antibacterials and antivirals. It was also, reported to have anti-inflammatory activity. Saponins are capable of cleansing and having antiseptic properties. They act powerfully as antimicrobials against bacteria, viruses, fungi and yeasts.


Aloe vera has been used as a popular herbal medicine since ancient times for many conditions including burns. Much evidence has reported the efficacy of topical Aloe vera gel in the treatment of thermal burns through its different pharmacological actions. The mechanisms that may underlie its action include: anti-inflammation, antimicrobials, wound healing promotion, and biological/immunological modulation.


The use of aloe vera is being promoted for a large variety of conditions. The extensive literature search was carried out to identify all in vitro and in vivo studies as well as clinical trials on aloe vera preparations. Data were extracted from these in a predefined standardized manner. Forty studies were located. The results suggest that oral administration of aloe vera in mice is effective on wound healing, can decrease the number and size of papillomas and reduce the incidence of tumors and leishmania parasitemia by >90% in the liver, spleen, and bone marrow. Topical application of aloe vera can be effective for genital herpes, psoriasis, human papillomavirus, seborrheic dermatitis, aphthous stomatitis, xerosis, lichen planus, frostbite, burn, wound healing and inflammation. It can also be used as a biological vehicle and an anti-microbial and antifungal agent and also as a candidate for photodynamic therapy of some kinds of cancer.


In recent years, more head and neck cancer patients have been treated with radiotherapy. Radiation-induced mucositis is a common and dose-limiting toxicity of radiotherapy among patients with head and neck cancers. Patients undergoing radiation therapy for head and neck cancer are also at increased risk of developing oral candidiasis. A number of new agents applied locally or systemically to prevent or treat radiation-induced mucositis have been investigated, but there is no widely accepted prophylactic or effective treatment for mucositis. Topical Aloe vera is widely used for mild sunburn, frostbites, and scalding burns. Studies have reported the beneficial effects of Aloe gel for wound healing, mucous membrane protection, and treatment of oral ulcers, in addition to anti-inflammatory, immunomodulation, antifungal, scavenging free radicals, increasing collagen formation and inhibiting collagenase. Herein the author postulates that oral Aloe vera mouthwash may not only prevent radiation-induced mucositis by its wound healing and anti-inflammatory mechanism but also may reduce oral candidiasis of patients undergoing head and neck radiotherapy due to its antifungal and immunomodulatory properties. Hence, Aloe vera mouthwash may provide an alternative agent for treating radiation-induced oral mucositis and candidiasis in patients with head and neck cancers.