Aloe vera, or Aloe barbadensis, is perhaps the most ubiquitous plant in skin care products across the world and was used even in ancientGreece, Rome, Babylonia, and China. Historical evidence suggests that both the leaf and pulp of this plant have been used extensively to treat dermatological ailments and were believed to prevent skin senescence, acne, psoriasis, relieve pruritus, prevent premature graying of the hair, improve alopecia, and promote wound healing.1 This Notable Note addresses the myriad of conditions aloe alleviates and provides a brief historical perspective of this “plant of immortality.”
During the reign of Emperor Nero, around 50 BC, the Greek physician Dioscorides cited aloe as being able to alleviate skin irritation, sunburn, and acne. Subsequently, Pliny the Elder, a physician who lived from AD 23 to 79, confirmed in his encyclopedia, Natural History, the discoveries of Dioscorides.2 While some studies show that aloe vera may inhibit growth of Staphylococcus aureus, Shigella flexneri, and other superficial mycoses-causing fungus, others suggest that it is ineffective in preventing Propionibacterium acnes–induced acne.1 In ancient Egypt, Cleopatra and Nefertiti incorporated aloe as part of their daily skin and beauty care.
The dead were embalmed with aloe vera because of its antibacterial and antifungal properties. It was believed that in stopping the physical decomposition process, eternal life could be attained physically and also spiritually. Aloe’s antiaging and anti-inflammatory effects were well documented in the Papyrus Eber of 1550 BC. In Sanskrit, the plant is known as Ghrita-Kumari. Kumar means girl, and it was believed that this plant provided womanly youthfulness. Modern studies have shown that aloe gel significantly improves wrinkles and elasticity in photoaged human skin, increases collagen production in photoprotected skin, and decreases collagen-degrading MMP-1 gene expression.1 Alexander the Great was thought to have used aloe juice to heal the war wounds on his warriors.
Aloe was so important to Alexander that he arranged for transportable carts of planted aloe as supplies during his numerous battle campaigns. Aristotle even convinced the great conqueror to capture the island of Socotra specifically to gain possession of the precious aloe groves—allowing Alexander’s army to acquire sufficient medication to heal the wounds of entire battalions.3 In modern times, mechanistic studies1 have proven that aloe can enhance the synthesis of glycosaminoglycancomponents (hyaluronicacid and dermatan sulfate) in the matrix of a healing wound to increase the collagen content of the granulation tissue and the degree of crosslinking. While many studies in modern times have validated the positive effects of aloe, contradictory observations exist for the treatment of psoriasis.
As Pliny and Dioscorides described in ancient medical texts,2 the true efficacy of aloe vera perhaps also depends on the interplay of its compounds, its geographic origin, and processing methods. Author Affiliation: Department of General Medicine, National University Hospital, Singapore. Corresponding Author: Valencia Long, MBBS, Department of General Medicine, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (valencialong@gmail.com).
Additional Contributions: I would like to thank Shiyao Yang, MRCP, Department of Medicine, National University Hospital, for assistance with editing the manuscript. No compensation was provided. 1. Watson R. Bioactive Dietary Factors and Plant Extracts in Dermatology. New York, NY: Humana Press; 2013. 2. Baker OT. The Amazing Ancient to Modern Useful Plant Aloe Vera: Amazing Plant of the Magic Valley. Lemon Grove, CA: R. Prevost; 1975. 3. Barcroft A. Aloe Vera: Nature’s Legendary Healer. London, England: Souvenir Press; 1996.
Source: JAMA Dermatology December 2016 Volume 152, Number 12
Authors: Valencia Long, MBBS, Department of General Medicine, National University Hospital, 5 Lower Kent Ridge Rd, Singapore
