Objectives: The objective of this study was to elucidate the safety and effectiveness of acemannan, a polysaccharide extracted from Aloe vera, in the treatment of oral aphthous ulceration.
Design: A skin patch test was performed on 100 healthy subjects, and 0.5% acemannan in Carbopol® 934P NF (Lubrizol Corporation, USA) was applied to the oral mucosa of the lower lip of 50 healthy participants 3 times/day for 7 days. Oral examinations and blood tests measuring liver and kidney function were performed prior to, and following, 7 days of application to assess the side-effects of acemannan when used on oral mucosa. Another 180 subjects with recurrent aphthous ulceration randomly received one of three treatments: 0.1% triamcinolone acetonide (HOE Pharmaceuticals, Malaysia), 0.5% acemannan in Carbopol® 934P NF, or pure Carbopol® 934P NF. Medications were applied to the ulcers 3 times/day for 7 days. Measurements of ulcer size and patient satisfaction ratings were performed on days 2, 5, and 7. Pain ratings were recorded daily.
Results: No subjects exhibited allergic reactions or side-effects to acemannan. There were no significant differences between the blood test values before and after 7 days of acemannan application. The effectiveness of acemannan in reducing ulcer size and pain was superior to that of control, but inferior to that of 0.1% triamcinolone acetonide. Patients were mostly satisfied with 0.1% triamcinolone acetonide and acemannan treatment.
Conclusions: Acemannan can be used for the treatment of oral aphthous ulceration in patients who wish to avoid the use of steroid medication, although the effectiveness was not comparable to that of 0.1% triamcinolone acetonide.