The research was undertaken in three parts: A literature review of the composition and actions of aloe vera; Laboratory work with cell cultures; A pilot study using aloe vera for the treatment of chronic venous leg ulcers.
Aloe vera appears to speed up the healing of damaged epithelial tissue in burns and leg ulcers by providing essential micronutrients, an anti-inflammatory effect, an antimicrobial effect and through the stimulation of skin fibroblasts. In the case of the pilot study carried out on chronic venous leg ulcers, seven patients were selected by nursing staff as being suitable for study. These patients had leg ulcers which had failed to heal using conventional methods including skin grafting. Each patient was first patch-tested to exclude allergy to the vehicle and preservatives in the topical aloe product. The ulcer was then traced, photographed and swabbed, and blood taken for routine testing. Each patient was given 60 ml (4 fl oz) each day of aloe vera gel drink consisting of 98% stabilised aloe vera gel. The ulcer crater was irrigated with tap water to remove debris. The crater was then filled with topical aloe jelly preparation containing 86 % stabilised gel. Using an appropriate waterproof dressing (such as Combiderm), the wound area was covered and followed by a short stretch pressure bandaging. This process was implemented daily if possible either in the department or by trained nursing help in the community.
The patient sample initally included six females and one male. Seven ulcers were treated which ranged in age from 4 to 15 years. One older patient withdrew from the study due to the initial stinging sensation when the aloe jelly is first applied. This common effect passes off in 20-30 minutes. The six ulcers treated for the duration of the pilot study included five venous leg ulcers and one ulcer resulting from a patient with systemic lupus erythematmosis (SLE). Six patients found the regime very acceptable and were pleased with the cleansing effect of aloe which resulted in reduced exudate and odour and less seepage through the bandaging.
The results indicated that subsequent swabs destroyed the wound's infecting bacteria, predominantly pseudomonas. Three of the five venous leg ulcer wounds healed completely, one partially and one evidenced no improvement. No attempt was made to distinguish the internal effects of the aloe drinking gel from the effects of the topical aloe gel preparation. A pleasant side effect of the treatment was a clear change in the quality of the patients' hair, nails and skin. Although no definitive conclusions can be drawn from such a small pilot study, the results are promising and indicate the need for a larger trial. Ethical permission has been granted to carry out a randomised control trial involving 30 patients which will compare the topical aloe gel effects with standard gel dressing.
Subsequent to the publication of this article, Dr Atherton reported that the patient with SLE experienced complete healing of the ulcer and the patient who had the very severe ulcer for 15 years was healed to the point where a skin graft was possible. Such results are highly significant bearing in mind that all previous treatments had failed over many years.
Reviewed by AloeVera-USA, March 1999
