Summertime medicine chest must - ALOE

On a recent trip to Florida's Gulf Coast, I was quite vividly reminded of the virtues of aloe.

Being a physician, I ought to be well aware of the risks associated with excessive sun exposure. As a former swimming instructor, and an avid lover of the outdoors, I certainly know a lot about the risks associated with excessive sun exposure. One would think that on my own vacation I would follow the sage advice I give to patients travelling to sunny climates in mid-winter.

Apparently not. When confronted with sunny blue skies, 80 degree balmy air and calm, salty, green-blue water, I spent way too much time having fun in the sun. Within 24 hours of touchdown, I was red, itchy, tender -- and pretty chagrined.

"You know dear," my Mom said as I sat emitting my own heat wave at the dinner table, "I've got aloe gel in the cupboard."

"Aloe! Aloe? Mom, you have aloe?" I asked, already feeling better as I made my way to her medicine cabinet.

"Well yes," she responded, a little confused at my surprise. "You're the one who told me about it years ago; I would never be in the sun without it!"
Traditional Use

People have known about the medicinal value of aloe for thousands of years. In 5,500 B.C., Egyptians used it as a laxative. Writings from 550 B.C. indicate that the plant gel was popular during that time for the treatment of skin infections. Legends assert that Cleopatra used aloe in lotions and medicines, that the armies of Alexander the Great used aloe for treating wounds and that aloe ranked among the most popular of medicines in ancient Rome and Greece.

Aloe is included in the pharmacopeia of Indian Ayurvedic physicians and in the literature on Chinese herbal medicine. And, it has long been extremely popular in Europe and in North America.
Botany: Just what is aloe?

Aloe (Aloe vera) is a member of the Liliaceae, or Lily, family. The family includes many familiar plant friends such as garlic, onion, asparagus and tulip. Aloe is a perennial, succulent plant, extremely drought resistant and varying in color from gray to bright green. Its stiff, fleshy leaves produce two therapeutic substances: a gel and a dried powder.

The inner parenchymal cells of the inner portion of the plant leaf produce a thick, sticky substance known as "aloe gel." The gel is used for topical applications in skin conditioners and in cosmetic products; juice (for drinking) is made with gel and water.
Constituents

Aloe gel contains a polysaccharide known as glucomannan, effective as an anti-inflammatory, and in the treatment of itching and wound heating. The dried powder contains anthraquinones, substances which act as powerful laxatives. Another constituent of aloe, emodin is thought to have antibiotic activity and to be effective against cancer.
Aloe to the rescue

Aloe's very best use is as a gel, in the topical treatment of skin conditions. The gel is applied to the skin to treat burns, wounds, abrasions, skin ulceratinos, psoriasis and even frostbite damage.

Psoriasis is an extremely challenging skin disease. It is qutie common, occurring in approximately 2 to 4 percent of the white population, and to lesser extent among blacks. Typically, there is a strong family history, with the onset of symptoms beginning as early as 10 years of age.

Though simple psoriasis does not affect the general health, the emotional stress of living with an unattractive skin disorder can be profound. I have treated patients with psoriasis; the lesions are thick, scaly patches, usually pink-gray in color, and flaky. Lesions can occur anywhere on the body, even sometimes on the face, eyebrows and scalp.

It is not unusual for psoriasis sufferers to cover themselves with long-sleeved shirts and pants even in the heat of summer; to avoid sitting in dark furniture for fear of leaving behind a trail of white skin flakes: and to avoid swimming pools, beaches and gyms. Additionally, many of the medications used to treat psoriasis, such as corticosteroids and, m severe cases, the chemotherapeutic agent methotrexate, have serious side effects with long-term use.

While aloe may not be a complete cure for psoriasis, research indicates that the plant gel offers relief equivalent to more dangerous medications. A study presented at the Fourth Congress of the European Academy of Dermatology and Venereology, held in Brussels, Belgium in 1995 indicated that psoriasis could be well managed with a topical aloe-vera cream.

In this study, 60 patients aged 18 to 50 years with mild-to-moderate chronic plaque-type psoriasis were randomly divided into two groups. Each participant received a 100-g tube of medication, either placebo or a 0.5 percent aloe vera extract in a hydrophillic cream. Participants were instructed to apply the medication topically to the psoriatic lesions three times daily for five consecutive days per week for four weeks. Patients were examined weekly and evaluated using the Psoriasis Area and Severity Index (PASI).

After 4 weeks of active treatment, 45 percent of patients were considered "cured." The mean PASI for the aloe group had been lowered from 9.3 to 2.2. Study participants reported no adverse symptoms, and no allergic reactions to the aloe product.
What about aloe latex?

Aloe latex has strong cathartic properties. In its powdered form, it is often an ingredient in herbal laxatives. As with any strong laxative, aloe powder should not be taken for more than 7 consecutive days. Use for longer than that can deplete the body's electrolytes and make existing gastrointestinal inflammation worse. Anyone with the need for dafiy laxative use should consult with a physician for a safe, long-term approach to healing the problem.

Overdosing on aloe latex can cause vomiting, intestinal spasms and diarrhea; excessive aloe latex can damage the kidneys. People with Crohn's disease, ulceratire colitis or inflamed hemorrhoids should completely avoid aloe latex. The herb is also contraindicated in pregnant women and children under 12.
Aloe in the cupboard

As with any effective medicine, it pays to be prepared with aloe. Because of its many good uses, aloe qualifies as a permanent member of a home herbal medicine kit. I'm planning to follow some pretty wise advice: never be in the sun without aloe! Remember, though: aloe does not protect against ultraviolet (UV) rays and should not be used instead of sunblock.

PHOTO (COLOR): J. Jamison Starbuck
REFERENCES

Blumenthal, M, et al, eds. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: American Botanical Council, 1998.

Gamick, J, et al. "Effectiveness of a medicament containing silicon dioxide, aloe, and allantoin on apthous stomatitis," Oral Surgery Oral Medicine Oral Pathology 86(5):550-556, 1998.

Reynolds, T, et al. "Aloe vera leaf gel: a review update" Journal Ethnopharmacology 68(1-3):3 37, Dec. 15, 1999.

Sved, TA, et al. "Management of psoriasis with aloe vera extract in a hydrophilic cream: a placebo controlled, double-blind study," Tropical Medicine and International Health (4): 505-9, Aug. 1, 1996.

Tilgner, Sharol. Herbal Medicine from the Heart of the Earth. Creswell, OR: Wise Acres Press, Inc., 1999.

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By J. Jamison Starbuck, J.D., N.D.

Adapted by J.D., N.D.

J. Jamison Starbuck, J.D., N.D., is a licensed naturopathic and homeopathic physician. Her family practice treats the whole person via constitutional homeopathy, botanical medicine, nutrition, counseling and other natural modalities.

FOUR C'S FOR SKIN CARE

Lots of herbs help heal and rejuvenate the skin. These are four favorites, useful alone, or combined with one another'.

Calendula -- o member of the Aster family, the flowers are a bright yellow or orange. It is also know as pot marigold, but should not to be confused with the common garden marigolds of the Tagetes species. Available in sprays for wounds or burns, salves for rashes or itchy skin and lotions as a general skin cream.

Chamomile -- also a member of the Aster family, chamomile has mild anti-inflammatory and antiseptic properties. It is useful for bails and skin ulcerations, like bedsores and canker sores. It also makes a nice hair tonic and is often found in shampoos and conditioners.

Chickweed -- of the Caryophyllaceae family, this herb treats burns, wounds and cuts. It is also helpful in reducing the symptoms of hemorrhoids, and can be found in a variety of herbal hemorrhoidal preparations.

Comfrey -- a member of the Borage family, this herb is well known for its powerful pyrrolozidine alkaloids, thought to make the herb unsafe for internal use. Externally applied, comfrey is quite safe, and it is often included in herbal salves for wounds and skin irritations. It is excellent in topical applications for the treatment of sprains and strains.

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