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Aloe Vera: General and Dental Implications – Overview of Literature



Plants have been a major source of medicine since ancient times. Natural plant products have been used throughout human history for various purposes. Natural plant medicines have been a boon in the health care of both ancient and modern cultures. A wide range of disorders have been treated by the Indian system of holistic medicine known as " Ayurveda, " which uses mainly plant-based drugs or formulations. Aloe vera is a medicinal plant with anti-inflammatory, antimicrobial, antioxidant and immuneboosting properties. The use Aloe vera in treatment of various oral and dental conditions is increasing day by day, thereby gaining attention by the researchers. This article briefly reviews the history, mechanism of action and uses of Aloe vera in dermatological and dental conditions.
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1 Journal of Orofacial and Health Sciences 5(1), 2014
Aloe Vera: General and Dental Implications – Overview
of Literature
Shamimul Hasan
*, Sarah Asif
, Shakeba Quadri
Plants have been a major source of medicine since ancient times. Natural plant products have
been used throughout human history for various purposes. Natural plant medicines have been
a boon in the health care of both ancient and modern cultures. A wide range of disorders have
been treated by the Indian system of holistic medicine known as “Ayurveda,” which uses mainly
plant-based drugs or formulations. Aloe vera is a medicinal plant with anti-inflammatory,
antimicrobial, antioxidant and immuneboosting properties. The use Aloe vera in treatment of
various oral and dental conditions is increasing day by day, thereby gaining attention by the
researchers. This article briefly reviews the history, mechanism of action and uses of Aloe vera
in dermatological and dental conditions.
Keywords: Aloe vera, Dentistry, Medicinal plants
1Assistant Professor,
Department of Oral Medicine
and Radiology, Faculty of
Dentistry Jamia Millia Islamia,
New Delhi, India.
2Z.A. Dental College &
Hospitals Aligarh Muslim
University Aligarh, India.
Received : 15/02/14
Review completed : 11/03/14
Accepted : 19/03/14
Prevention and treatment of oral infections has been
taken care by many medicinal plants and their products,
and among them Aloe vera is of particular interest and
has been used therapeutically for a long time. The name
Aloe vera is derived from the Arabic word “Alloeh”
meaning shining bitter substance and “vera” in Latin
means true. The Greek scientists considered aloe vera
as the universal panacea.
Aloe vera is a cactus plant that belongs to the Liliaceae
family. More than 300 species of aloe plants exist, but
only 2 species Aloe barbadensis Miller and Aloe
aborescens have been studied. The aloe plant is grown
in warm, tropical areas and cannot survive freezing
temperatures. The efficacy of Aloe barbadensis Miller
increases when the plant is harvested after years of
growth, but its nutritive potency decreases after 12 years
of growth. If aloe vera is exposed to sunlight for more
than hours, it will lose its complete potency (because of
easy oxidation); therefore, it is necessary to stabilize it
under pharmaceutical standards for ready use and longer
shelf life.
The Aloe barbadensis plant consists of two different
parts, each part produces substances with completely
different compositions and therapeutic properties. The
parenchymal tissue makes up the inner portion of the
aloe leaves and produces the aloe vera gel (or mucilage),
a clear, thin, tasteless, jelly-like material. This tissue is
recovered from the leaf by separating the gel from the
inner cellular debris. The other part of the plant is a group
of specialized cells known as the pericyclic tubules,
which occur just beneath the outer green rind of the leaf.
These cells produce an exudate that consists of bitter
yellow latex with powerful laxative-like actions. This
exudate which is not to be confused with the gel/
mucilage from the parenchymal leaf tissue is available
commercially for systemic ingestion to produce
Aloe vera has been used for medicinal purposes in
several cultures for millennia: Greece, Egypt, India,
Mexico, Japan and China. Egyptian queens Nefertiti and
Cleopatra used it as part of their regular beauty regimes.
Alexander the Great and Christopher Columbus used it
Address for correspondence:
Shamimul Hasan
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2Journal of Orofacial and Health Sciences 5(1), 2014
Aloe Vera: General and Dental Implications – Overview of Literature Shamimul Hasan
et al.
to treat soldiers wounds. The first reference to aloe vera
in English was a translation by John Goodyew in 1655
A.D. of Dioscoridesí Medical treatise De Materia
1. Wound-Healing Effects. Glucomannan, a
mannose-rich polysaccharide, and gibberellin, a growth
hormone, interact with growth factor receptors on the
fibroblast, thereby stimulating their activity and
proliferation, which in turn significantly increases
collagen synthesis after topical and oral aloe vera
treatment. Aloe gel increases the collagen content of the
wound and also alters the collagen composition (more
type III), thus increasing the collagen cross linking. This
hastens the wound contraction and increases the breaking
strength of the resultant scar tissue Reports of increased
hyaluronic acid and dermatan sulphate in the granulation
tissue of healing wound following oral or topical aloe
vera treatment has also been documented. Davis et al
noted that aloe vera gel improved wound healing by
increasing blood supply; increased oxygenation, which
results in increased fibroblast activity and collagen
2. Moisturizing Effects: The moisturizing effect of aloe
vera gel appears to be due to the mix of water and
polysaccharide components, creating a jelly-like
consistency that holds the water within the mix and
minimizes its evaporation, providing a sustained moist
environment when applied to drying tissues and
humectant properties that promote retention of moisture
in tissuesThe amino acid also softens the hardened skin
cells and zinc acts as an astringent to tighten pores. It
also improves skin integrity in patients with dry skin
due to occupational exposure, decreasing the appearance
of fine wrinkles and erythema.
3. Prevention of Radiation Damage to the Skin: Aloe
vera gel has been reported to have a protective effect
against radiation damage to the skin. 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. Aloe vera also reduces the formation and release
of keratinocyte-derived immunosuppressive cytokines
like interleukin-10 (IL-10) and hence prevents ultraviolet
induced suppression of delayed type hypersensitivity.
4. Anti-inflammatory Effects: Reports by various
research showed that aloe vera has anti-inflammatory
action. Fujita et al stated that carboxypeptidase in aloe
vera relieves pain by inactivating bradykinin by 67%.
Bautista et al stated that carboxypeptidase in aloe vera
inhibits prostaglandin synthesis andarachidonic acid,
thus a potent anti-inflammatory agent. Salicylate
magnesium lactate decarboxylase in aloe vera inhibits
histidine, thus preventing the formation of histamine
from histidine in mast cells. Vazquez et al stated that
aloe vera decreases edema and number of neutrophils
and also prevents the migration of poly morpho nuclear
leuocytes (PMNs). Aloe vera inhibited cyclo-oxygenase
and lipo-oxygenase pathways by inhibiting the
stimulated granulocyte matrix metalloproteinases
(MMPs). Hart et al in an in vivo study stated that aloe
vera depleted the chemical and alternate pathways of
complement activity to inhibit the production of free
oxygen radicals by activated PMNs.
5. Effects on the Immune System: Alprogen inhibit
calcium influx into mast cells, thereby inhibiting the
antigen antibody mediated release of histamine and
leukotriene from mast cells.Acemannan stimulates the
synthesis and release of IL-1 and necrosis factor from
macrophages in mice, initiating an immune response and
resulting in necrosis and regression of the cancerous
6. Antibacterial, Antifungal and Antiviral Effects: The
antimicrobial effects of aloe vera have been attributed
to the plant’s natural anthraquinones: aloe emodin,
aloetic acid, aloin, anthracine, anthranol, barbaloin,
chrysophanic acid, ethereal oil, ester of cinnamonic acid,
isobarbaloin, and resistannol. In relatively small
concentrations together with the gel fraction, these
anthraquinones provide analgesic, antibacterial,
antifungal and antiviral activity; in high concentrations,
they can be toxic. It is noteworthy that some compounds
like anthraquinones and saponin present in aloe vera gel
have direct antibacterial activities, while some other
components, such as acemannan, have been considered
to exert indirect bactericidal activity through the
stimulation of phagocytosis.
7. Anti-tumor Effects: 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
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Journal of Orofacial and Health Sciences 5(1), 2014 3
Aloe Vera: General and Dental Implications – Overview of Literature Shamimul Hasan
J et al.
Aloe vera was used in the gingivectomy sites and showed
that healing was better and faster. Aloe vera can also be
used as a local drug delivery system.
2. Wound Healing of Extraction Sites: Application of
aloe vera to the extraction sites results in proper healing
and prevention of dry socket formation. Studies
suggested that the SaliCept Patch (containing acemannan
hydrogel) resulted in significant reduction in the
incidence of alveolar osteitis as compared to
clindamycin-soaked Gelfoam.
3. Lichen Planus With Systemic Involvement: Hayes
first described the use of aloe vera juice and aloe vera
gel for the treatment of oral lichen planus. Choonhakarn
et al. used 70% aloe vera gel for lichen planus,that
healing was better and faster. Treatment regimen
involved 3 times daily drinking of 2 ounces of aloe vera
juice and topical application with aloe vera lip balm and
aloe vera cream for itching hands. Treatment caused
clearing of oral lesions within 4 weeks, although the
systemic took some longer time to clear.
4. Apthous ulcers: Studies have shown that acemannan
hydrogel accelerates the healing of aphthous ulcers and
reduces the pain associated with them. Acemannan
hydrogel is advantageous as it does not have a
disagreeable taste and texture associated with traditional
therapies and does not sting when applied. Garnick et al
evaluated the effect of a gel containing allantoin, aloe
vera and silicon dioxide on apthous ulcers of the oral
cavity. Application of the gel on the ulcers for a period
of 3 to 4 months resulted in the reduction of number,
size, duration, interval and pain associated with apthous
ulcers. A recent study using 2% aloe vera oral gel was
carried out, and it not only decreased the pain score and
wound size but also decreased the apthous wound
healing period.
5. In Denture Adhesive Formulations: The inherent
sticky/viscous nature of makes it ideal for denture
adhesive formulations. Studies have reported that
acemannan formulations of 150:1 (containing 0.05%
benzalkonium chloride, 0.1% methylparaben and 0.01%
hyamine 1622) exhibited ideal adhesive strength and pH
and minimal cytotoxicity.
6.Anti-Caries Agent: Studies using aloe vera in
toothpastes have shown that aloe vera tooth gel and the
toothpastes were equally effective against Candida
benzopyrene–deoxyribonucleic acid adducts. An
induction of glutathione S-transferase and an inhibition
of the tumour-promoting effects of phorbol myristic
acetate have also been reported, suggesting a possible
benefit of using aloe gel in cancer chemoprevention.
8. Other Effects: Aloin and aloe–emodin possess
laxative, hepatoprotective, and antineoplastic
characteristics. Saponins, which contain glycoside, are
soapy substances that have both cleansing and antiseptic
properties. Aloe vera is a potent nutraceutical, as aloe
vera gel showed a significant increase in body weight
and hematological parameters and antioxidant
Aloe vera may be used in a variety of clinical conditions,
although controlled trials are essential to determine its
effectiveness in the following conditions:
1. Uses based on scientific evidence: These uses have
been tested in humans or animals and safety and
effectiveness have not always been proved.
Conditions: Seborrheic dermatitis, psoriasis vulgaris,
genital herpes, skin burns, diabetes type 2), HIV
infection, cancer prevention, ulcerative colitis, pressure
ulcers, mucositis, radiation dermatiti, acne vulgaris,
frostbite and constipation.
2. Uses based on tradition or theory: These have not
thoroughly been tested and safety and effectiveness have
not always been proved.
Conditions: Alopecia, bacterial and fungal skin
infections, chronic leg wounds, parasitic infections,
systemic lupus erythematosus, arthritis and tic
Aloe vera is used in a variety of oral conditions.
1. Gingival and Periodontal Conditions: Periodontal
conditions show marked improvement after subgingival
administration of aloe vera gel. Aloe vera is extremely
helpful in the treatment of gum diseases like gingivitis
and periodontitis. Bleeding, inflammation and swelling
of the gums is markedly reduced. It works as a powerful
antiseptic in pockets where normal cleaning is difficult.
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4Journal of Orofacial and Health Sciences 5(1), 2014
Aloe Vera: General and Dental Implications – Overview of Literature Shamimul Hasan
et al.
albicans, Streptococcus mutans, Lactobacillus
acidophilus, Enterococcus faecalis, Prevotella
intermedia and Peptostreptococcus anaerobius. Aloe
vera tooth gel demonstrated enhanced antibacterial effect
against Streptococcus mitis. As these microorganisms
are the causative agents in dental caries, aloe vera has a
role as anti-caries agent.
7. Radiation Ulcers of Mucous Membranes: Modern
use of aloe vera was first documented in the 1930s to
heal radiation burns. Role of aloe vera in the treatment
of radiation ulcerations of the mucous membranes has
also been documented.
8. Root Canal Medicament: Aloe vera has been used
in root canal treatment as a sedative dressing and file
lubrication during biomechanical preparation.
9. Miscellaneous Uses: Aloe vera sprays can be used
for painful tooth eruptions, joint pains and throat
Rarely, cases of reversible hepatotoxicity, contact
dermatitis, and mild itching have been documented,
although no adverse side effects of aloe vera have been
reported in humans. Risk of colorectal cancer may be
seen on prolonged use. Electrolyte imbalances (low
potassium levels) may be seen due to the plant’s laxative
Use of aloe vera should be done with precautions during
pregnancy, lactation and in case of allergy toLiliaecea
family. Aloe vera can cause stimulation of uterine
contractions during pregnancy and during lactation, it
may cause gastrointestinal distress in the nursing infant.
Aloe vera is a natural plant that has gained importance
in cosmetic field. Dental implications of this medicinal
plant are increasing day by day, although controlled trials
are essential to determine the real efficacy.
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How to cite this article: Hasan S, Asif S and Quadri S, Aloe Vera: General
and Dental Implications – Overview of Literature. JOHS 2014; 5(1), 1-5
Source of Support: Nil, Conflict of Interest: None declared
... This is causing damage the cell membrane of bacteria results in bacterial lysis and death. (29,31) This result was in agreement with Prabhakar et al., 2015 (11) who evaluated the efficacy of Aloe Vera and propolis as cavity disinfecting agents for minimally invasive hand excavation of dental caries. They found Aloe Vera extracts showed a significant reduction in the bacterial counts. ...
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Abstract Objective: To evaluate the antibacterial effect of Aloe Vera and glass ionomer modified by Aloe Vera on Streptococcus mutans in comparison to Chlorhexidine. Methods: A total of fifty samples were used in the study and divided into 5 groups according to the materials used (n=10) Group 1:2% Chlorhexidine gluconate(CHX); Group 2: Aloe Vera (AV); Group 3: Glass ionomer (GI); Group 4: 2% Chlorhexidine gluconate added to glass ionomer (CHX+ GI) and Group 5: Aloe Vera added to glass ionomer (AV+GI) and. The antibacterial effect of each group were assessed by disc diffusion methods after two-time intervals: 24 and 48 hours. Data were tabulated and statistically analyzed using Two-way ANOVA followed by Bonferroni’s post-hoc test. Results: There was a statistically significant difference between the materials used on inhibition zone diameter after 24 and 48 hours. CHX showed the statistically significantly highest mean inhibition zone diameter followed by AV > CHX + GI > AV + GI. GI group showed the lowest mean inhibition zone diameter with a statistically significantly. Conclusion: Aloe Vera is beneficial in the inhibition of Streptococcus mutans growth up to 48 hours. The incorporation of Aloe Vera in glass ionomers seems to improve the antibacterial activity of glass ionomer restoration.
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Oral hygiene products have been used widely among people since many years ago. Toothpaste and mouthwashes are the main products that are used for health and beauty and the demand for such dental products is high. These products include both chemical and herbal products. Plants form a large part of the surrounding nature, so they are the first choice for health problems. Nevertheless, due to the fast development of chemistry and lack of natural resources herbal products are replaced by chemical compounds. Compared with herbal products, chemical compounds are associated with more side effects, so using herbal drugs are more favorable and researchers are more interested to such products. In oral hygiene drugs the plant extracts affecting inflammation and bleeding are of significant interest to dental professionals. This article introduces one of the most common herbal drugs used as oral care product. © 2016, Mazandaran University of Medical Sciences. All rights reserved.
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Big Data (BD), with their potential to ascertain valued insights for enhanced decision-making process, have recently attracted substantial interest from both academics and practitioners. Big Data Analytics (BDA) is increasingly becoming a trending practice that many organizations are adopting with the purpose of constructing valuable information from BD. The analytics process, including the deployment and use of BDA tools, is seen by organizations as a tool to improve operational efficiency though it has strategic potential, drive new revenue streams and gain competitive advantages over business rivals. However, there are different types of analytic applications to consider. Therefore, prior to hasty use and buying costly BD tools, there is a need for organizations to first understand the BDA landscape. Given the significant nature of the BD and BDA, this paper presents a state-of-the-art review that presents a holistic view of the BD challenges and BDA methods theorized/proposed/employed by organizations to help others understand this landscape with the objective of making robust investment decisions. In doing so, systematically analysing and synthesizing the extant research published on BD and BDA area. More specifically, the authors seek to answer the following two principal questions: Q1 – What are the different types of BD challenges theorized/proposed/confronted by organizations? and Q2 – What are the different types of BDA methods theorized/proposed/employed to overcome BD challenges?. This systematic literature review (SLR) is carried out through observing and understanding the past trends and extant patterns/themes in the BDA research area, evaluating contributions, summarizing knowledge, thereby identifying limitations, implications and potential further research avenues to support the academic community in exploring research themes/patterns. Thus, to trace the implementation of BD strategies, a profiling method is employed to analyze articles (published in English-speaking peer-reviewed journals between 1996 and 2015) extracted from the Scopus database. The analysis presented in this paper has identified relevant BD research studies that have contributed both conceptually and empirically to the expansion and accrual of intellectual wealth to the BDA in technology and organizational resource management discipline.
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__________________________________________________________________ Abstract Aloe vera contains numerous vitamins and minerals, enzymes, amino acids, natural sugars and agents which may be anti-inflammatory and anti-microbial. The combination and balance of the plant's ingredients are what purportedly gives it its healing properties. The part of the Aloe vera which is used are the leaves. The Aloe is an Emollient, Purgative and Vulnerary. It is also used for its antibacterial, anesthetic and antiseptic properties, and is good to use as a tool for restoration of tissue. It is most commonly used on burns and minor cuts, especially good for sunburns, although it is being used for the treatment of skin cancer. Aloe is very useful on rashes caused by Poison Ivy, and it may help to draw out infection. It may help with Vaginal Yeast Infections, although this is not solid at this time. Aloe be made into a warm tea, made from the juice as a wash for eyes. The washing of eyes with Aloe may protect the eyes from ultraviolet rays from the sun. It can be used as a purgative. Aloe is also an extremely powerful laxative, and it is not recommended that it is taken internally. It is recommended that the fresh juice from the plant is used, and not the store bought juice within other products or on its own. The reason for this is that the medicinal use of the plant diminishes with time, and there is much questioning about whether or not you can receive benefits from the store bought aloe, even if the product has been filled with preservatives. It gives a healthy and supple look to the skin by reducing wrinkles, curing acne, rejuvenating and giving it a youthful glow.
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Aphthous ulcer is one of the most common diseases of the oral cavity with no known effective treatment so far, which could cause severe discomfort in patients. Aloe vera (A.V.) is a tropical plant with anti-inflammatory and immunostimulant effects, which could be of benefit in a diversity of wound healing conditions. The aim of this study is to evaluate topically administered A.V. gel on oral cavity minor aphthous healing. As a double-blind (case control) clinical trial, 40 patients with oral minor aphthous lesions were randomly allocated in either the case group (A.V. gel) or the control (placebo) group. The healing time (days after gel application), patient's pain score; the lesion and its surrounding inflammation diameters were recorded for 2 weeks. The obtained results were analyzed by either "Fishers exact" or t-student test using SPSS software. The mean (±SD) of patients' age was 29.25 ± 8.48 and 27.95 ± 7.96 years in the control and A.V.-treated groups, respectively, which were not significantly different (P > 0.05). The duration of complete wound healing, pain score, wound size and inflammation zone diameter in the A.V.-treated group were significantly lower than the control group (P ≤ 0.05) on specific time points after treatment. It seems likely that A.V. 2% oral gel is not only effective in decreasing the recurrent aphthous stomatitis patients' pain score and wound size but also decreases the aphthous wound healing period.
The mechanism of cathartic effect of barbaloin, representative of Aloe, was investigated by using male rats. Barbaloin administered orally was demonstrated to decompose to aloe-emodin-9-anthrone and aloe-emodin in the rat large intestine. And, these decomposed compounds were likely to change each other in the large intestine. Any compound of barbaloin, aloe-emodin-9-anthrone and aloe-emodin administered orally to rats was found to cause an obvious increase of water content in the large intestine, and only aloe-emodin-9-anthrone administered orally caused a significant increase of water content in the small intestine. Furthermore, the clear increase of water content and abnormality of electrolytes (Na⁺, K⁺) in the colon segment of rat were observed only by aloe-emodin-9-anthrone when compounds tested were injected directly into the colon segment. Therefore, it seemed that aloe-emodin-9-anthrone, a decomposition product of babaloin in the rat large intestine, caused an increase of water content in the large intestine by a different mechanism from the stimulation of peristalsis and this played an important role in cathartic activity of barbaloin.
BACKGROUND Genital herpes simplex virus infection is unique to humans, and is one of the commonest sexually transmitted diseases worldwide. OBJECTIVE The purpose of this double-blind placebo-controlled study was to determine the clinical efficacy and tolerability of Aloe vera extract 0.5% in a hydrophilic cream to cure patients afflicted with the first episodes of genital herpes. METHODS Preselected patients (n=60), aged 18–40 years (mean 23.6), with culture-confirmed diagnosis of herpes simplex genitalis, harboring 738 lesions (mean 12.3), were randomized to active or placebo treatment. Patients entered the study within 7 days (mean 4.1) of the onset of the lesions. Each patient was provided with a precoded 40-g tube, containing placebo/active preparation with instructions on self-application of the trial medication to their lesions three times daily for 5 consecutive days (maximum 15 topical applications per week). To assess the clinical efficacy and other beneficial effects patients were examined twice weekly and reepithelialized lesions with some residual erythema were considered as healed. Patients whose lesions resolved during the active treatment period (1 or 2 weeks) were spared further medication, and were requested to report to the clinic as scheduled for review and recurrence control. Empty tubes were collected from the remaining patients, and similarly coded replacement tubes were given to continue the treatment (in total 102 tubes were used). RESULTS The group treated with Aloe vera extract cream had both significantly shorter mean time to healing than the placebo group (4.9 days vs 12 days; P CONCLUSION The clinical results suggest that Aloe vera extract (0.5%) in a hydrophilic cream is more efficacious than placebo, thus supporting the benefits of Aloe vera therapy as an alternative, reliable and effective treatment to cure the first episodes of genital herpes in men.
Various Aloe vera extracts are widely used in a variety of over-the-counter skin products, but only a few studies have been conducted to provide support for the use of Aloe vera (A. barbadensis), one of the most commonly used species of Aloe vera, in the treatment of inflammatory skin conditions. Seborrheic dermatitis is a common inflammatory skin disorder for which available topical treatment may be helpful but not curative. The objective of this study was to evaluate the effect of an emulsion formulated from a crude extract of Aloe vera (A. barbadensis) on seborrheic dermatitis. A double-blind, randomized, placebo-controlled prospective clinical trial was performed in 44 adult patients with seborrheic dermatitis. A comparison of symptom scores in the Aloe vera (A. barbadensis) and placebo groups, before and after treatment revealed a significant decrease in scaliness, pruritus and the number of sites involved in seborrheic dermatitis, but not in erythema. Global improvement rates in patients treated with Aloe vera (A. barbadensis) were significantly higher than in placebo-treated patients, as assessed by both dermatologists (58% and 15%, respectively; P=0.009) and patients (62% and 25%, respectively; P=0.03). The results of the present study indicate that Aloe vera (A. barbadensis) crude extract emulsion is effective in the therapy of patients with seborrheic dermatitis.
The influence of Aloe vera (L.) Burman f. on the glycosaminoglycan (GAG) components of the matrix in a healing wound was studied. Wound healing is a dynamic and complex sequence of events of which the major one is the synthesis of extracellular matrix components. The early stage of wound healing is characterized by the laying down of a provisional matrix, which is then followed by the formation of granulation tissue and synthesis of collagen and elastin. The provisional matrix or the ground substance consists of GAGs and proteoglycans (PGs), which are protein GAG conjugates. In the present work, we have studied the influence of Aloe vera on the content of GAG and its types in the granulation tissue of healing wounds. We have also reported the levels of a few enzymes involved in matrix metabolism. The amount of ground substance synthesized was found to be higher in the treated wounds, and in particular, hyaluronic acid and dermatan sulphate levels were increased. The levels of the reported glycohydrolases were elevated on treatment with Aloe vera, indicating increased turnover of the matrix. Both topical and oral treatments with Aloe vera were found to have a positive influence on the synthesis of GAGs and thereby beneficially modulate wound healing.