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See also: Dermatologic UsesRadiation, and Wound Healing

Abstract: In recent years, more head and neck cancer patients have been treated with radiotherapy. Radiation-induced mucositis is a common and dose limiting toxicity of radiotherapy among patients with head and neck cancers. Patients undergoing radiation therapy for head and neck cancer are also at increased risk of developing oral candidiasis. A number of new agents applied locally or systemically to prevent or treat radiation-induced mucositis have been investigated, but there is no widely accepted prophylactic or effective treatment for mucositis. Topical Aloe vera is widely used for mild sunburn, frostbites, and scalding burns. Studies have reported the beneficial effects of Aloe gel for wound healing, mucous membrane protection, and treatment of oral ulcers, in addition to anti-inflammatory, immuno-modulation, antifungal, scavenging free radicals, increasing collagen formation and inhibiting collagenase. Herein the author postulates that oral Aloe vera mouthwash may not only prevent radiation-induced mucositis by its wound healing and anti-inflammatory mechanism, but also may reduce oral candidiasis of patients undergoing head and neck radiotherapy due to its antifungal and immuno-modulatory properties. Hence, Aloe vera mouthwash may provide an alternative agent for treating radiation-induced oral mucositis and candidiasis in patients with head and neck cancers.

Abstract: Burn wound healing is a complicated process including inflammation, re-epithelialization, granulation, neovascularization and wound contraction. Several biochemicals are involved in burn healing process including antioxidants, cytokines and liver and kidney damage bio-markers. Although several preparations are available for the management of burn wound, there is still a necessity of researching for efficacious medicine. The aim of the present study was to evaluate herbal preparations and their phytochemical constituents for burn wound management. For this purpose, electronic databases including Pubmed, Scirus, Scopus and Cochrane library were searched from 1966 to July 2013 for in vitro, in vivo or clinical studies which examined the effect of any herbal preparation on different types of burn wound. Only 3 human studies were found to include in this review. In contrast, there were 62 in vivo and in vitro studies that show the need for more clinical trials to prove the plant’s potential to cure burn wound. Among single herbal preparations, Allium sativum, Aloe vera, Centella asiatica and Hippophae rhamnoides showed the best burn wound healing activity. Flavonoids, alkaloids, saponins and phenolic compounds were active constituents present in different herbs facilitating wound closure. Glycosides including madecassoside and asiaticoside and proteolytic enzymes were among the main active components. Phytochemicals represented positive activity at different stages of burn wound healing process by various mechanisms including antimicrobial, anti-inflammatory, antioxidant, collagen synthesis stimulation, cell proliferative and angiogenic effect. Overall, several herbal medicaments have shown marked activity in the management of wounds (especially burn wounds) and therefore can be considered as an alternative source of treatment. Furthermore, various natural compounds with verified burn-induced wound healing potential can be assumed as future natural drugs.

Abstract: Phytotherapeutics are widely used in medicine. The aim of this study was the evaluation of the anti-inflammatory potential of seven medical plant extracts using the ultraviolet (UV) erythema test. Aloe vera, Chamomilla recutita, Melissa officinalis, Melaleuca alternifolia and Coriandrum sativum showed an anti-inflammatory effect compared to UV-control and unguentum leniens. However, the results were only statistically significant for Aloe vera. All tested plant extracts were well tolerated. Aloe vera possesses an anti-inflammatory effect on UV-induced erythemas.

Abstract: In vitro studies indicate that aloe has immunomodulatory, anticancer, antioxidant, and anti-inflammatory properties. Emodin, an extract of aloe, inhibits cell proliferation and induces apoptosis in human liver cancer cell lines via p53- and p21-dependent pathways. One study showed topical aloe vera to be superior to silver sulfadiazine (drug information on silver sulfadiazine) cream, an agent commonly used to treat second-degree burns. A few trials have explored aloe’s anticancer effects. Concurrent oral administration of aloe with chemotherapy was reported to increase the efficacy of chemotherapy in patients with metastatic cancers and to prevent oral mucositis. Data on topical aloe’s role in alleviating radiation therapy-induced skin damage are inconsistent. More research is needed to determine the safety and efficacy of aloe vera in cancer patients.

Abstract: This from the University of Chicago Burn Center, is exceptional because the 70% burns received accidentally by this monkey should have been fatal, but the animal was not only saved but quickly returned to good health by treatment, the primary part of which was by Aloe vera.

Abstract: This report by the University of Chicago Burn Center is about two dogs, both mixed shepherds, who were accidentally burned over such a large portion of their bodies that ordinary treatment would have been considered nearly futile. The very successful use of an Aloe vera cream is carefully documented.

Abstract: The present study, anti-cancer property of Aloe vera was evaluated against 7,12-dimethylbenz (a) anthracene (DMBA) induced skin tumorigenesis in Swiss albino mice. A single topical application of 7,12-dimethylbenz (a) anthracene (100 g/100 l of acetone), followed 2 weeks later by repeated application of croton oil (1% in acetone three times a week) for 16 weeks exhibited 100 percent tumor incidence (group III). In contrast, animals treated topically with Aloe gel (group IV) or orally with Aloe extract (group V) and topical with Aloe gel plus orally with extract (group VI) exhibited 40, 50 and 20 per cent tumor incidence, which significantly higher than 100% tumor
incidence in the group III (control). The cumulative number of papillomas during the observation period of 16 weeks was significantly decreased in the Aloe treated groups IV, V and VI (4, 5 and 2 in Aloe gel, Aloe extract, and Aloe gel plus Aloe extract treated animals respectively) in compare to 36 cumulative number of papillomas in carcinogen control group. The average latent period significantly increased from 4.9 weeks in the control group to 5.3, 6.4 and 6.5 weeks in all Aloe treated groups. The tumor burden and tumor yield were significantly lesser (1.33, 1.25 and 1.0 and 0.4, 0.5 and 0.2) as compared to DMBA/croton oil treated control (3.6 and 3.6). Furthermore, the level of lipid peroxidation was significantly lesser than in the control animals (group III) in skin. In addition, depleted levels of reduced glutathione (GSH), DNA, catalase and protein were restored in Aloe-treated groups. The study has revealed the inhibition of dimethylebenz (a) anthracene (DMBA)/croton oil induced skin tumorigenesis in Swiss albino mice by Aloe vera treatment.

Abstract: This method has proved so simple and the results have been so satisfactory, that I have not used any other treatment for burns since the spring of 1935. I employ an ointment of which the active ingredient is Aloe.

Abstract: Recent medical literature contains many excellent articles on the treatment of burns. While numerous methods have been mentioned, in those most generally accepted, tannic acid is employed. In Bettman’s treatment, tannic acid is applied in a spray, and this is followed by application of 10 percent silver nitrate. Apparently, this sequence has distinct advantages over the use of tannic acid alone. Good as these methods are, I have experienced annoyance from infection, and from the long period required for separation and removal of the coagulum in some cases in which I have used tannic acid. It has been a relief to me, therefore, to find a treatment which has eliminated these disadvantages. This method has proved so simple and the results have been so satisfactory, that I have not used any other treatment for burns since the spring of 1937.

Abstract: Fresh Aloe vera used for x-ray dermatitis. This article by Dr. Creston Collins and his father was the landmark report, creating waves of interest throughout the world among medical science. Since the new wonder treatment of roentgen rays had some tragic side effects, the ancient and often scoffed at “Medicine Plant” provided the only workable solution for many cases.

Abstract: Pearl Harbor, World War II, and other burn disasters prompted this discussion of possible burn treatments.

Abstract: The effects of Aloe vera on microcirculation and levels of TNF-α and IL-6 were investigated in rats after inducing burn. Seventy-two male Wistar Furth rats were equally divided into four groups as follow: controls (CON), untreated burn-wound rats (BURN), normal saline-treated burn-wound rats (BURN-NSS) and Aloe vera-treated burn-wound rats (BURN-ALOE). The animals in each group were equally subdivided into three subgroups for the study on day 3, 7 and 14 post-burn. Dorsal skinfold chamber preparation and intravital fluorescence microscopic technique were performed to examine leukocyte adhesion on postcapillary venules. ELISA techniques were performed to examine serum TNF-α and IL-6 levels. It was found that the amount of leukocyte adhesion was significantly reduced in the BURN-ALOE group compared to rats in the BURN group on day 14. Levels of TNF-α and IL-6 were also decreased significantly compared to BURN at all three monitored time points. Aloe vera could inhibit the inflammatory process following burn injury, as characterized by the reduction of leukocyte adhesion, as well as those pro-inflammatory cytokines.

Abstract: The product, while quickly relieving pain, particularly from burns, appears thereby to have an analgesic and anesthetic effect; particularly in the type of healing rapidly promoted by the composition, it appears to have a detoxifying effect that may be the results of the reducing action inherent in the polyuronide without causing irritation, because burns, even second and third degree burns, become healed unusually rapidly, and the skin re-forms with rapid granulating, without scab formation.

Abstract: Aloe vera Linne or aloe barbadensis Miller is a succulent from the Aloe family (400 different species), a tropical plant which is easily grown in hot and dry climates and widely distributed in Asia, Africa, and other tropical areas. The use of aloe vera is being promoted for a large variety of conditions. The aim of this systematic review was to summarize all dermatology-oriented in vitro and in vivo experiments and clinical trials on aloe vera preparations. Extensive literature search were carried out to identify all in vitro and in vivo studies as well as clinical trials on the subject. Data were extracted from these in a predefined standardized manner. Forty studies were located. The results suggest that oral administration of aloe vera in mice is effective on wound healing, can decrease the number and size of papillomas and reduce the incidence of tumors and leishmania parasitemia by >90% in the liver, spleen, and bone marrow.

Abstract: Background and purpose: Calendula of cinalis owers have long been employed time in folk therapy, and more than 35 properties have been attributed to decoctions and tinctures from the owers. The main uses are as remedies for burns (including sunburns), bruises and cutaneous and internal in ammatory diseases of several origins. The recommended doses are a function both of the type and severity of the condition to be treated and the individual condition of each patient. Therefore, the present study investigated the potential use of Calendula of cinalis extract to prevent UV irradiation-induced oxidative stress in skin. Methods: Firstly, the physico-chemical composition of marigold extract (ME) (hydroalcoholic extract) was assessed and the in vitro antioxidant ef cacy was determined using different methodologies. Secondly, the cytotoxicity was evaluated in L929 and HepG2 cells with the MTT assay. Finally, the in vivo protective effect of ME against UVB-induced oxidative stress in the skin of hairless mice was evaluated by deter- mining reduced glutathione (GSH) levels and monitoring the secretion/activity of metalloproteinases. Results and conclusions: The polyphenol, avonoid, rutin and narcissin contents found in ME were 28.6 mg/g, 18.8 mg/g, 1.6 mg/g and 12.2 mg/g, respectively and evaluation of the in vitro antioxidant activity demonstrated a dose-dependent effect of ME against different radicals. Cytoxicity experiments demonstrated that ME was not cytotoxic for L929 and HepG2 cells at concentrations less than or equal to of 15 mg/mL. However, concentrations greater than or equal to 30 mg/mL, toxic effects were observed. Finally, oral treatment of hairless mice
with 150 and 300 mg/kg of ME maintained GSH levels close to non-irradiated control mice. In addition, this extract affects the activity/secretion of matrix metalloproteinases 2 and 9 (MMP-2 and -9) stimulated by exposure to UVB irradiation. However, additional studies are required to have a complete understanding of the protective effects of ME for skin.

Abstract: From the time immemorial man has been exposed to ionizing radiation from the environment in which he lives. Radiation protection concepts and philosophy have been evolving over the past several decades. Materials and Methods: The radio protective effect of Aloe vera leaf extract (1000 mg/kg b.wt. orally for 15 consecutive days) has been studied against 6 Gy of gamma radiation in the intestine of Swiss albino mice at various post-irradiation intervals viz. 12 hrs, 24 hrs. and 3, 5, 10, 20 and 30 days. Results: Crypt survival, villus length, apoptic cells, mitotic figures and goblet cells in jejunum were studied after irradiation. Irradiation produced a significant decrease in crypt survival, mitotic figures and villus length; whereas goblet and apoptic cells showed a significant increase from sham irradiated animals. The major changes were observed on day 3 after irradiation. AVE pre-treated irradiated animals resulted in a significant increase in the number of crypt cells, mitotic figures and villus length; whereas the counts of apoptic and goblet cells showed a significant decrease from respective control group at all the autopsy intervals. Irradiated animals resulted in the elevation in lipid peroxidation and a reduction in glutathione activity. On contrary, AVE treatment before irradiation caused a significant depletion in lipid peroxidation and elevation in glutathione activity. Conclusion: The present study suggests the possible radio protective ability of Aloe vera leaf extract.

Abstract: Homeopathic medicines are used by patients with cancer, often alongside conventional treatment. Cancer treatments can cause considerable morbidity and one of the reasons patients use homeopathic medicines is to help with adverse effects. OBJECTIVES: Evaluate effectiveness and safety of homeopathic medicines used to prevent or treat adverse effects of cancer treatments. CONCLUSIONS: This review found preliminary data in support of the efficacy of topical calendula for prophylaxis of acute dermatitis during radiotherapy and Traumeel S mouthwash in the treatment of chemotherapy-induced stomatitis. These trials need replicating. There is no convincing evidence for the efficacy of homeopathic medicines for other adverse effects of cancer treatments. Further research is required.

Abstract: We have carried out a clinical study to evaluate whether the concomitant administration of aloe may enhance the therapeutic results of MLT in patients with advanced solid tumors for whom no effective standard anticancer therapies are available. Both treatments were well tolerated. This preliminary study would suggest that natural cancer therapy with MLT plus A. vera extracts may produce some therapeutic benefits, at least in terms of stabilization of disease and survival, in patients with advanced solid tumors, for whom no other standard effective therapy is available.

Abstract: Reports two cases of aloe used for roentgen burns.

Abstract: Animal research on acute radiation damage.

Abstract: Aloe vera has been traditionally used for burn healing but clinical evidence remains unclear. We conducted a systematic review to determine the efficacy of topical aloe vera for the treatment of burn wounds. We electronically searched relevant studies in MEDLINE, CINAHL, Cochrane Library, HealthSTAR, DARE, Southeast Asia Database, Chinese Databases, and several Thai local Databases (1918, June 2004). Only controlled clinical trials for burn healing were included. There were no restrictions on any language of publication. Two reviewers independently extracted data on study characteristics, patient characteristics, intervention, and outcome measure. Four studies with a total of 371 patients were included in this review. Based on a meta-analysis using duration of wound healing as an outcome measure, the summary weighted mean difference in healing time of the aloe vera group was 8.79 days shorter than those in the control group (P = 0.006). Due to the differences of products and outcome measures, there is paucity to draw a specific conclusion regarding the effect of aloe vera for burn wound healing. However, cumulative evidence tends to support that aloe vera might be an effective interventions used in burn wound healing for first to second degree burns. Further, well-designed trials with sufficient details of the contents of aloe vera products should be carried out to determine the effectiveness of aloe vera.

Abstract: Literature on Aloe vera therapy for radiation ulcers of the skin is briefly reviewed. Radiation ulcers of the mucous membranes and adjacent tissues of body cavities may also be treated with the fresh leaf of Aloe vera. A case of osteo-radio-necrosis of the mouth so treated and well two years following healing is briefly reported.

Abstract: Reactive oxygen species (ROS) generated from UV-B radiation have the capacity to cause oxidative decomposition which leads to the formation of toxic components as well as lipid peroxidation. Considering this fact, the present study was performed to evaluate the effect of a cream (O/W) containing the essential oil of Calendula officinalis on biochemical parameters of the skin of albino rats against UV-B radiation. The fingerprint analysis of Calendula essential oil was performed by HPLC with special reference to 1,8-cineole and a-pinene. The results indicated that the treatment with creams containing 4% and 5% of Calendula essential oil caused a significant decrease in the malonyldialdehyde level, whereas the levels of catalase, glutathione, superoxide dismutase, ascorbic acid, and the total protein level were significantly increased after one month of daily irradiation and treatment when compared to untreated control groups. The results suggest that the cutaneous application of the essential oil of Calendula prevents UV-B-induced alterations in the level of antioxidants in skin tissue.

Abstract: Carboxypeptidase (Cpase) was partially purified from Kidachi aloe
(Aloe Arborescens Mill. var natalensis Berger) by FPLC system, and was administered intravenously to female ICR mice with inflammation. The enzyme preparation revealed significant effects on alleviation of pain and inhibition of vascular permeability in abdominal region. It also revealed an anti-thermal burn action on rat’s hind paws, when it was administered to female Wister rat intravenously.

Abstract: Preparations of Aloe Vera have long been used to ease inflammatory processes originating from a wide variety of triggering causes. This article sets out the nature of inflammation, how Aloe Vera works to influence it, and what clinical problems can be helped as a result.

Abstract: The effectiveness of nonsteroid topical agents for the prevention of acute dermatitis during adjuvant radiotherapy for breast carcinoma has not been demonstrated. The goal of this study was to compare the effectiveness of calendula (Pommade au Calendula par Digestion; Boiron Ltd, Levallois-Perret, France) with that of Trolamine (Biafine; Genmedix Ltd, France), which is considered in many institutions to be the reference topical agent. Between July 1999 and June 2001, 254 patients who had been operated on for breast cancer and who were to receive postoperative radiation therapy were randomly allocated to application of either Trolamine (128 patients) or calendula (126 patients) on the irradiated fields after each session. The primary end point was the occurrence of acute dermatitis of grade 2 or higher. Prognostic factors, including treatment modalities and patient characteristics, were also investigated. Secondary end points were the occurrence of pain, the quantity of topical agent used, and patient satisfaction. The occurrence of acute dermatitis of grade 2 or higher was significantly lower (41% v 63%; P < .001) with the use of calendula than with Trolamine. Moreover, patients receiving calendula had less frequent interruption of radiotherapy and significantly reduced radiation-induced pain. Calendula was considered to be more difficult to apply, but self-assessed satisfaction was greater. Body mass index and adjuvant chemotherapy before radiotherapy after lumpectomy were significant prognostic factors for acute dermatitis. Calendula is highly effective for the prevention of acute dermatitis of grade 2 or higher and should be proposed for patients undergoing postoperative irradiation for breast cancer.

Abstract: To determine (a) whether a wound dressing gel that contains acemannan extracted from aloe leaves affects the severity of radiation-induced acute skin reactions in C3H mice; (b) if so, whether other commercially available gels such as a personal lubricating jelly and a healing ointment have similar effects; and © when the wound dressing gel should be applied for maximum effect. Methods and Materials: Male C3H mice received graded single doses of gamma radiation ranging from 30 to 47.5 Gy to the right leg. In most experiments, the gel was applied daily beginning immediately after irradiation. To determine timing of application for best effect, gel was applied beginning on day -7, 0, or +7 relative to the day of irradiation (day 0) and continuing for 1, 2, 3, 4, or 5 weeks. The right inner thigh of each mouse was scored on a scale of 0 to 3.5 for severity of radiation reaction from the seventh to the 35th day after irradiation. Dose-response curves were obtained by plotting the percentage of mice that reached or exceeded a given peak skin reaction as a function of dose. Curves were fitted by logic analysis and ED50 values, and 95% confidence limits were obtained. Results: The average peak skin reactions of the wound dressing gel-treated mice were lower than those of the untreated mice at all radiation doses tested. The ED50 values for skin reactions of 2.0-2.75 were approximately 7 Gy higher in the wound dressing gel-treated mice. The average peak skin reactions and the ED50 values for mice treated with personal lubricating jelly or healing ointment were similar to irradiated control values. Reduction in the percentage of mice with skin reactions of 2.5 or more was greatest in the groups that received wound dressing gel for at least 2 weeks beginning immediately after irradiation. There was no effect if gel was applied only before irradiation or beginning 1week after irradiation. Conclusion: Wound dressing gel, but not personal lubricating jelly or healing ointment, reduces acute radiation-induced skin reactions in C3H mice if applied daily for at least 2 weeks beginning immediately after irradiation.

Abstract: A comparative study of the immediate and delayed histopathological changes of the skin in untreated and treated thermal burns.

Abstract: The study reported in this paper was undertaken in connection with an attempt to isolate and characterize the principle contained in Aloe vera leaf that is responsible for its activity in promoting the healing of third degree x-ray reactions on white rats.

Abstract: This present report deals with further observations on the use of the fresh jell, or pulp, of the leaf, as well as other portions of the leaf, in the treatment of experimentally produced third degree X-ray reactions on the skin of white rats.

Abstract: From the results obtained, fresh Aloe vera jell shows some promise of being of value in the treatment of X-ray reactions.

Abstract: This article is not a clinical study. It acknowledges that application of Aloe vera to a burn provides immediate pain relief and speeds the healing process, with no infection or systemic symptoms resulting, and answers what the ingredients of this plant are that give these results.

Abstract: This article by the University of Chicago Burn Center deals with one of the earliest recognized benefits of Aloe vera. Back in the thirties, when x-Ray treatments were first being used, medical reports showed that Aloe vera was the only thing that would heal many of the radiation induced lesions of the skin. Now, with this testing on rats, the data is established in true, scientific testing.

Abstract: These studies demonstrate that topical application of Aloe barbadensis gel extract
to the skin of UV-irradiated mice ameliorates UV-induced immune suppression by a mechanism that does not involve DNA damage or repair.

Abstract: The use of aloe vera is being promoted for a large variety of conditions. Often general practitioners seem to know less than their patients about its alleged benefits. Aim: To define the clinical effectiveness of aloe vera, a popular herbal remedy in the United Kingdom. Method: Four independent literature searches were conducted in MEDLINE, EMBASE, Biosis, and the Cochrane Library. Only controlled clinical trials (on any indication) were included. There were no restrictions on the language of publication. All trials were read by both authors and data were extracted in a standardized, pre-defined manner. Results: Ten studies were located. They suggest that oral administration of aloe vera might be a useful adjunct for lowering blood glucose in diabetic patients as well as for reducing blood lipid levels in patients with hyperlipidaemia. Topical application of aloe vera is not an effective preventative for radiation-induced injuries. It might be effective for genital herpes and psoriasis. Whether it promotes wound healing is unclear. There are major caveats associated with all of these statements. Conclusion: Even though there are some promising results, clinical effectiveness of oral or topical aloe vera is not sufficiently defined at present.

Abstract: Our previous study showed that aloe polysaccharides (AP) could evidently decrease the mortality of irradiated mice mainly through increasing the amount of hemocytes and ameliorating immune function of mice. Whether AP can protect the cells in vitro from irradiation damage is unknown. This study was to explore radioprotective effect of AP on 3 non-tumor cell lines, and its effect on cell cycle. AP has radioprotective effect on non-tumor cells. This effect might relate to alleviating of cell cycle turbulence.

Abstract: From the case reported, it would seem that x-ray ulceration, even of several years’ duration, will respond to the use of aloe vera. The permanence of results can be determined only by watching cases thus treated over a period of time. Little can be expected in the treatment of telangiectasis as a result of irradiation beyond a smoothing and softening of the affected skin.