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Year : 2021  |  Volume : 22  |  Issue : 3  |  Page : 284-285

Aloe Vera treatment for acne resulting in allergic contact dermatitis

Department of Dermatology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India

Date of Submission20-Feb-2019
Date of Decision27-May-2020
Date of Acceptance04-Apr-2021
Date of Web Publication30-Jun-2021

Correspondence Address:
Ghanshyam Kumar Verma
Department of Dermatology, Indira Gandhi Medical College, Shimla, Himachal Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijpd.IJPD_21_19

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How to cite this article:
Verma GK, Tegta GR, Negi AK, Chauhan A. Aloe Vera treatment for acne resulting in allergic contact dermatitis. Indian J Paediatr Dermatol 2021;22:284-5

How to cite this URL:
Verma GK, Tegta GR, Negi AK, Chauhan A. Aloe Vera treatment for acne resulting in allergic contact dermatitis. Indian J Paediatr Dermatol [serial online] 2021 [cited 2021 Jul 25];22:284-5. Available from: https://www.ijpd.in/text.asp?2021/22/3/284/319976


Aloe barbadensis commonly referred to as Aloe vera native to North Africa and Arabian Peninsula is the most potent among approximately 420 species. The pharmacologically active ingredients are concentrated in inner parenchymatous tissue and outer pericyclic tubules.[1] Aloin is an anthraquinone present in A. vera which is regarded as a potential sensitizer.[2] Despite its widespread use, reports of allergic reactions are rare.

A 17-year-old male presented with erythematous rash over cheeks for 2 days subsequent to rubbing of A. vera plant leave pulp from his kitchen garden, for acne treatment. He was of opinion that it will cure acne, rejuvenate skin, and will give a youthful glow. He complained of intense itching and subsequent rash within 24 h of application. He was not suffering from any atopic diathesis. There was no history suggestive of photosensitivity or aggravation of rash on sun exposure. Clinically, he had multiple well-defined erythematous papules with background erythema on both cheeks [Figure 1]a and [Figure 1]b. Patch test was performed with Aloe jelly from the leaf [Figure 2] due to nonavailability of the standard patch test antigen, provided by the patient, “as is” by mounted on Finn Chamber along with control (petrolatum). Patch test results showed positive reactions to Aloe jelly (++) [Figure 3] after 48 h and 72 h. The Aloe extracts were applied in the same way on five volunteers; none of them experienced an irritant or allergic reaction. The application of Aloe was strongly dissuaded and topical hydrocortisone 1% cream and levocetrizine 5 mg once a day were prescribed. The patient improved with this treatment within a week [Figure 4].
Figure 1: (a and b) Multiple well-defined erythematous papular lesions on both cheeks

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Figure 2: Aloe vera leaf, jelly which was applied directly on cheeks

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Figure 3: Patch test results with ++ positivity to the Aloe vera jelly from the leaf

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Figure 4: Complete recovery of allergic contact dermatitis after treatment

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A. vera is considered a medicinal plant with numerous properties to treat a large number of conditions including skin diseases such as acne, dermatitis, fungal infections, and alopecia. It has been used in burns, diabetic foot ulcers, rheumatoid arthritis, rheumatic fever, dysentery, diarrhea, piles, and acid peptic disease including various cancers in alternate medicine considering its anti-inflammatory effects. Despite its widespread use, reports of allergic reactions are rare. In a study where 702 patients underwent patch test with an oily extract from different parts of the aloe vera plant revealed no sensitivity, concluding that it is a safe plant. None of the subjects showed any reaction. A woman with peripheral venous insufficiency who used self-home-made A. vera juice over the legs for relief from pain developed dermatitis on the legs followed by erythema on the eyelids. Patch test showed positive reactions to the leaf of Aloe, the macerated Aloe jelly, and nickel sulfate.[3] Hypersensitivity manifested by generalized nummular eczematous and papular dermatitis developed in a 47-year-old man after using oral and topical aloe. Patch tests for Aloe were positive.[4] Acute bullous reactions have been described with local application of Aloe leaves. Contact urticaria has been also reported with local application of A. vera juice. Another case of contact dermatitis to A. vera in a 65-year-old man with recurrent generalized itching with lichenified skin over the face and extensors of both extremities. An African American woman who used A. vera gel for the dermatitis over the neck, back, axilla, and groin had symptom aggravation. Patch test in this patient revealed positive reaction to aloe vera gel.[5]

In this part of the world, the local belief about the safety of natural products such as A. vera is very popular. However, crude product may cause adverse cutaneous reactions as reported by us. The adverse effects of herbal medicines which otherwise thought to be without side effects need to be suspected and investigated, as these are rare but real causes of allergic contact dermatitis.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Sharma P, Kharkwal AC, Kharkwal H, Abdin MZ, Varma A. A review on pharmacological properties of Aloe vera. Int J Pharm Sci Rev Res 2014;07:31-7.  Back to cited text no. 1
Rietschel RL, Fowler JF. Medications from plants. Fisher's Contact Dermatitis. 5th ed. Philadelphia: Lippincott, Williams and Wilkins; 2001. p. 137-47.  Back to cited text no. 2
Ferreira M, Teixeira M, Silva E, Selores M. Allergic contact dermatitis to Aloe vera. Contact Dermatitis 2007;57:278-9.  Back to cited text no. 3
Morrow DM, Rapaport MJ, Strick RA. Hypersensitivity to aloe. Arch Dermatol 1980;116:1064-5.  Back to cited text no. 4
Short J, Ehrlich A, Dodds K. Aloe vera gel as a culprit of allergic contact dermatitis: A case report. J Am Acad Dermatol 2014;70:AB67.  Back to cited text no. 5


  [Figure 1], [Figure 2], [Figure 3], [Figure 4]


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