Aloe vera (Aloe Vera Barbadensis) is easily one of the most amazing medicinal plants mankind has yet discovered. There’s over 400 species of the aloe plant of which just four, including aloe vera, are cultivated for medicinal purposes.
The history of aloe vera among humanity dates back at least 6000 years, which we know from Ancient Egyptian stone carvings of aloe vera. Egyptians referred to the leaves’ gel-like substance as “the blood” and used it for daily beauty and skincare. Both Cleopatra and Nefertiti used aloe vera on their skin daily as part of their regimen.
In fact its healing properties were so widely hailed that the Egyptians embalmed newly dead mummies with aloe vera gel, with the idea of preventing decomposition and granting eternal life. The Papyrus Eber, a medical text which dates back to 1550 B.C., contains detailed descriptions of aloe vera’s anti-inflammatory and analgesic effects.
Fast forward a couple of thousand years to Ancient Greece, and the masses were still enthusiastically using aloe vera for skincare on a daily basis. For Alexander the Great, King of the Ancient Greek kingdom of Macedon, aloe vera was so sacred and medicinally valuable that he conquered the entire land of Socrata in an obsessive attempt to gain control of the plantations.
In fact King Alexander regularly brought along his own supply of aloe plants to treat the wounds of his soldiers. Hence, during his later schemes to invade India it’s believed that Alexander the Great based his army in Socrota to ensure a fresh supply.
Hundreds of years later there was extensive documentation of Indian tribes using aloe vera for topical purposes in the 1600s. Aloe was considered to be one of the 16 sacred plants in Indian lore and hence, they rubbed aloe vera juice all over their body to protect themselves from insect bites.
Elsewhere it is even said that Christopher Columbus brought pots of aloe vera with him on his ships as he set sail to discover America.
Aloe vera has given birth to fantastical tales of skin-enriching miracles in every culture and civilisation it has ever come into contact with…
…and today, scientific experiments are finally backing up what our ancient ancestors knew from experience. Back in 2014 a study was released showing that aloe vera has a strong ability to clear acne.
50% aloe vera gel slashes acne
Scientists led by Dr Z Hajheydari gathered 60 acne-ridden volunteers and divided them into two test groups of 30; group 1, who were treated with a topical retinoid cream (0.05% tretinoin in this case), and group 2, who received the same cream but featuring 50% aloe vera gel. Both group 1 and group 2 received the treatments daily for eight weeks, during which time both non-inflammatory and inflammatory acne lesions were measured and analysed.
The results offered the clearest recommendation for aloe vera you could possibly hope for.
The tretinoin treatment was decent, but the combined tretinoin/aloe vera gel resulted in a far greater reduction in inflammatory acne lesions, non-inflammatory acne-lesions, and total acne lesions. Apparently, “the combination therapy showed superior efficacy to TR and placebo”.
What’s almost as great is that the combination cream group endured far fewer side effects too. Obviously one of the 75 medicinal compounds in aloe vera was acting as damage control. The scientists concluded that “the combination TR/AVG was well tolerated and significantly more effective than TR and vehicle for the treatment of mild to moderate acne vulgaris”.
How does aloe vera, a common succulent (it’s not a cactus) found in Africa, Asia and the Middle East, achieve this magic? Easily, that’s how; out of all the natural topical treatments, few can match the indisputable fact that aloe vera contains over 75 medically recognised bioactive compounds. First, there are traces of the standard vitamins and minerals like zinc, vitamin C and vitamin E. Then there’s saponins with anti-inflammatory powers, there’s antioxidant proteins like metallothionein, there’s almost all the essential amino acids needed for human survival.
Aloe vera contains twelve members of a strong phenolic antioxidant family called anthraquinones, including aloin and emodin. Lastly, all of the aforementioned compounds are powerful, but several are especially well researched and they include glucomannan, a polysaccharide (sugar), and gibberellin, a plant based growth hormone.
The aloe vera plant contains so much natural goodness that if it so much as brushes against your face, your acne will have a hard time recovering. But what are the specific scientific mechanisms involved?
Aloe vera’s standout acne power – wound healing
To get beautiful, radiant and clear skin it’s not enough to stop pimples from forming – you have to massively accelerate their healing too. That way you will have less acne on your face at any given time.
One of the most critical strategies for doing so is accelerating the conveyor belt of collagen formation. Collagen is a protein which forms 30% of protein in the human body. It forms a scaffolding in the skin which other proteins and immune actors congregate around, and is hence vital for rebuilding the skin following acne. Increasing collagen formation is a key power of treatments like royal jelly and, according to many studies, aloe vera too.
Firstly, we have this 2000 study by Thai scientists where aloe vera was shown to accelerate the healing of second degree burns. 24 male rats were divided into four groups, some of which were deliberately burnt, and one of which received aloe vera as a topical treatment once daily for two weeks.
The aloe vera was dramatically superior for treating the burn wounds both 7 and 14 days after the initial burns. The conclusion was promising for acne: “aloe vera could exhibit the actions of both anti-inflammation and wound healing promotion when applied on a second degree burn wound”.
Secondly, we have this interesting 1996 study led by Dr JP Heggers where rats were wounded and then treated with aloe vera to heal that wound. The aloe vera was applied topically 3 times per day for 14 days.
The aloe vera significantly accelerated the contraction of the wound, which according to the scientists, was due to an increase in the rat’s skin collagen levels.
Next on the never-ending list we have two very similar studies both conducted by the same team led by Dr P Chithra in 1998 which again applied aloe vera to rat wounds.
In the first study scientists created thick incision wounds in the diabetic rats. The rats were divided into 5 groups, two of which featured aloe vera, and their wounds were treated with the various extracts three times daily for 21 days. The results showed that aloe vera improved the wound healing of the rats in a wide variety of ways: wound inflammation decreased, collagen levels increased, and wound maturation and contraction improved.
The second study was extremely similar, and the scientists concluded that “it was observed that aloe vera increased the collagen content of the granulation tissue as well as its degree of crosslinking”, or in other words, there was more collagen and stronger collagen thanks to aloe vera.
Finally, we have a study where a combination of aloe vera gel and collagen applied to wounds on human volunteers led to a dramatically higher wound healing rate. After ten weeks the wound had successfully healed and the scientists concluded that “the compound was well accepted and efficient in this particular case”.
As you can see, there’s a mountainous pile of evidence that aloe vera can heal old acne scars and accelerate at the pace at which your newly dead acne fades away.
Two compounds in aloe vera stand tall above the rest. Glucomannan, a polysaccharide, and gibberellin, a plant growth hormone, both interact with growth factor receptors on the wound’s fibroblasts (skin cells which manufacture collagen and other proteins), stimulating their activity and proliferation and in turn dramatically accelerating collagen production.
Scientists also claimed that an increase in hyaluronic acid and dermatan sulfate in the wound site was responsible. I didn’t have a clue what those substances are, but a quick search reveals that they’re two proteins and chemicals involved in the reformation of wounds, so that’s yet another bullseye for aloe vera.
Also promising is aloe vera’s known natural bleaching ability, which simply dyes your acne scars and skin back to its original colour. Throughout history we can see the benefits for wound healing as well, such as Alexander the Great using aloe vera to heal his soldiers.
Aloe vera has countless anti-inflammatory compounds
As you probably know already, chronic inflammation is the main cause behind acne vulgaris. Your top priority is to tailor your diet, nutrient intake and lifestyle to bring your entire immune system under control.
Nevertheless, topical treatments like rose water and resveratrol are great for directly reducing inflammatory cytokines on the skin surface. According to numerous studies, aloe vera is just effective for this not just because of one anti-inflammatory compound (such as resveratrol), but similarly to raw honey, thanks to dozens of smaller enzymes and compounds.
Firstly, the aloe vera plant is rich in an enzyme called bradykinase which helps to break down bradykinin, an important inflammatory mediator. This study confirmed that aloe barbadensis, AKA aloe vera, could lower bradykinin levels when applied to the skin’s surface. In the conclusion they praised both this power and aloe vera’s general anti-inflammatory effect: “aloe barbadensis gel contains a material that inhibits the bradykinin effect, which might explain the anti-inflammatory properties of Aloe barbadensis”.
Secondly, aloe vera contains an anti-inflammatory compound called C-glucosyl chromone, which according to this study that isolated and applied it to an inflamed mouse ear, has just as strong topical anti-inflammatory activity as pharmaceutical hydrocortisone (catabolic steroids). Aloe contains plenty of C-glucosyl chromone; in fact it was the first plant from which the compound was isolated in 1996.
Then there’s the aloe vera plant’s class of phenolic antioxidants called anthraquinones. The most notable is aloin, a bitter yellow coloured compound found in at least 68 of the aloe species. Aloin was long used as a laxative before the FDA ruled it as unsafe in 2002, but it’s been born again as an inflammation slasher. This study found that aloin could inhibit COX-2, basically the public enemy number 1 of inflammation which controls the release of many immune system cytokines behind acne.
The study also showed that another compound called aloe-emodin could reduce COX—2 and inflammation; they commented that “the anti-inflammatory effect of aloe-emodin was comparable to that of kaempferol and quercetin, indicating aloe-emodin as a possible key constituent responsible for the anti-inflammatory activity of aloe”. Aloe-emodin is another anthraquinone, found in the plant, leaves and sap of aloe vera.
This study and this study also found that emodin has anti-inflammatory powers against pro-inflammatory chemicals behind acne like interleukin-1beta. Interestingly, aloe-emodin also possesses a strong anti-viral effect against both the herpes virus in tests on cells. Could it kill p.acnes bacteria as well? Who knows? The truth is fogged with the clouds of mystery.
Gibberellin, the plant hormone that upregulates collagen output, has the ability to decrease inflammation in diabetic mice with poor wound healing in a dose dependent manner according to this excellent study, which concluded that gibberellin was an active anti-inflammatory component of aloe vera. An old study from 1989 found virtually identical results.
This study was more mixed, finding that gibberellin could increase the activity of anti-inflammatory mast cells. But what really puts the cherry on the acne-clearing cake is gibberellin’s ability to inhibit substance P.
Substance P is one of the least well-known villains behind acne. It’s a compound in acne-prone skin which directly increases both inflammation and sebum production. Gibberellin could lower substance P in both prolonged and single doses.
Aloe vera gel contains lupeol
Next we have what I believe to be the greatest anti-inflammatory phytonutrient in aloe vera of them all – lupeol.
Lupeol is a triterpenoid fatty acid found in aloe vera gel, and also mango and dandelion coffee. There’s so many studies on lupeol and inflammation that reading them all would make your brain explode. This study, this study, this study, this study, this study, this study, and many more found that lupeol lowered inflammation, whether extracted from aloe vera itself or from other medicinal plants.
The most clear-cut of these showed that lupeol reduced the swelling of an inflamed rat paw by 39%, which was even better than the pharmaceutical NSAID indomethacin, which achieved a 35% reduction.
Another study compared lupeol to the notable anti-inflammatory compound a-mangosteen found in the mangosteen fruit. Mangosteen has been hyped up as a superfood for years now but the 38.70% reduction of skin inflammation achieved by a-mangosteen fell well short of the massive 57.14% achieved by lupeol from aloe vera.
The lupeol in aloe vera reduces inflammation when applied to rat skin, human skin, mouse skin – probably even alien skin if we could track them down. If you’re the scientific type then you’ll love this massive review of lupeol’s anti-inflammatory powers.
Lupeol is found in abundance in aloe vera. In fact, it’s one of the greatest medicinal compounds in aloe vera and what’s more, it’s found in very few other plants.
One juggernaut of a compound we haven’t addressed yet is the polysaccharide glucomannan. This relatively uncommon plant-based sugar traditionally extracted from the elephant yam (konjac) has flooded into the supplement market during the last ten years as a natural weight loss pill.
It’s also used as an emulsifier and thickener in processed food but what we really care about is this study showing that topical application of glucomannan to mice controlled the strength of their inflammatory responses. The mice had the inflammatory skin conditions eczema and atopic dermatitis and were fed glucomannan for 8-9 weeks daily. There was a big reduction in inflammatory chemicals such as interleukin-4 and TNF-alpha.
That was just with feeding glucomannan to the mice orally. By applying the glucomannan topically the anti-inflammatory properties should become hyper concentrated.
What’s interesting is that again, glucomannan had the ability to lower substance P. That’s two compounds in aloe vera now with that power, and it suggests that aloe vera can successfully lower sebum production as well as inflammation, which is not a power it’s well known for. Glucomannan even caused a reduction in hyperkeratosis, an overgrowth of the sticky protein keratin which can cause acne by gluing dead skin cells together and clogging the pores.
What about aloe vera itself?
These compounds are fantastic but there’s one last hurdle – what about the whole aloe vera gel or extract? Could there be a random irritating plant chemical which outweighs all the anti-inflammatory benefits and scuppers its ability to clear acne?
For most people, the answer is a resounding no, because studies directly on aloe vera have been just as conclusive:
- This 2003 study concluded that aloe vera extract had significant inhibitory activity against p.acnes-induced skin inflammation. Deadly pro-inflammatory, pro-acne chemicals such as interleukin-8 and TNF-a fell off a cliff.
- Scientists reached an exciting conclusion in this old 1989 study: “the results show that small amounts of A. vera given topically will inhibit inflammation induced by a moderate amount of irritant”. The results showed that aloe vera lowered skin inflammation by a gigantic 47.1%.
- This 1996 study was particularly interesting; scientists applied aloe vera to inflamed rat paws and observed a reduction in inflammatory chemicals called neutrophils. Excessive amounts of neutrophils are especially dangerous for acne because one of their main jobs is to fire out free radicals in order to break down damaged cells. For us acne patients, the conclusion could not be clearer or more promising: “these results demonstrated that the extracts of Aloe vera gel have anti-inflammatory activity”.
If you apply aloe vera to a particularly inflamed piece of acne, then it’s safe to say that the acne’s prospects are grim. There are very few plants which beat the sheer number of anti-inflammatory compounds found in aloe vera. It seems that wound healing and lowering inflammation are where aloe vera really stands out among natural acne treatments.
Elsewhere there’s one truly excellent study we haven’t discussed yet. Instead of following acne patients it analysed the effect of topical aloe vera on volunteers with psoriasis, a skin condition that causes red, crusty, flaky, inflamed patches of skin which is particularly common between ages 15 and 35.
Scientists in the study compared a 0.5% concentration aloe vera cream to a placebo. They gave both creams to 60 patients aged between 18 and 50 years old (mean age 25.6), who all had moderate to slight psoriasis. The patients applied the creams three times daily for five consecutive days per week.
By the end of the experiment the psoriasis cream had cured 25 out 30 patients (83.33% success rate), while the placebo cured a truly shocking 2/30 (6.66% success rate) patients. Furthermore there were no side effects whatsoever. The study was conducted superbly, being double-blind and placebo controlled. Before the study took place the mean duration of the disease among the patients was 8.5 years, so these weren’t just “casual” psoriasis sufferers.
Psoriasis has inflammatory roots very similarly to acne, so this is a stellar result for us acne-clearing crusaders.
Any side effects for acne?
Since every human being on planet earth is so different and has a slightly different set of genetics and thus foods and compounds they can healthily consume, almost all natural topical treatments can cause allergies in a tiny minority of people. Raw honey, royal jelly and grapeseed oil, for instance, are known to cause allergic rashes and swelling in a few.
Aloe vera is no exception to this rule. In fact, the one major downside of using topical aloe vera for acne is that it seems to have a higher rate of allergic reactions than others. I gleamed that fact mainly from extensive trawling through the archives of the internet.
Some of the reactions spoken of include…
-A rash of eczema popping up despite an improvement in acne.
-Tiny red bumps all over the face.
-Red rashes springing up despite an improvement in acne.
Elsewhere there’s this study. It documents the case of a 72 year old woman who had taken to bathing her legs with homemade aloe vera juice in order to get pain relief. Scientists had observed patches of dermatitis (an inflammatory skin disorder) on her legs. Tests of the patches showed positive reactions to both the leaf of Aloe and macerated Aloe jelly. This study and this study observed other side effects such as redness, irritation, and contact dermatitis.
It’s not surprising; with such an endless array of compounds comes a higher chance that your skin might react to one. However, the scientists from the first study did comment that “reports of allergic reactions are rare”, and they certainly are; they’re only moderately more common than other topical acne treatments. Many of the studies on wound healing and inflammation above specifically praised the lack of side effects from aloe vera. The only real risk is an allergy, it would seem.
The solution for acne then? It’s a smart idea for acne patients to apply a patch of aloe vera to your arm before your face, to establish whether you have a sensitivity or not.
Another common fear is that aloe vera increases the skin’s sensitivity to sunlight, and hence acne from sunlight due to the free radicals caused by ultraviolet light.
One study supports this theory, claiming that aloe vera leads to phototoxicity among other symptoms. However, another study found the exact opposite. Apparently, applying aloe vera gel to human skin generates an antioxidant protein called metallothionein, which both scavenges free radicals and prevents antioxidants like glutathione and superoxide dismutase from being suppressed. This had the effect of lowering inflammation in ultraviolet irradiated areas of skin.
This study however, concluded that topical application of aloe vera is neither an effective preventative treatment for sunburn, suntan, nor sunlight induced radiation injuries.
There’s little evidence of harm either though. Hence the jury is out on whether aloe vera alters your skin’s sensitivity to sunlight.
The final advantage is that unlike the popular acne treatment cocoa butter, aloe vera does not possess an ounce of comedogenicity, or the ability to clog skin pores.
As part of the American Academy of Dermatology’s ongoing scheme to research and analyse every topical acne and skincare treatment, aloe vera gel was assigned the comedogenicity score of a stone-cold zero.
Five (“high change of clogging pores”) is top and zero (“will not clog pores”) is lowest, so aloe vera is totally harmless. Plus, the lowering of substance P achieved by gibberellin and glucomannan should have a positive effect on sebum production. Consider that grapeseed oil has a comedogenic score of 2, but it still only rarely clogs skin pores.
One final important note: do not consume aloe vera! Doing so could lead to nausea, digestive problems, and even liver problems! There’s no point at all in eating aloe vera. For acne, it’s strictly a topical treatment.
The best aloe vera product for acne?
If you want the aloe vera topical gel that has the greatest amounts of nutrients and compounds possible, then you’ll have to trek to the arid deserts of Africa or Asia with a machete to hack the leaves off the plant yourself. The second best option is to grow your own miniature aloe vera plant in your house.
The fresh version of aloe vera, applied from leaf to face, will contain more bioactive compounds. This study found that pasteurizing aloe vera reduced the vitamin C content and antioxidant activity by 16% and 57% respectively. The glucomannan content fell by over 30% as well.
The problem is that most products on the market are heated and processed so harshly. What it seems like is that the developers don’t care about the effectiveness of the product; they simply want an excuse to slap aloe vera on the label. Hence the beneficial gibberellin, glucomannan, antioxidants and fatty acids get warped or destroyed entirely…
…but there’s one product where that age-old rule doesn’t apply: Aubrey Organics Pure Aloe Vera 4 oz Gel.
The makers of this product have taken special care to process the aloe gel in a way that preserves many of the special compounds. This natural product is entirely free of harsh chemicals added to cheap products such as sodium hydroxymethylglycinate.
There’s no thickeners either, and any preservatives they’ve used are entirely natural ones like citric acid or even radish root, which is not an ingredient I’ve ever stumbled across anywhere before. Compared to other commercial aloe vera products, Aubrey Organics is far more liquid due to the lack of thickeners, which allows it to last longer.
Short of trekking to the plant’s homeland and getting lost in the desert on the way back, or emptying your entire bank account on the super-elite versions, Aubrey Organics Pure Aloe Vera is the best aloe vera product for acne bar none.
If you’re not obsessed with getting ultimate pure quality and want something cheaper ounce-for-ounce, then this Seven Minerals Aloe Vera Gel is slightly impurer but still 99% organic and miles above the standard product.
Aloe vera packs such a powerful punch against acne that your poor old pimples will be crawling to the edge of the ring within 5 seconds.
What’s more, it has a very clear place in the pantheon of acne topical treatments. Grapeseed oil prevents clogged pores by supplying vitamin E. Raw honey is perhaps the greatest topical treatment for acne of all time, but it mostly functions due to its antibacterial compounds like Methylgyloxal, peptides like bee-defensin 1, and other enzymes. In other words, it clears acne by wiping out p.acnes bacteria.
Aloe vera meanwhile, is a top-notch treatment for lowering inflammation and accelerating wound healing. The only reason to avoid aloe vera from a scientific standpoint is the slight risk of an allergy.
Again, the best product is Aubrey Organics Pure Aloe Vera 4 oz Gel.
Last but not least, if you’re looking for a really interesting overview of all the science about aloe vera and skincare you should check out this review. It contains links to tons of different studies about aloe vera and inflammation, aloe vera and antioxidant levels, and all sorts of fascinating stuff about the various compounds it contains.
In summary, aloe vera is a top-notch topical acne treatment which is best for accelerating the healing of old pimples and acne scars, and for lowering inflammation topically.
Thanks for reading!