Can Aloe Help Acne?

Results Are Mixed and More Research Is Needed

Can Aloe Help Acne?

Article Summary

Although we would expect Aloe to improve acne through its healing properties, scientific evidence to date indicates that Aloe is not likely to help acne to a measurable degree.

Anti-inflammatory effects: The anti-inflammatory activity demonstrated by Aloe appears to be restricted to molecules that do not play a role in acne and, in fact, Aloe might even increase the production of inflammatory molecules that are involved in the formation of acne lesions

Antibacterial effects: Aloe does not appear to have an antibacterial effect against the most common acne bacteria, P. acnes

Skin irritation and dryness: The evidence that Aloe can help with skin irritation and dryness is contradictory.

Penetration enhancing effects: On a positive note, there is some evidence that Aloe may act as a penetration enhancer, boosting the effectiveness of certain topical acne drugs.

Wound healing effects: Acne lesions are, in essence, wounds. While Aloe is widely spoken about as a soothing agent that can help heal wounds, the evidence that it improves wound healing is inconclusive.

An additional note: We will need more research before we know whether single Aloe extracts by themselves or the Aloe plant as a whole is better for the skin. 

And finally, since Aloe tends to be unstable and quickly degrade, it can be difficult to find high-quality Aloe on the market, so even if there is some evidence that it might help the skin in some ways, over-the-counter Aloe products may not deliver on their promises.

Aloe and Its Potential for Healing

The Aloe plant has been used in traditional medicine for centuries. The flesh from the plant has been used to create gels, drinks, cosmetics, and as a folk remedy for the treatment of a wide range of illnesses.1,2,4Aloe exhibits anti-inflammatory and antibacterial action, and may promote wound healing. It has been used to aid in the treatment of a variety of medical issues including wounds and injuries, bruises, allergic and parasitic skin conditions, cancerous lesions, gastrointestinal ulcers, and is also used to soothe the skin.2-4Aloe is now integrated into Western medicine, as described in a recent publication in Biomedicine & Pharmacotherapy:
 

Biomedicine and Pharmacotherapy.jpg

“Numerous in vitro and in vivo pharmacological studies as well as clinical trials have confirmed the traditional uses of Aloe including wound healing and anti-ulcer activities. These studies have also indicated new properties such as anti-diabetic, hypoglycemic, anti-cancer, antimicrobial, antiviral, antihyperlipidemic and anti-ulcer activities.”2

 

Healing Properties of Aloe



However, as we will see as we investigate Aloe’s potential role in the treatment of acne, there is conflicting evidence related to some of the healing properties of Aloe. The conflicting results may be due to researchers using different strains of Aloe plants, and also because Aloe gel can be unstable and degrade. But the bottom line is that acne-prone people are unlikely to derive much benefit from over-the-counter Aloe when it comes to acne.


The Components of Aloe

The most common strain of Aloe studied by medical researchers is Aloe vera. The two products most commonly used in medicines and supplements are Aloe juice, a bitter and yellow latex that is extracted from the outer leaves, which is less commonly used, and Aloe gel that refers to the interior of the succulent leaves, and which is commonly used in skin care products. 

Since Aloe gel is what is most commonly used, let's focus on that. Aloe gel is made up of over 99.5% water. Aside from water there are also over 75 different compounds, including polysaccharides (a specific kind of carbohydrate), vitamins, minerals, enzymes, and other phytochemicals.2Because there are so many compounds in Aloe gel, its healing effects may be explained by the effect of all of Aloe's components combined together, and not necessarily from just one compound in the plant.2,4
 

Components of Aloe



Why Explore Aloe as an Acne Treatment?

Aloe has five properties that are potentially relevant to acne:

  1. Inflammation: Acne is primarily an inflammatory disease and Aloe has anti-inflammatory properties
  2. Bacteria: Acne can be aggravated by bacteria and Aloe has antibacterial properties
  3. Skin irritation and dryness: People with acne tend to have irritated skin and Aloe may help calm the skin, but evidence is contradictory
  4. Penetration enhancement: Aloe may help topical acne medications penetrate into the skin
  5. Wound healing: Acne lesions are essentially small wounds of the skin and Aloe speeds wound healing

Since Aloe has potentially beneficial properties in some of these areas it is logical to examine the role Aloe might play in treating acne. However, as we'll see below, the promise of Aloe seems to fade when it comes to acne when we look more closely at the data.

Keep in mind as you read below that there are no direct studies on Aloe and acne in particular. Instead, we will look at how Aloe affects inflammation, bacteria, and wound healing as a whole.


Aloe and Inflammation

Inflammation can be triggered by a number of different inflammatory mediators in the body. Inflammatory mediators are chemicals that are involved in the inflammation process. As researchers from a study published in Phytomedicine explain:
 

Phytomedicine Journal

Scientists have confirmed Aloe as “an established anti-inflammatory drug” against some types of inflammatory mediators. However, results from the researchers’ 2003 study indicate that Aloe is ineffective against the inflammatory mediators that are most relevant to acne. In fact, their research showed that Aloe could increase the production of two specific inflammatory mediators called cytokines are known to aggravate acne.5


Aloe and Bacteria

The antibacterial activity of Aloe has been proven against several types of bacteria, for example, Staphylococcus.2,3However, Aloe may fall short when it comes to killing acne bacteria:
 

Phytomedicine Journal

The same study in the journal Phytomedicine found that Aloe was ineffective in killing Propionibacterium acnes (P. acnes), a bacterial strain that aggravates acne by inducing inflammation. Because P. acnes is the most important bacteria in acne pathology, it is unlikely that Aloe’s antibacterial properties are relevant for acne.5


Aloe for Skin Irritation and Dryness

Skin irritation, dryness, and scaling are common side effects of topical acne treatments. Additionally, acne patients typically have impaired skin barrier function which makes the skin lose more water and become dehydrated more easily than acne-free skin. Can the application of Aloe reduce the irritation and dry skin associated with acne and acne medication? The evidence to date is contradictory.
 

Pharmacognosy Journal

Pharmacognosy Magazine published a study in which researchers examined the role Aloe in skin hydration and skin irritation. They found that when participants used Aloe gel repeatedly, it dehydrated the skin compared to a placebo. They did, however, find that two strains of Aloe--Aloe vera and Aloe ferox--showed anti-redness activity similar to hydrocortisone, a common topical anti-inflammatory medication.7
 

Skin Research & Technology Journal

In a study published in Skin Research and Technology, researchers applied freeze-dried Aloe vera extract on 20 female subjects twice daily for a period of 2 weeks. The researchers found that the treatment increased the water content of the outermost layer of the skin, but did not reduce water loss through the skin. In other words, the Aloe did not improve the skin barrier and did not moisturize the skin; rather, it solely added moisture to the surface of the skin for a short period of time.8
 

Skin Pharmacology and Physiology Journal

Another study, published in 2008 in Skin Pharmacology and Physiology, showed Aloe gel to be ineffective in reducing the inflammation associated with UV irritation of the skin. UV irritation is similar to sunburn and is relevant to acne since topical acne treatments may increase susceptibility to sunburn. In this study of 40 individuals, Aloe gel reduced skin irritation better than a placebo, but not as well as a traditional anti-inflammatory cream.6


Aloe and Penetration Enhancement

One study has shown that Aloe can increase the effectiveness of other topical medications by improving their ability to be absorbed into the skin.9Can Aloe also improve the effectiveness of topical acne treatments?
 

Journal of Dermatological Treatment

One study published in the Journal of Dermatological Treatment examined combinations of Aloe and topical retinoids among 60 subjects with mild to moderate acne. They found that the combination of Aloe gel and topical retinoids was slightly more effective in reducing acne lesions, but the addition of Aloe did not reduce the side effects of the medication.10
 

International Journal of Aromatherapy

Another study published in the International Journal of Aromatherapy examined a combination treatment of Aloe and Ocimum gratissimum oil, a plant-based oil that has anti-acne properties. The study involved 84 acne patients and found that the efficacy of the Ocimum oil was increased with the addition of Aloe gel and that the Ocimum/Aloe combination was superior to clindamycin, an antibiotic that is also anti-inflammatory.1


Aloe and Wound Healing

The wound healing process is important to acne. Acne lesions are essentially skin wounds, and slow healing of acne wounds can lead to scars and post-inflammatory hyperpigmentation (dark/red spots).

Medical practitioners have used Aloe for centuries to promote wound healing. Aloe gel contains several components that scientists know can accelerate wound healing, including glucomannan, vitamin E, vitamin C, and amino acids.11,12While some studies have shown that Aloe can improve wound healing, a review of clinical evidence to date shows mixed results.2,11

Archives of Dermatological Research

For example, reviews of 7 wound-healing studies involving a total of 347 patients were published in Archives of Dermatological Research and BioMed Research International in 2015 and concluded that further high-quality trials, preferably using standardized treatment settings, are necessary to better understand the impact of Aloe on wound healing.11,12

 

Aloe in Petrie Dish



Why Is There So Little Conclusive Evidence?

The research around the effectiveness of Aloe, particularly regarding skin irritation and wound healing, is inconclusive. Some studies have shown benefits to using Aloe and some have shown it to be ineffective. The differences in Aloe formulations and the instability of the polysaccharides found in Aloe gel may explain the contradictory data.
 

Molecules Journal

As researchers from a 2008 study published in Molecules explain, “these conflicting results could be due to the use of plants from different locations with variations in their chemical composition and also because of different isolation techniques that were used to extract compounds from the Aloe leaf pulp…Furthermore, the polysaccharides found in Aloe gel are not stable, especially under stress conditions such as heat, the presence of acid and enzymatic activities.3


If researchers can adopt a standardized method for producing Aloe gel products that avoid degradation of the unstable polysaccharides in the gel, it may be possible to achieve more consistent study results.But for the time being, based on what we can gather from existing data, Aloe most likely does not hold great promise in acne treatment.

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Aloe Vera



How to Do It:

If you would like to try adding an aloe vera mask to your daily regimen, follow these simple instructions:

  1. Cleanse your skin using your bare hands and a mild facial cleanser. Then gently pat dry with a towel. Physical irritation of the skin makes acne worse, so stay ultra-gentle. 
  2. Mash aloe vera gel (store-bought 100% pure aloe vera gel, or taken directly from the plant) and a few drops of fresh lemon juice together in your hands
  3. Very gently apply to the skin, avoiding eye areas. Stay exceedingly gentle and don't scrub. Leave the mask on for 15 minutes.
  4. Rinse off the aloe mask and gently pat dry. You can now apply other products if you wish.

The Experts at Acne.org

Our team of medical doctors, biology & chemistry PhDs, and acne experts work hand-in-hand with Dan (Acne.org founder) to provide the most complete information on all things acne. If you find any errors in this article, kindly use this Feedback Form and let us know.

References:

  1. Orafidiya, L. O. et al. The effect of Aloe vera gel on the anti-acne properties of the essential oil of Ocimum gratissimum Linn leaf - A preliminary clinical investigation. Int. J. Aromather. 14, 15–21 (2004).
  2. Akaberi, M., Sobhani, Z., Javadi, B., Sahebkar, A. & Emami, S. A. Therapeutic effects of Aloe spp. in traditional and modern medicine: A review. Biomed. Pharmacother. 84, 759–772 (2016).
  3. Hamman, J. H. Composition and applications of Aloe vera leaf gel. Molecules 13, 1599–1616 (2008).
  4. Singab, A.-N. B., El-Hefnawy, H. M., Esmat, A., Gad, H. A. & Nazeam, J. A. A systemic review on Aloearborescens pharmacological profile: biological activities and pilot clinical trials. Phyther. Res, 29, 1858–1867 (2015).
  5. Jain, A. & Basal, E. Inhibition of Propionibacterium acnes-induced mediators. Phytomedicine 10, 34–38 (2003).
  6. Reuter, J. et al. Investigation of the anti-inflammatory potential of Aloe vera gel (97.5%) in the ultraviolet erythema test. Skin Pharmacol. Physiol. 21, 106–110 (2008).
  7. Fox, L. T. et al. In Vivo skin hydration and anti-erythema effects of Aloe vera, Aloe ferox and Aloe marlothii gel materials after single and multiple applications. Pharmacogn. Mag. 10, 392–403 (2014).
  8. Dal’Belo, S. E., Rigo Gaspar, L. & Maia Campos, P. M. B. G. Moisturizing effect of cosmetic formulations containing Aloe vera extract in different concentrations assessed by skin bioengineering techniques. Ski. Res. Technol. 12, 241–246 (2006).
  9. Cole, L. & Heard, C. Skin permeation enhancement potential of Aloe Vera and a proposed mechanism of action based upon size exclusion and pull effect. Int. J. Pharm. 333, 10–16 (2007).
  10. Hajheydari, Z., Saeedi, M., Morteza-Semnani, K. & Soltani, A. Effect of Aloe vera topical gel combined with tretinoin in treatment of mild and moderate acne vulgaris: a randomized, double-blind, prospective trial. J. Dermatolog. Treat. 25, 123–129 (2014).
  11. Sidgwick, G. P., McGeorge, D. & Bayat, A. A comprehensive evidence-based review on the role of topicals and dressings in the management of skin scarring. Arch. Dermatol. Res. 307, 461–477 (2015).
  12. Hashemi, S. A., Madani, S. A. & Abediankenari, S. The review on properties of Aloe Vera in healing of cutaneous wounds. Biomed Res. Int. 2015, 1–7 (2015).
See More References

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