Aloe vera has been used to treat skin conditions, including eczema, for time immemorial. Its first recorded use was by the Ancient Egyptians. Alexander the Great went as far as capturing the island of Socotra to secure the aloe growing there. Today Aloe vera is a common ingredient in skincare products and also appears as a food supplement to support a huge variety of complaints from digestive issues to osteoporosis.
Natural aloe vera gel is about 98.5% to 99.5% water. The remaining solid portion contains over 75 active compounds, including vitamins (A, C, E, B12), minerals (calcium, magnesium, zinc), amino acids, enzymes, and powerful polysaccharides that give its healing and hydrating properties1.
How Aloe Vera targets eczema
Replaces lost moisture: Aloe vera gel has a high water content and contains mucopolysaccharides which bind the moisture into the skin. This rehydration relieves dry, flaky skin typical of eczema.
Reduces inflammation: Aloe vera blocks chemical pathways associated with inflammation and reducing the redness and swelling associated with eczema flare-ups.
Calms the immune system: By blocking histamine release, Aloe vera can suppress the eczema itch.
Prevents secondary infections: Aloe vera inhibits the growth of Staphylococcus aureus, a bacteria that frequently infects broken skin and is known to aggravate eczema.
Is there scientific evidence for the effectiveness of Aloe vera
While research into the effectiveness of aloe in treating eczema is encouraging, it is not yet robust. A recent review of complementary eczema treatments found only one trial involving aloe that meets the Cochrane requirements2. This trial compared the effectiveness of a cream of aloe vera and olive oil (Olivederma) to a topical corticosteroid (beclomethasone) in 36 adults with AD. After 6 weeks, there was a statistically significantly greater reduction in severity of AD in the aloe vera and olive oil group. While betamethasone showed faster initial response, Olivederma demonstrated meaningful symptom improvement over the study period with a more favourable side effect profile3. What is not clear from this study is the relative importance of the two active ingredients, aloe vera and olive oil.
Robust studies into using Aloe vera to treat similar conditions including seborrheic dermatitis4 and radiation induced dermatitis found found good results5[ref]. There is also evidence that Aloe vera is effective at treating the symptoms of eczema (dry skin, inflammation and infections) in animal models6. So there is good reason to believe that Aloe vera should be effective in treating eczema, but so far this has not been confirmed by robust studies.
Interestingly, a small study in 1991 suggests that aloe vera may increase the effectiveness of steroid creams, but this has not yet been followed up by larger, more robust studies7.
How to use aloe vera to treat eczema
The most reliable way to obtain fresh aloe gel without additives is to harvest it directly from the plant. Break off a leaf and split it lengthwise to extract the whitish, translucent jelly. There’s usually more than you need in one leaf. You can store any excess in the fridge for 5-7 days, or in the freezer for up to 6 months (ice cube trays are brilliant for this).
Rinse the affected area, pat dry and apply a thin layer of the jelly directly to the skin. As the gel dries, it can leave a thin residue over the skin. Personally, I dislike the feel of this so apply a layer of regular emollient over the top, which seems to solve the problem. Most studies use twice daily applications, which is a good place to start.
If you’re looking for a ready-made product:
- make sure that aloe vera is the first ingredient (meaning that it makes up at least 50% of the product)
- Avoid products that use the whole leaf rather than just the jelly. Some people are sensitive to the yellow latex layer between the jelly and the leaf.
- Look for simple products with a short ingredients list without alcohol/ethanol and fragrances
- While preservatives are necessary to give a reasonable shelf-life, check that you are not sensitive to the ones listed. MCI and parabens are commonly used but are also known eczema irritants.
Whether you're using fresh gel or a ready-made product, as with any new topical treatment, patch test on a small area first. Some people are sensitive to aloe and commercial preparations often contain potentially irritating ingredients like preservatives, alcohol and fragrances. If there is no redness or itching after 24-48 hours, the risk of a widespread reaction is small.
When Aloe vera isn't appropriate
While reactions to Aloe vera are relatively rare, it can cause contact dermatitis especially in those with sensitivity to the Liliaceae family (which also includes onions, garlic and lilies). Always patch test in a small area before widespread application.
In summary
While there isn’t a great deal of high quality research into the effectiveness of Aloe vera in treating eczema, what research there is appears to support the anecdotal evidence of its effectiveness. Given its long history and low risk of adverse reactions, we think that it is definitely a remedy worth trying.
Aloe vera should be treated as an add-on treatment, rather than a replacement for emollients and prescribed topical treatments. It can be used in addition to steroid creams and there is some research suggesting that it can enhance their effectiveness7.
Our references
- Surjushe, A. et al. (2008). Aloe Vera: A short review. Indian journal of dermatology. https://pmc.ncbi.nlm.nih.gov/articles/PMC2763764/
- Anheyer, M. et al. (2024, July). Herbal Medicine in Children and Adults With Atopic Dermatitis: A Systematic Review and Meta-Analysis. Dermatitis. https://pubmed.ncbi.nlm.nih.gov/38963342/
- Panahi, Y. et al. (2020, September). Comparing the Therapeutic Effects of Aloe vera and Olive Oil Combination Cream versus Topical Betamethasone for Atopic Dermatitis: A Randomized Double-blind Clinical Trial. Journal of Pharmacopuncture. https://pubmed.ncbi.nlm.nih.gov/33072415/
- Barak-Shinar, D. et al. (2017, April). Treatment of seborrheic dermatitis using a novel herbal-based cream. The Journal of Clinical and Aesthetic Dermatology. https://pmc.ncbi.nlm.nih.gov/articles/PMC5404776/
- Tungkasamit T. et al (2022). Reduction in severity of radiation-induced dermatitis in head and neck cancer patients treated with topical Aloe vera gel: A randomized multicenter double-blind placebo-controlled trial. European Journal of Oncology Nursing. https://pmc.ncbi.nlm.nih.gov/articles/PMC5404776/
- Chelu, M. et al. (2023, July). Aloe vera-based hydrogels for wound healing: Properties and therapeutic effects. Gels. https://pmc.ncbi.nlm.nih.gov/articles/PMC10379830/
- Davis RH. et al. (1991) Aloe vera as a biologically active vehicle for hydrocortisone acetate. Journal of the American Podiatric Medical Association. pubmed.ncbi.nlm.nih.gov/1993971/.
