Aloe vera may cure middle age acne
For many years I suffered from middle age acne. This is the story about how I discovered that leaves of Aloe vera mixed with shampoo actually removed my symptoms. I have a critical scientific mind so this is not just another anecdote:
Initially I got professional help from a Swedish dermatologist who prescribed a tetracycline antibiotic. It removed my symptoms, but after nine months I got tired of eating pills, also fearing my natural bacterial flora would be harmed with implications on vitamin k synthesis and fungal infections (fungi and bacteria balance each other on mucus membranes). Although tetracyclines occur naturally in soil bacteria (Streptomyces), over consumption of antibiotics may contribute to resistance in other pathogenic bacteria.
I have tried many, I really emphasize many, alternative remedies such as cleansing waters and liquid soaps from both governmental Swedish pharmacies and miracle decoctions found at market stalls in Thailand. Nothing but Body Shop’s ‘Aloe gentle facial wash’ could replace the antibiotic treatment. I was finally free from pustules and antibiotics, but my curiosity demanded more exploration.
Since we grow Aloe vera at Dokmai Garden, I simply transplanted some side shoots to nine new pots and once I had enough material I began experimenting. I used the aloe vera gel, which is the slimy glass-like interior of a succulent leaf, composed of transparent parenchymatous mucilaginous cells used for water storage in arid habitats. To my disappointment simply smearing the aloe vera gel onto my facial skin did not work.
I checked the ingredient declaration of the Body Shop product again. Aqua (the pharmaceutical term for ‘water’) is the chief ingredient and Aloe barbadensis is the second ingredient and therefore present in the second largest quantity. If aloe is mentioned at the end, then the product only contains insignificant traces to excuse a fancy label or trade name. The quantity is kept secret to protect the recipe. Aloe barbadensis is a synonym of the accepted scientific name Aloe vera. Although the Body Shop aloe is grown in Guatemala, the plant is native to the SW Arabian peninsula where it has a long reputation as a skin remedy.
Other compounds of Body Shop’s facial wash are sodium cocoamphoacetate (surfactant/detergent), pentylene glycol (moisturizer/preservative), sorbitol (moisturizer), disodium cocoyl glutamate (detergent), butylene glycol (for viscosity), glycerine (moisturizer), citric acid (pH, antioxidant), sodium laureth sulphate (detergent), coco-clucoside (emulsifier to keep oils in water solution), glyceryl oleate (emulsifier), sodium cocoyl glutamate (detergent), dimethicone copolyol (emulsifier), ascorbyl palmitate (antioxidant), lecithin (emulsifier) and tocopherol (vitamin E, antioxidant).
If we concise the list of ingredients, Body Shop’s facial wash contains: water, aloe vera and liquid soap (detergents, moisturizers, emulsifiers and antioxidants).
Antioxidants are probably needed as a preservative or an oxidation may change the colour of the product. The raw aloe vera gel also contains moisturizers, but emulsifiers and detergents are probably needed to make active compounds water soluble and to reduce the surface tension to make sure the active compounds penetrate the skin, or they will be stuck in the gel.
My ordinary shampoo also contains Aloe vera but it is listed near the end which implies a symbolic or insignificant amount. It contains detergents (sodium laureth sulphate is its chief ingredient), emulsifiers and moisturizers too.
I figured if I combine the aloe vera gel from a raw leaf with my ordinary shampoo I should have the same effect as with Body Shop’s facial wash.
If I do nothing I get pustules within 12-24 hours.
If I wash my face with shampoo only (a one minute treatment once a day) I get pustules within 12-24 hours.
If I wash my face with aloe vera gel from a raw leaf (a one minute treatment once a day) I get pustules within 12-24 hours.
If I gently and thoroughly mix aloe vera gel from a raw leaf with my ordinary shampoo 1:1 (volume:volume) and apply to my face I am free of pustules! Mix the shampoo and the aloe gel between your hands and massage into the facial skin for 15 seconds. Then leave the mix for one minute (equal to the time needed to apply ordinary soap to the rest of the body with my eyes closed) after which you rinse your face with water. Repeat this procedure every morning.
This is how I extract the aloe vera gel:
1. Detach a leaf of Aloe vera and clean the surface with water. If you snap off a leaf leaving a stump, the stump may keep growing. A 20 cm long leaf is sufficient but in this picture I have a much larger leaf including the base. Note the yellow sap (due to anthraquinones) which smells like rhubarb (also rich in anthraquinones).
2. Break off a 2-3 cm long piece from the leaf base. Leave the rest of the leaf in the shower and use it for the next treatment. The green thin ‘rind’ is equivalent to the upper part of a ‘normal flat leaf’, composed of the palisade parenchyma carrying the chloroplasts for photosynthesis (solar panels), covered with protective epidermal cells (skin) which in turn are covered with a cuticle. It has channels for the yellow sap to heal a wound and to deter predators. The gel is equivalent to the spongy parenchyma in ordinary leaves, but in the case of succulents these cells can store huge amounts of water by using polysaccharides and glycoproteins (mucilage). In the lower green rind are special openings (stomata) regulating gas exchange. Carbon dioxide gas is transformed into solid sugars using light and water.
4. This amount of aloe vera gel is sufficient. Add an equal amount of shampoo, gently and slowly mix the two ingredients with your hands. If you apply to much pressure or if you are in a hurry, the gel may slip out of your hands. Apply to your face and massage for about 15 seconds, then leave it for one minute after which you rinse thoroughly with water.
To avoid that I was fooling myself I applied and interrupted the treatment for three days three times. Every time I interrupted the treatment, the pustules came back after 12-24 hours, but with the treatment the pustules disappeared. My definition of a pustule is a red spot with a white top of pus observed in the morning before taking a shower. A red spot was not considered. Without treatment the symptoms deteriorate with large red areas and frequent pustules near the nose. Such a deterioration is halted with tetracycline or Body Shop’s Aloe facial wash or aloe gel & shampoo 1:1.
Of course, this may not work for every person on any skin problem, but it is a cheap and simple method you can try before seeking medical help.
As to the active compounds, I do not know what they are. I do not even know if the active compounds are within the aloe vera gel, or in fact from the yellow sap of the leaf contaminating the gel. I am surprised there is not more thorough research. I have read a few articles and their conflicting results might be due to what skin problem is studied (Aloe vera can not cure everything), what strain or species of Aloe vera was studied, and if it was raw or processed aloe vera gel.
My condition is apparently due to bacteria since the pustules disappear with tetracycline antibiotics. In my case I do not believe the active ingredient(s) in aloe vera are moisturizers or detergents, or other cleansers would have worked. I believe the active compound(s) are antibiotic too, although an alternative mechanism could be an enhanced immune reaction or due to steroids or a combination thereof. Antibiotic activity of two years old freeze dried aloe vera gel against the skin pathogen Streptococcus pyogenes was reported by Ferro et al. (2003). Finding out the antibiotic mechanism of aloe vera gel would be a very interesting prospect.
Should you eat Aloe vera? Some claim it is a miracle cure, some claim that depends on the processing of the gel, some say it is a laxative. I am careful because Aloe vera uses chemicals to protect its juicy leaves from thirsty predators, and does it well; I have never seen pests on it and our water buffalo and wild boars reject it. I simply use the plant’s chemical defense to suppress bacteria on my surface. Could a long term application on facial skin be dangerous? Possible, but I intend to go on since there are no reports of the opposite, in spite of its use for millennia.
Some botanical notes of interest
The plant was scientifically described by the Swedish gentleman Carl Linnaeus as Aloe perfoliata var. vera in Species Plantarum published in 1753. Linnaeus adopted the Greek word ‘aloe’ which was already an established name (see e.g. Mathias Gast’s illustration from 1566 and Johnson’s illustrated 1633 edition of John Gerard’s herbal). Pereira (1853) wrote in his ‘The Elements of De Materia and Therapeutics’ that neither Hippocrates nor Theophrastus mentioned aloe, while both Dioscorides (40-90 AD) (Lib iii. cap. xxv) and Pliny (23-79 AD) (Naturalis Historiae lib. xxvii. cap. v) did. What they actually meant with ‘aloe’ can be debated since the original books are gone and later copies and translations might be misunderstandings. Still, Pliny’s description is quite accurate so I think his and Linnaeus’ aloe are at least plants of the same genus.
Confusingly, the Hebrew ‘ahaloth’ (ahalim) in the Old Testament of the Holy Bible has been translated into ‘aloexylum’ in Latin. That would mean ‘aloe wood’ and clearly refer to another plant since Aloe vera is a succulent, not woody. In addition, the Old Testament only refers to ahaloth when describing fragrance, while Aloe vera is hardly a perfume. Hebrew ‘ahaloth’ is possibly related to Hindee ‘elwa’, referring to the same tree. According to Mabberley that could be ‘aloewood’ (Aquilaria agallocha syn. A. malaccensis, Thymelaeaceae), which is a large tree native to Southeast Asia. The fragrant aloewood resin is used for medicinal and cosmetic purposes. A related substitute of equal economic importance is eaglewood (Aquilaria crassna) which grows here at Dokmai Garden. The misleading vernacular name ‘aloe wood’ is not more surprising than ‘Persian lilac’ (Melia azedarach), which is neither from Persia nor a lilac.
The etymology of the Greek word ‘aloe’ is likely to be Arabic, the homeland of the plant. Arab, Israeli and Greek Dokmai Dogma readers are welcome to help me here, since internet is full of fairy tales and mistakes.
‘Vera’ means ‘true’ in Latin, but what Linnaeus meant with that is debated. Some say it is a distinction from similar-looking American Agave (their leaf mesophyll is not clear like glass, but fibrous). There is no sense in emphasizing a variety ‘vera’ to distinguish it from another plant family (Agavaceae) from another continent (America). I think the physician Linnaeus meant this is the true pharmaceutical ingredient, different from the other 446 species in the genus Aloe, chiefly from Africa, Arabia and Madagascar, and different from the pharmaceutical term ‘aloe xylum’ or ‘lignum aloe’ (Aquilaria malaccensis).
Nicolaas Laurens Burman erected the variety ‘vera’ to species (Aloe vera) in Flora Indica (1768). Like the ordinary apple, Aloe vera has many forms and varieties, and they are sometimes erected to species level. I use the common household cultivar with white spots, sometimes referred to as Aloe vera var. chinensis or A. massawana. Wild strains of Aloe vera are unknown, and it is possible it is a hybrid. Its family affinity is confused, originally included in Liliaceae, now jumping around between Aloeaceae, Asparagaceae, Asphodelaceae, Xanthorrhoeaceae.
At Dokmai Garden we grow the plant in pots kept in the shade. Pots will dry out quickly which is essential during the rainy season. To my experience Aloe vera plants grown in full sun may suffer. In nature many Aloe species tend to grow in the shade of plants and rocks. Recently I transferred one specimen to the African desert display under the shade of a young (four years) date palm, facing east. The soil is pure sand with an underlying layer of gravel for quick drainage.
If you wish to buy it from a Thai market, ask for ‘wan hang chora ke’ (‘the crocodile tail medicinal herb’). In Chiang Mai, the northern Thai name is ‘wan fai mai’ (which translates into ‘the medicinal herb for burns’).
Upcoming experiment: how to make your own shampoo from local Litsea glutinosa (Lauraceae) and whether or not that shampoo combined with aloe vera gel can remove acne symptoms too?
Text & Photo: Eric Danell
(For a superb microscopical picture of a sectioned Aloe vera leaf with parenchyma cells and their large vacuoles, see Glenn Doherty’s contribution here).
Precipitation report for the first week of October: 2 mm on the 2nd of October, 5 mm on the 6th of October.