Aloe gel is put to the test head-to-head versus steroids against the chronic inflammatory skin disease psoriasis.
Aloe Vera for Psoriasis
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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
Psoriasis is a chronic, inflammatory skin disease that affects about one in 40 people, making it “one of the most frequent chronic skin diseases worldwide.” There’s lots of drugs for it, some of which cost more than $100,000 a year to get a response. There are cheaper drugs like cyclosporine, but it carries the “long-term risk of [kidney damage], hypertension, and malignancies.” The drug can cause cancer; kidney toxicity in “more than 50% of the patients” treated long-term; and, in terms of risk of malignancies, up to 42 times the rate of cancer. And, it doesn’t even work that well, keeping the disease at bay in a little more than half of patients over a four-month period. There’s got to be a better way.
What about plants? “Topical botanical agents for the treatment of psoriasis.” Well, aloe vera gel is said to possess “anti-inflammatory, anti-[itching], and wound-healing properties.” Yeah, but as I described before, when it was put to the test for wound healing, it actually made things worse. “[T]he exploitation of aloe preparations has been accompanied too often by misinformation and exaggerated claims,” but there is some “impressive” evidence. For example, to test its anti-inflammatory properties, it was tested head-to-head against steroids for mustard gas exposure.
Mustard gas is probably the most popular chemical warfare agent, starting in World War I. The last widespread military use was in the 80s during the Iraq-Iran war, with more than 100,000 exposed and many “still suffering from the long-term complications,” predominantly itching. Even decades after surviving a gas attack, 70% to 90% are still suffering.
Topical steroids are the most frequently administered medications, and they help. But long-term use “is not recommended, and is associated with” a variety of side effects. Therefore, how about safer agents, like aloe vera?
“Sixty-seven…chemical warfare-injured [vets] were randomized to apply an [aloe] vera/olive oil cream” or the steroids, and the aloe vera mixture appeared to work as well as the drug.
Okay; well then, let’s give it a try for the management of psoriasis. By the end of the month-long study, the aloe vera cream had cured 83% of the patients, compared to the placebo cure rate of less than 10%, “resulting in significant clearance of the psoriatic plaque” skin lesions.
All right, but that’s compared to an inactive placebo. How about compared to steroids? Aloe was found to be “more effective…in reducing the clinical symptoms.” Like taking this nasty belly button and clearing the itchy, scaly rash away.
Here’s another beautiful sequence of before-and-after pictures, but in this case, this may have very well been the placebo treatment. In this “double-blind, placebo-controlled study of a commercial Aloe vera gel in the treatment of slight to moderate psoriasis,” things got better in 70% of the aloe-treated sites, but 80% of the placebo-treated areas improved. The placebo beat out the aloe. “[T]he high response rate of [the] placebo [gel] indicated a possible effect in its own right.” The placebo was just basically xanthan gum and water, and they were like, hey, instead of aloe failing, maybe xanthan gum just works, too!
All in all, the “[r]esults on the effectiveness [of aloe vera] for psoriasis are contradictory.” But applying it on the skin appears safe, so I figure why not give it a try.
Please consider volunteering to help out on the site.
- Morton JF. Folk Uses and Commercial Exploitation of Aloe Leaf Pulp. Econ Bot. 1961;15:311-319.
- Schmidt JM, Greenspoon JS. Aloe vera dermal wound gel is associated with a delay in wound healing. Obstet Gynecol. 1991;78(1):115-117.
- Panahi Y, Davoudi SM, Sahebkar A, et al. Efficacy of Aloe vera/olive oil cream versus betamethasone cream for chronic skin lesions following sulfur mustard exposure: a randomized double-blind clinical trial. Cutan Ocul Toxicol. 2012;31(2):95-103.
- Gutknecht M, Krensel M, Augustin M. Health economic analyses of psoriasis management: a systematic literature search. Arch Dermatol Res. 2016;308(9):601-616.
- Farahnik B, Sharma D, Alban J, Sivamani RK. Topical Botanical Agents for the Treatment of Psoriasis: A Systematic Review. Am J Clin Dermatol. 2017;18(4):451-468.
- Maza A, Montaudié H, Sbidian E, et al. Oral cyclosporin in psoriasis: a systematic review on treatment modalities, risk of kidney toxicity and evidence for use in non-plaque psoriasis. J Eur Acad Dermatol Venereol. 2011;25 Suppl 2:19-27.
- Paul CF, Ho VC, McGeown C, et al. Risk of malignancies in psoriasis patients treated with cyclosporine: a 5 y cohort study. J Invest Dermatol. 2003;120(2):211-216.
- Ellis CN, Fradin MS, Hamilton TA, Voorhees JJ. Duration of remission during maintenance cyclosporine therapy for psoriasis. Relationship to maintenance dose and degree of improvement during initial therapy. Arch Dermatol. 1995;131(7):791-795.
- Syed TA, Ahmad SA, Holt AH, Ahmad SA, Ahmad SH, Afzal M. Management of psoriasis with Aloe vera extract in a hydrophilic cream: a placebo-controlled, double-blind study. Trop Med Int Health. 1996;1(4):505-509.
- Choonhakarn C, Busaracome P, Sripanidkulchai B, Sarakarn P. A prospective, randomized clinical trial comparing topical aloe vera with 0.1% triamcinolone acetonide in mild to moderate plaque psoriasis. J Eur Acad Dermatol Venereol. 2010;24(2):168-172.
- Paulsen E, Korsholm L, Brandrup F. A double-blind, placebo-controlled study of a commercial Aloe vera gel in the treatment of slight to moderate psoriasis vulgaris. J Eur Acad Dermatol Venereol. 2005;19(3):326-331.
- Miroddi M, Navarra M, Calapai F, et al. Review of Clinical Pharmacology of Aloe vera L. in the Treatment of Psoriasis. Phytother Res. 2015;29(5):648-655.
- Armstrong AW, Betts KA, Signorovitch JE, et al. Number needed to treat and costs per responder among biologic treatments for moderate-to-severe psoriasis: a network meta-analysis. Curr Med Res Opin. 2018;34(7):1325-1333.
Image credit: Lovesevenforty via Pixabay. Image has been modified.
Motion graphics by Avocado Video.
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
Psoriasis is a chronic, inflammatory skin disease that affects about one in 40 people, making it “one of the most frequent chronic skin diseases worldwide.” There’s lots of drugs for it, some of which cost more than $100,000 a year to get a response. There are cheaper drugs like cyclosporine, but it carries the “long-term risk of [kidney damage], hypertension, and malignancies.” The drug can cause cancer; kidney toxicity in “more than 50% of the patients” treated long-term; and, in terms of risk of malignancies, up to 42 times the rate of cancer. And, it doesn’t even work that well, keeping the disease at bay in a little more than half of patients over a four-month period. There’s got to be a better way.
What about plants? “Topical botanical agents for the treatment of psoriasis.” Well, aloe vera gel is said to possess “anti-inflammatory, anti-[itching], and wound-healing properties.” Yeah, but as I described before, when it was put to the test for wound healing, it actually made things worse. “[T]he exploitation of aloe preparations has been accompanied too often by misinformation and exaggerated claims,” but there is some “impressive” evidence. For example, to test its anti-inflammatory properties, it was tested head-to-head against steroids for mustard gas exposure.
Mustard gas is probably the most popular chemical warfare agent, starting in World War I. The last widespread military use was in the 80s during the Iraq-Iran war, with more than 100,000 exposed and many “still suffering from the long-term complications,” predominantly itching. Even decades after surviving a gas attack, 70% to 90% are still suffering.
Topical steroids are the most frequently administered medications, and they help. But long-term use “is not recommended, and is associated with” a variety of side effects. Therefore, how about safer agents, like aloe vera?
“Sixty-seven…chemical warfare-injured [vets] were randomized to apply an [aloe] vera/olive oil cream” or the steroids, and the aloe vera mixture appeared to work as well as the drug.
Okay; well then, let’s give it a try for the management of psoriasis. By the end of the month-long study, the aloe vera cream had cured 83% of the patients, compared to the placebo cure rate of less than 10%, “resulting in significant clearance of the psoriatic plaque” skin lesions.
All right, but that’s compared to an inactive placebo. How about compared to steroids? Aloe was found to be “more effective…in reducing the clinical symptoms.” Like taking this nasty belly button and clearing the itchy, scaly rash away.
Here’s another beautiful sequence of before-and-after pictures, but in this case, this may have very well been the placebo treatment. In this “double-blind, placebo-controlled study of a commercial Aloe vera gel in the treatment of slight to moderate psoriasis,” things got better in 70% of the aloe-treated sites, but 80% of the placebo-treated areas improved. The placebo beat out the aloe. “[T]he high response rate of [the] placebo [gel] indicated a possible effect in its own right.” The placebo was just basically xanthan gum and water, and they were like, hey, instead of aloe failing, maybe xanthan gum just works, too!
All in all, the “[r]esults on the effectiveness [of aloe vera] for psoriasis are contradictory.” But applying it on the skin appears safe, so I figure why not give it a try.
Please consider volunteering to help out on the site.
- Morton JF. Folk Uses and Commercial Exploitation of Aloe Leaf Pulp. Econ Bot. 1961;15:311-319.
- Schmidt JM, Greenspoon JS. Aloe vera dermal wound gel is associated with a delay in wound healing. Obstet Gynecol. 1991;78(1):115-117.
- Panahi Y, Davoudi SM, Sahebkar A, et al. Efficacy of Aloe vera/olive oil cream versus betamethasone cream for chronic skin lesions following sulfur mustard exposure: a randomized double-blind clinical trial. Cutan Ocul Toxicol. 2012;31(2):95-103.
- Gutknecht M, Krensel M, Augustin M. Health economic analyses of psoriasis management: a systematic literature search. Arch Dermatol Res. 2016;308(9):601-616.
- Farahnik B, Sharma D, Alban J, Sivamani RK. Topical Botanical Agents for the Treatment of Psoriasis: A Systematic Review. Am J Clin Dermatol. 2017;18(4):451-468.
- Maza A, Montaudié H, Sbidian E, et al. Oral cyclosporin in psoriasis: a systematic review on treatment modalities, risk of kidney toxicity and evidence for use in non-plaque psoriasis. J Eur Acad Dermatol Venereol. 2011;25 Suppl 2:19-27.
- Paul CF, Ho VC, McGeown C, et al. Risk of malignancies in psoriasis patients treated with cyclosporine: a 5 y cohort study. J Invest Dermatol. 2003;120(2):211-216.
- Ellis CN, Fradin MS, Hamilton TA, Voorhees JJ. Duration of remission during maintenance cyclosporine therapy for psoriasis. Relationship to maintenance dose and degree of improvement during initial therapy. Arch Dermatol. 1995;131(7):791-795.
- Syed TA, Ahmad SA, Holt AH, Ahmad SA, Ahmad SH, Afzal M. Management of psoriasis with Aloe vera extract in a hydrophilic cream: a placebo-controlled, double-blind study. Trop Med Int Health. 1996;1(4):505-509.
- Choonhakarn C, Busaracome P, Sripanidkulchai B, Sarakarn P. A prospective, randomized clinical trial comparing topical aloe vera with 0.1% triamcinolone acetonide in mild to moderate plaque psoriasis. J Eur Acad Dermatol Venereol. 2010;24(2):168-172.
- Paulsen E, Korsholm L, Brandrup F. A double-blind, placebo-controlled study of a commercial Aloe vera gel in the treatment of slight to moderate psoriasis vulgaris. J Eur Acad Dermatol Venereol. 2005;19(3):326-331.
- Miroddi M, Navarra M, Calapai F, et al. Review of Clinical Pharmacology of Aloe vera L. in the Treatment of Psoriasis. Phytother Res. 2015;29(5):648-655.
- Armstrong AW, Betts KA, Signorovitch JE, et al. Number needed to treat and costs per responder among biologic treatments for moderate-to-severe psoriasis: a network meta-analysis. Curr Med Res Opin. 2018;34(7):1325-1333.
Image credit: Lovesevenforty via Pixabay. Image has been modified.
Motion graphics by Avocado Video.
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Title
Aloe Vera for Psoriasis
LicenseCreative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Content URLDoctor's Note
Here’s the video I referred to: Is Aloe Effective for Blood Pressure, Inflammatory Bowel, Wound Healing, and Burns?
I’ve got a bunch of others, as well, as part of my extended series on aloe. The most amazing one is probably Can Aloe Cure Cancer?
There’s also Is Aloe Vera Gel the Best Treatment for Lichen Planus? and Aloe for the Treatment of Advanced Metastatic Cancer.
What about eczema, another inflammatory skin disease? See:
- Treating Asthma & Eczema with Plant-Based Diets
- Eczema Treatment with Coconut Oil, Mineral Oil vs. Vaseline
- Best Foods to Avoid for Eczema
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