Aloe vera: its best evidence is in surgical wounds, not in cosmetics

A 2018 double-blind, randomised, controlled trial in Thailand. Twelve patients with 24 donor sites after split-thickness skin graft harvesting from the thigh were divided between aloe and placebo. Each person contributed two sites, which matches conditions well.

Time to complete epithelialisation was 11.5 ± 1.45 days with aloe and 13.67 ± 1.61 days with placebo (p < .05).

The same paper carries a systematic review. Five articles met the inclusion criteria: four in burns, one in graft donor sites. Three of the four burn studies showed improved epithelialisation and one did not. In the donor-site study, the control differed significantly from both aloe and placebo, but the healing rate itself was not statistically different between groups.

How to read this item: twelve people. And the five pooled studies do not all point the same way. The direction is broadly positive, but the scale is small and the results are mixed.

Also, the wounds here are surgically created wounds. That is a different state from the intact skin a cosmetic goes on.

The same 2018 trial also measured pain — a visual analogue scale after dressing changes.

Aloe 17.18 ± 13.17; placebo 18.63 ± 11.20. No statistical significance between groups.

The authors' conclusion separates the two precisely: topical aloe vera gel significantly accelerated donor-site healing but did not show significant pain relief.

There is a reason this sits as its own item. Even within one trial, the answer changes with what you measure. Epithelialisation is something you count; pain is a score someone reports. Collapsing both into 'aloe works' erases that difference.

And since many people reach for aloe expecting soothing, it is worth being plain: what this trial established was healing speed, not soothing.

A 2026 randomised trial in Indonesia in 35 patients with chronic kidney disease on haemodialysis. A 30% aloe vera cream or a 20% urea cream was applied to both arms for four weeks, with corneometer readings and an overall dry skin (ODS) score taken weekly.

Both creams significantly increased hydration and reduced the dryness score from baseline (p < .05). But no significant difference was found between the two (p > .05).

Thirty-five people cannot demonstrate 'no difference' — with a small sample, a real difference can easily fail to reach significance. So the result is not 'they are equal' but 'at this size we could not find a difference'.

There is also no untreated arm in this trial. That both creams beat their own baseline cannot be separated from the effect of applying anything consistently for four weeks.

The population matters too: xerosis in dialysis patients has different causes, and does not transfer straight across to ordinary dry skin.

The human clinical data we found for aloe clusters in wounds, burns and xerosis.

We found no randomised trial of aloe alone for cosmetic outcomes — wrinkles, pigmentation, elasticity, pores.

Products containing aloe have been tested. One trial used a lotion for intertrigo, for instance — but that lotion also contained tapioca starch, shea butter extract, argan oil, rosehip oil and allantoin. That trial cannot separate which ingredient did the work.

To be exact about what this means: it does not mean aloe has no effect. It means we have not yet found a properly designed trial pointed at cosmetic outcomes.

This is the most important item on the page. Aloe is widely used and has been for a long time, but being widely used and being demonstrated are different things.